Commit to new deal for healthcare workers or risk ‘deadly exodus’, IPPR warns government

As many as one in four healthcare workers – equivalent to 330,000 staff - say they are more likely to leave the NHS due to a year of unprecedented pressure, according to new polling by IPPR/YouGov. The figure - which includes the equivalent of 100,000 nurses and 8,000 midwives – adds pressure to a workforce that was experiencing a crisis of unfilled vacancies even before the pandemic.

A new IPPR report ‘Recover, Reward, Renew’ argues that this is a direct result of pandemic pressures, on top of a decade of austerity. Polling of 1,000 healthcare workers shows that:

• Workers have been under severe strain during the pandemic. Just under half worked an under-staffed shift once a week or more, and a 49 per cent report being unable to provide the level of patient care they would like to due to constraints beyond their control.
• The mental health impact of the pandemic has been severe. Two thirds report being mentally exhausted on at least a weekly basis. A quarter report using alcohol and/or drugs to deal with stress weekly or more often. And 5 per cent of workers – the equivalent of 80,000 staff – report thinking about suicide or self-harm once a week or more.
• Discrimination is rife. Workers from minority ethnic backgrounds were twice as likely to report experiencing discrimination or unfair treatment from managers or colleagues (31 per cent) compared to staff from white ethnic backgrounds (16 per cent).
• Government policy is seen as a key driver of the pandemic’s severity. Almost nine in 10 workers identify slow or delayed government policy during the pandemic - such as late lockdowns - as an important contributor to the country’s Covid-19 outcomes. Eight in 10 identify the fact the NHS was under-resourced at the start of the pandemic as important.

This new analysis follows IPPR’s landmark report earlier this month – The State of Health and Care, which demonstrated the significant health challenge the country now faces. Findings included 4,500 more cancer deaths this year, 12,000 more heart attacks and strokes over the next five years, and a doubling in eating disorder referrals amongst children as a result of the pandemic. Without a coherent workforce strategy, the government will struggle to meet these challenges or to ‘build back better’.

A bold workforce policy for healthcare staff is urgently needed, according to today’s report. It says the government should focus this ‘new deal’ on three key areas:

• Recover - Many have not taken leave during the pandemic or have lost access to flexible working. IPPR recommends a shift to flexible working by default; guaranteed rollover of all accumulated annual leave for the next five years; and a new NHS-wide compensation scheme that provides either additional time off in lieu or a pay bonus to staff who are refused annual leave on the dates requested.
• Reward - Not only is a substantial pay award fair after the pressures of Covid-19, but it would also support retention, the wider economic recovery and worker’s mental health. IPPR argues for a 5 per cent average pay award, tilted in favour of the lower paid, and a government-subsidised living wage guarantee for social care workers.
• Renew - Progression is important to retention and IPPR argues skills developed during the pandemic should be formally recognised through a national certification scheme. IPPR also argues that the NHS must change its recruitment, training and progression processes to stamp out institutional racism.

IPPR/YouGov polling indicated nearly universal support for a substantial pay award. Seven in 10 healthcare workers identified pay as one of the most important issues for them right now. Our polling also identified that a 5 per cent minimum pay award was the most popular option amongst healthcare professionals (selected by 27 per cent of respondents). Separate IPPR/YouGov polling of the UK public showed overwhelming support for a pay rise, with approximately eight in 10 supporting an increase of 5 per cent or more. IPPR’s NHS staff pay proposals are costed at £1.4 billion per year.

Dr Parth Patel, IPPR research fellow and NHS doctor, said:

“The last 12 months have stretched an already very thin workforce to breaking point. Many are exhausted, frustrated and in need of better support. If the government does not do right by them now, more may leave their jobs.

“This should ring alarm bells for a government that came into power pledging big increases in nursing numbers. It would have significant consequences for patient safety and quality of care.

“The backlog of care is long and the pandemics’ disruptions will be felt for years to come. The hard road to renewal in health relies, first and foremost, on a new deal for NHS workers.”

Chris Thomas, IPPR senior research fellow, said:

"Applause and empty plaudits are not a workforce strategy. Healthcare workers need a new deal based on recovery, reward and renewal after a year of unprecedented pressure.

“A new deal for the workforce means a right to flexible working, a five-year guarantee for untaken annual leave and compensation when leave requests are rejected. It means a fair pay award, to help retain workers and to boost the economy. And it means more career progression and tougher action to end discrimination.

“Bad policy during the pandemic and during the austerity decade created our workforce crisis. Good policy can get us out of the crisis now. If that’s not forthcoming, the government risks a deadly exodus of healthcare workers in the years to come.”

ENDS

IPPR senior research fellow Chris Thomas, and research fellow Dr Parth Patel (who is also an NHS hospital doctor) are available for interview.

NOTES TO EDITORS

1. The IPPR paper, Recover, Reward, Renew by IPPR, will be published at 1830 on Tuesday March 30th. It will be available for download at: http://www.ippr.org/research/publications/recover-reward-renew
2. Advance copies of the report are available under embargo on request.
3. Full polling available on request.
4. Polling of healthcare professionals was commissioned by IPPR and undertaken by YouGov, with a representative sample of 1,006 healthcare professionals from across the UK. Fieldwork was undertaken between 9 - 15 February, 2021. The survey was carried out online. All figures have been weighted and are representative of the NHS workforce by occupation group.
5. Polling of attitudes on pay among the general public was commissioned by IPPR and undertaken by YouGov, with a representative sample of 2,116 drawn from across the UK. Fieldwork was undertaken between February 12 and 15. The survey was carried out online. The figures have been weighted and are representative of all UK adults (aged 18+).
6. Previous polling by IPPR of the health and care workforce was published in April 2020, during the first peak of Covid-19. Care fit for carers is available at: https://www.ippr.org/research/publications/care-fit-for-carers
7. This new research follows IPPR’s landmark report The State of Health and Care – our major annual report on the sector released on March 16, 2021. This is available at https://www.ippr.org/research/publications/state-of-health-and-care < /! span>
8. IPPR recommends that the 5 per cent (average) pay rise is administered progressively, with more money awarded to lower paid workers.
9. Quantification of workers more likely to leave the NHS compares YouGov polling results to routinely released NHS Digital workforce data. 330,000 NHS workers is equal to 25 per cent more likely or much more likely to leave, according to the poll. 100,000 nurses and 8,000 midwives reflects 29 per cent likely or much more likely to leave. Nurse figures include health visitors.
10. IPPR is the UK’s pre-eminent progressive think tank. With more than 40 staff in offices in London, Manchester, Newcastle and Edinburgh, IPPR is Britain’s only national think tank with a truly national presence. www.ippr.org