How can the NHS resolve its current staff crisis?

The latest NHS statistics are worrying. Last month, a record high of accident and emergency (A&E) patients had to wait for more than four hours to be seen, according to recent statistics from NHS England. 

Alarmingly, the figures show that 275 526 A&E patients were seen after waiting for more than four hours – the target time – compared with 208 083 in July 2018, which is an increase of almost a third (32.4%). This represents the highest number of delays for July since the current records began in August 2010. Within this figure it was revealed that 436 A&E patients waited more than 12 hours to be seen. 

Going some way to explain the exceptional delays, the figures also show that admissions at A&E departments have hit records levels in England – rising 6 per cent in a year to reach 2.27 million last month. A record number of people are also waiting for routine operations.

Alongside the increased demand for services, the delays seem to be the cumulative result of numerous adverse factors that have created a ‘perfect storm’ for the retention and recruitment of clinical staff within the NHS. These include significant rota gaps in hospitals, together with difficulty in recruiting GP partners, the infamous pension taper crisis and Brexit-related uncertainty for our European colleagues, all of which result in a pronounced loss of morale.

What can be done to resolve this deteriorating situation? Matt Hancock’s offer of a 3% per annum pay increase to junior doctors over the next three years hardly seems adequate when the private sector is seeing much higher rates of salary increase.

Sajid Javid has promised ‘pension flexibilities’ to avoid the punitive tax charges that are discouraging doctors from doing overtime and incentivising them to take early retirement. Perhaps the creation of an AI Lab, which will bring together the industry’s best academics, specialists and technology companies to work on some of the biggest challenges in healthcare, including earlier cancer detection, new dementia treatments and more personalised care, will help? This lab will sit within NHSX, the new organisation that will oversee the digitisation of the health and care system, in partnership with the Accelerated Access Collaborative. Potentially, at least AI can play an important role, giving staff of the future the ‘gift of time’, as outlined in the Topol Review, to care for more patients with time-saving support from AI, but this is all some way off.

There is an upcoming event on NHS recruitment and retention that will seek top address some of these issues for anyone interested in attending. 

What recommendations do you have to encourage high quality staff to join and stay within the NHS? All suggestions welcome!

Comments (2) Add yours ↓
  1. Nitin Shrotri Consultant Urologist &FTSUG

    1. Take Consultants 55+ off the on call rota. They will work for more years
    2. Offer seniors more Academic contracts, thereby less punitive work
    3. Increase respect for all senior doctors, black, brown or white
    4. Make up for the lost years of no increments
    5. Make junior doctors lives better with no rubbish duties and ensure they are treated with respect
    6.Pay junior doctors attractive salaries
    7. Ministers who destroyed the medical professions morale should be held to account.
    8. Consultants should look after their juniors better instead of running after money/targets. This will make them feel valued. We have lost the art of doing this.

    August 14, 2019 Reply
  2. Hannah Warren Core trainee

    The rising waiting times in A&E simply stem from a year-on-year rise in demand without a matching rise in resources. Hospitals have relatively fixed numbers of hospital beds and staff, and while they have been coming up with ingeneous ways for patient flow to circumvent the emergency department (ambulatory services for example) the demand is simply outpacing the supply.

    I think there is a commonly held belief that many A&E attendees could have been managed by community services, but having worked in a busy A&E department for 4 months over winter there were only 2 patients that I recall seeing that I felt really didn’t need emergency care. From that number I have excluded the sorry population of London’s homeless – often with very real health issues (victims of random acts of violence, deep vein thromboses from sleeping in a seated position night after night, and mental health issues), albeit the health issue in question had usually been saved up for a particularly bitter, cold night.

    It is easy to blame years of austerity for this issue, both for creating the demand (the vulnerable homeless being a case in point), and with the supply issues of staff outline above.

    So how can we retain talented staff? Based on some of the high and lowlights of my career so far I think these would be key points:
    1. Removal of ‘box-ticking’ exercises to be undertaken in one’s precious free time – mandatory e-learning and complex ePortfolios I’m looking at you.
    2. Socialise with colleagues outside of work. It is so much more enjoyable to work with people you also consider to be friends. The loss of firm structure has eroded this somewhat (remnants still exist in surgery which is part of the draw for me, but this is not so in other specialties). Include your juniors in this – particularly those on the disorienting merry-go-round of 4 monthly rotations
    3. And the simplest of all – recognise achievement and give thanks where it’s due. Free and simple but goes a long way to making colleagues feel valued, satisfied and contented.

    August 16, 2019 Reply

Your Comment

All comments are moderated. Trends in Urology & Men’s Health reserves the right not to publish material we deem inappropriate.

Web design and marketing agency Leamington Spa