Bolder policies and specific goals to close gaps in NHS staffing
levels are needed from the next UK government if it is to get a
grip on stubborn staffing shortfalls that leave patients in some
areas of the country struggling to access GP appointments and
some NHS services plagued with severe shortages.
The challenge from the Nuffield Trust to political parties comes
ahead of the upcoming general election this year and is the first
set of electoral policy ‘tests’ that the next UK government must
meet to address some the longstanding issues facing health and
care services in England.
Data analysed by the Nuffield Trust illustrates an uphill
struggle faced by patients in some regions of England to see GPs
- even when accounting for the typical health needs of the local
population. People in Gloucester have 45% more GPs per head than
those in Kent and Medway (1,868 patients per GP vs 2,702). The
government has failed to meet a pledge to deliver 6,000 more GPs
by 2024-25 and incentives to attract GPs to underserved areas,
including £20,000 golden hellos, are not well understood and
little evidence exists on their attractiveness to doctors in
training.
The government has met its manifesto pledge to grow the nursing
workforce by 50,000 over the last four years but the benefits are
not being felt equally. The headline figures mask a 19% fall in
health visitors and an 8% fall in learning disability nurses,
with the latter contributing to a 44% reduction in learning
disability nurses since 2010.
The call for specific goals to close staffing gaps is one of
five NHS workforce policy tests
set out by the Nuffield Trust in the first of its general
election briefing series funded by the Nuffield Foundation. To
firmly address entrenched workforce challenges and to support the
existing NHS long term workforce plan, the think tank is also
urging the next government to:
- Address unacceptably high dropout rates at every stage of
clinical training and in early NHS careers to support the
ambitious training goals of the long-term workforce plan. This
includes the recommendation to gradually
write-off the student debt of healthcare workers such as
nurses over a period of 10 years, with the scope to expand to
doctors and other groups.
- Reform the NHS pay review body process which has failed to
avoid sustained industrial action and has lost the confidence of
all sides. Pay review bodies must publish recommendations which
can address different financial realities of staffing groups more
quickly.
- Ensure that new roles which can support doctors and nurses
are rolled out safely and effectively by boosting public
understanding and providing clear regulation and oversight which
accounts for staffing needs of local healthcare systems.
- Support and develop the skills of NHS managers and leadership
to create a culture which can reverse the declining experience of
the NHS workforce.
Nuffield Trust Senior Fellow Dr Billy Palmer said:
“The public are all too aware of staff shortages, long waits and
disruptive strikes creating real difficulties for health and care
services and they deserve bold action from government to address
these workforce challenges.
“Growing the NHS workforce is popular, and an ambitious workforce
plan already exists, but to succeed it needs to be accompanied by
robust policies or we risk wasting money, time and talented
people too early in their NHS careers. This oversight will do
nothing to reduce our reliance on overseas recruitment, nor will
it stem severe shortages in some clinical professions and in
regions of the country. The status quo of hoping some of these
issues around retention and work experience will sort themselves
out isn’t good enough.
“Solely boosting the number of staff nationally in the NHS is not
enough alone – the next government should set a clear aim of
reducing the uneven distribution of key staffing groups and
shortfalls to tackle unfairness in access for patients. This
could be in the form of minimum numbers of GPs compared to
patients in local areas, and better incentives to attract GPs to
under-doctored areas should be considered.”
Ends.
Notes to Editor:
- We have summarised the five policy tests on NHS staffing into
an accompanying slide set
here.
- The first in our general election briefing series What
health and care need from the next government? Focused on
NHS staffing has been launched on the second day of the annual
Nuffield Trust Summit. It has been published ahead of a panel
discussion titled Shifting attitudes and expectations over
work. The session is chaired by Professor David Oliver,
Consultant in Geriatrics and General Internal Medicine at Royal
Berkshire NHS Foundation Trust. Speakers include Dr Billy Palmer
(Senior Fellow, Nuffield Trust), Dr Nish Manek (GP and Clinical
Fellow, Granta Medical Practices and NHS England), Dr Crystal
Oldman (CEO, Queen’s Nursing Institute) and Professor Oonagh
Smyth (CEO, Skills for Care). You can sign up to our Summit live
stream here.
- Ahead of the expected UK general election this year, the
Nuffield Trust will be publishing a series of election briefings
which brings evidence to bear on what health and care services
need from the next government. This series of briefings has been
funded by the Nuffield Foundation. The briefing series will cover
five topics, with NHS staffing being the first, followed by
social care, primary care, quality, and timely access to care and
NHS finances.
