Staffing is the issue keeping NHS leaders awake at night  and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. 

“Gimmick-land” was a phrase used by one HSJ reader to describe news this week that 200 army medics and personnel have been drafted in to help hospitals in the Midlands under increasing covid pressure.

This is part of a national agreement for 400 Army officers to be made available to NHS England, and although the extra pairs of highly trained hands will be welcome in many trusts, there remains frustration that it is not easier for experienced clinicians wanting to return to the NHS to start work.

“I have volunteered time and again to help out on the frontline and yet the machinery is so slow that I am yet to be deployed,” another reader added. Considering the high staff sickness rates (although not as high as in the spring), the bureaucracy enabling staff to return to the health service must be slimmed down.

”Bringing in the Army” makes for a startling headline, as did reopening the Nightingale hospitals, but this is far from what the health service – and the workforce – need in reality.

In the East of England more than one in 10 nurses are off sick, with over half citing covid as the reason. A national agreement to allow nursing students to opt in and help with the covid response has been reached and is symptomatic of the desperation in the health service at the moment.

Mark Radford, chief nurse at Health Education England, has stressed the need to balance support for students wanting to help with covid nursing, with protecting the future pipeline of qualified nurses.

Ticking time-bomb

Ensuring the bigger education and training picture is not forgotten is crucial, both for the learning and wellbeing of students and future pipelines. Healthcare organisations do not always get this right.

An open letter sent by the president of the student union at Imperial College’s school of medicine lambasted its redeployment of students on clinical placements into an “unpaid compulsory role… to cover nursing and HCA shifts” just a few weeks before exams.

This heavy-handed approach is of course terrible for morale and potentially damaging for final year medics about to take their exams. And of course, it assumes they are equipped to take on roles which are different from what they are being trained to do.

Treating students badly at the beginning of their careers could well cause problems in the future.

An on-point Twitter thread from the director of UCL’s clinical operations unit, Christina Pagel, highlighted the need to plan for the future.

“For junior staff, there is the additional stress of missing months of training, falling behind in their exams. Don’t underestimate this. There will be pressure to dive back into study (often self-imposed pressure),” Professor Pagel said.

She called for an extension of the existing practitioner health programme for doctors and dentists, for mental health to be discussed openly by leaders, and health and wellbeing app usage scaled up.

“We burn out staff, we damage them and their families, we lose valuable expertise from the NHS and we lose compassionate, high quality care,” Professor Pagel said. “And we owe it to them.”

Barriers to vaccination?

Finally, a particular line in NHS chief operating officer Amanda Pritchard’s leaders update last week piqued our interest. Ms Pritchard said: “Making clear, as covered in the two sets of guidance above, that we should be universally offering locum, agency, bank and students the opportunity to be vaccinated, so please do press ahead with all these groups.”

If you are in one of these groups, or know of anyone who is, who has been denied a vaccine, I’d be keen to speak to you. You can contact me in confidence by emailing