The NHS is battling a spell of ill-health. Suffering from a chronic shortage of nurses, doctors, midwives and general practitioners; as well as developing a dependency on costly agency workers. The NHS workforce crisis has been further compounded by recent figures from the Nursing and Midwifery Council and British Medical Association indicating that the number of EU healthcare professionals coming to work in the UK is depleting at an astonishing rate; as the number of medics from the European Economic Area leaving the UK is rising at a ratio of almost one in every five.
The widely maligned public sector pay cap, uncertainty created by Brexit, staff shortages and under funding are creating an environment that has led to:
Additionally, in the chancellor's November budget statement, Phillip Hammond pledged £2.8bn (£350m immediate investment, £1.6b in 2018-19 and £850m in 2019-20) to the NHS. Despite the chancellor labelling the commitment an 'exceptional' measure, it is still a far cry from the £4bn requested by NHS bosses to fill the funding gap for the coming year alone. The health budget has traditionally received an additional 4% a year above inflation in order to cope with an ageing population, increasing long-term health conditions and the rising cost of medicines. However, since 2010, this figure has dropped close to 1%.
Budget cuts, sweeping healthcare reforms and austerity have pushed the NHS workforce to breaking point. NHS Staff: Skills, Retention and Recruitment will bring together health and social care leaders, economists, policy makers and frontline staff to collaborate in pursuit of an actionable strategy for supporting, recruiting, retaining and upskilling NHS staff.
In November 2017, the General Medical Council released a report that indicated, despite industrial action from junior doctors in 2016, trainee medics are working in conditions that are far from suited to delivering the high standard of patient care the NHS has built a global reputation on. The report noted that: 'A worrying number of doctors in training continue to raise concerns about heavy workloads and shortness of sleep while on duty, with some missing educational opportunities because of these pressures.’ As well as the health risks posed to NHS staff by the increasing strain of workloads, patient health has been risked by junior doctors forced to act beyond their medical competence and run hospital units due to understaffing. Charley Massey, chief executive of the GMC stated:
"In some cases trainees are being left to fend for themselves when they clearly don't have the competence to make the decisions about patients' treatment that are being asked of them. That's a real concern. Significant proportions of trainees, especially those early in their careers, feel very exposed in terms of what they are being asked to do."
What changes need to occur in order to ensure the current generation of junior NHS workers, and those that will follow, are entering into a safe, sustainable career in public service?
According to official figures, in March 2017 there were 30,613 vacant full-time positions within the NHS; a 15.8% increase on the previous year. Overall, in the first quarter of 2017, 86,035 positions were advertised; many of which were looking for multiple new employees as part of recruitment programmes, meaning the true figure is likely even higher. Nearly 40% of the advertised vacancies were for nursing and midwifery roles, averaging a worryingly thin three applications per-role. This is a little less surprising when taken into account that nursing pay has fallen by 14% in real terms since 2010, equating to around £3,000 each year.
In April 2017, one month after the previous vacancy figures were taken, a further 1,274 nurses left the NHS.
Data analysis made available in January 2018 revealed that NHS staff are contributing an average of 204 hours of unpaid overtime a year due to under-staffing; equating to £1.6bn of work. The figures reflect that 45% of NHS staff are putting in up to five hours of unpaid work per week. A further 10% are putting in 10 hours a week and a particularly over-stretched 4% are totalling up to 11 hours of unpaid overtime.
Figures released in November 2017 indicate that the ramifications of the UK's decision to leave the European Union are beginning to reverberate through the NHS; and not in the form of £350million a week...
In the last year 4,067 European medics have left the Nursing and Midwifery register, a 67% increase on the previous year. Looking further into the figures makes for increasingly grim reading. On average, 1,966 midwives and nurses from Spain joined the NMC's register between 2012 - 14; in 2016 - 17 that figure dropped to 104, a decline of 95%. Similar drop offs are reflected in midwives and nurses coming to the UK from:
In an attempt to bolster workforce numbers, the Department for Health has pledged to train an extra 1,500 doctors per year by 2020 – boosting the current number of student doctors by 25%. Additionally, 10,000 extra places will be made available for trainee nurses, midwives and allied health professionals. A spokesperson from the Department of Health commented on the staffing issues within the NHS, purporting a drastically more optimistic outlook than that of frontline workers on the wards: “Staffing is a priority – that’s why we have invested in frontline staff and there are almost 32,000 more professionally qualified clinical staff including almost 11,800 more doctors and over 12,500 more nurses on our wards since 2010.”
Jeremy Hunt, Secretary of State for Health and Social Care has promised there will be 21,000 more nurses, therapists and consultants working in mental health services in England by 2021. However, medical professionals have expressed concern with the government’s training initiatives, as the new students benefiting from the training places could take up to ten years to study and become senior doctors; therefore this initiative will not address the immediate shortage of doctors.
