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, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence.
NHS Digital’s workforce statistics drop last week revealed almost 32,000 additional full-time equivalent staff were working for the NHS in May this year compared to the same month last year. This might sound good, but it represents just a 3 per cent increase and, according to experts, the NHS workforce is simply not growing fast enough to fill the gaps.
NHS Providers director of policy and strategy Miriam Deakin said, although any growth in the workforce is “encouraging”, there are still more than 100,000 vacancies to fill at a time when the NHS “is under real pressure from increasing demand for services”.
“We need to see much more recruitment to key NHS roles and appropriate incentives for training for people keen to progress in a career in health and care,” she added.
Danny Mortimer, chief executive of NHS Employers, said the increase in staff over the last year “depends on where you are sitting”.
“If you work in a learning disability or mental health service, you haven’t seen a 3 per cent increase,” Mr Mortimer said. “You are feeling decline.”
A deeper dive into the specialist nursing data is certainly concerning. The number of community health nurses has steadily decreased from 41,351 in September 2009 – when NHS Digital’s data set begins – to just over 35,000 in May 2019, while the number of level one district nurses dropped by 44 per cent during the same period. Learning disabilities nurses numbers follow the same trend, falling by 42 per cent.
For nurses more generally, there has been a 1.7 per cent increase in numbers over the last year.
Ms Deakin said, to deal with the nursing recruitment crisis, the NHS needs targeted investment to address the shortage of specialist nurses.
“The NHS cannot solve this alone,” she stressed. “We need a commitment from government to additional funding and to remove barriers to recruitment and retention.”
The Treasury confirmed this week the spending review is now expected in early September, and, if earlier promises are kept, the NHS should expect the final People Plan shortly after.
There is undoubtedly pressure on this plan to deliver – and rightly so. It is, after all, the first major workforce strategy for 20 years.
Mr Mortimer stressed the need for capital to invest in the working environment is in the gift of the government, along with an investment in continued professional development funding so staff “know the NHS is prepared to invest in their development”.
Mr Mortimer also said a long-term migration policy is needed alongside a “short-term sensible policy” if we leave the EU without a deal.
“An automatic end to free movement without a transitional period is not sustainable for the NHS and not sustainable for social care,” he said.
The success of the People Plan will arguably depend on investment from government, particularly an increase in Health Education England’s budget to spend on CPD training, but Mr Mortimer made clear it isn’t only within the power of the national regulators and the government to solve.
“Members understand that staff experience is also within their gift,” he said.
Mr Mortimer said there is now a “real understanding and obligation on employers” to improve the quality in their offer for employees, which the People Plan will bring into “a sharper focus”.
Milton Keynes Hospitals springs to mind. Chief executive Joe Harrison told HSJ recently he was planning a major investment in building a new, free car park for staff and other initiatives to improve staff wellbeing and retention.
Mr Harrison pointed out the workforce in each region will have different needs and, in some cases, organisations have been too reliant on the centre to make changes.
Considering the slow increase in workforce alongside the high number of vacancies, the pressure is on the People Plan to deliver. But with the level of investment in the workforce currently unknown, NHS organisations must do all they can to retain happy workers and attract more people into the health service.
Without new money, this is a tall order. However, as early statistics from the national retention programme have shown, with a focused effort, it can be done. And, if service demand is to be met, it must be done.