Additionally, the £1billion that will fund the 21,000 new positions is not new money from HM Treasury but is instead coming from existing NHS budgets.
Recent figures from NHS Digital indicate that the number of practising GPs in England has dropped by 1,193; this, despite the government's commitment to increase the number of GPs by 5,000 in time for 2020. Opposition to the government have used these figures to demonstrate a failure to deliver on its promises to recruit more GPs by 2020 and those concerns are echoed by members of the medical community Dr. Krishna Kasaraneni, GP workforce lead for the British Medical Association commented on the GP shortage: “The government needs a long-term plan that addresses the fundamental pressures on general practice from rising patient demand, stagnating budgets and widespread shortages. Even considering recent announcements, the government is still going to be well short of its target of recruiting 5,000 new GPs by 2020.”
NHS services in the devolved nations are also under increased strain. According to a survey carried out in Scotland by The Royal College of Nursing, half of the 3,300 nurses surveyed reported that patient care was compromised on their most recent shift due to staffing shortages; one quarter of those polled believe there are not enough support workers, nearly half voiced concerns about the skills mix on wards and data suggests that one-in-eight nurses on the wards are not NHS staff but expensive, outsourced agency workers.
In collaboration with some of the leading minds in healthcare, policy making, health economics and clinical practice, Open Forum Events presents NHS Staff: Skills, Retention and Recruitment to develop an actionable strategy for supporting the NHS workforce.
Interminable top-down plans to transform NHS working practice have been the equivalent of fiddling while Rome burns. The prime driver has been to defund the NHS and to promote competition. This underlies the disastrous workforce planning of the last decade and an NHS in crisis. After many years of undermining of the idealism that made the NHS what it is – through under-funding, deskilling, outsourcing, competition and dis-integration – privatisation is steadily on the increase and the NHS is in disrepair. Let us reappraise how to restore the NHS to health and reassert its primary values. A strong public health service – alongside strong public social care and education – will ensure a healthy, well-educated population. A healthy population will deliver a healthy economy and society. If we respect, value and resource our NHS workforce, they will deliver an effective and safe NHS, and a healthy population.
The CapitalNurse Programme was established in July 2015 to secure a sustainable nursing workforce for London. It is a programme of collective action between Directors of Nursing and HR Directors from service providers, Health Education England, NHS England, NHS Improvement, education providers, STPs, trade unions and professional organisations. We have all agreed to collaborate to deliver the programme’s mission on behalf of the people of London and in doing so are creating a social movement to raise the vital role and profile of nursing for the health, well-being and care of the population. CapitalNurse is jointly sponsored by Health Education England (HEE), NHS England and NHS Improvement and is funded by HEE.
In this presentation, Chris Caldwell, the Programme Director will give an overview of the programme, its progressing impact to date and plans for next steps.
This presentation explores Skills for Cares programme on workforce productivity in adult social care. It looks at what the organisation has learnt so far, how they are putting that work into practice and why shouting at your team is likely to have the opposite effect to the one you desire.
As the parliamentary representative for Manchester Central, Lucy Powell has been a driving force behind healthcare campaigns within the city; holding private contractors to account, standing-up for mistreated hospital staff and supporting young carers in the city.
In this talk Naveen will elaborate on the following aspects:
The recruitment and retention of staff in social care is one of the biggest challenges which the Health and Care sector faces. Demographic change means there will be far more people who need care and support, but recruiting and retaining the workforce to deliver a variety of roles that support them is going to be more challenging.
Within social care there are particular challenges, especially when trying to recruit nurses and professions allied to medicine. In the face of these difficulties we need to look to new approaches and think about workforce development across both health and social care. We need to recruit on values, develop clear career pathways, remunerate appropriately and use training and development money across the entire system. There is much talk about integration, but it is unrealistic to expect integrated outcomes when we have fragmented approaches to workforce development.
In her address to delegates, Professor Anita Charlesworth will set out the case for introducing new measures of funding the National Health Service, such as a hypothecated NHS tax and the establishment of a body similar to the Office for Budgetary Responsibility for the NHS; providing clarity and accountability for tax and spending decisions. Additionally, Anita will make the argument for a greater emphasis on, and increased inclusion of the workforce when crafting health and social care policy.
Since being elected to serve as Mayor of Greater Manchester in May 2017 with 63% of the vote and majorities in all ten boroughs, Andy Burnham has proposed to enact a number of innovative health and social care policies that would see the region's NHS organisations radically reform how they recruit and retain staff as well as the delivery of services.
In his address to delegates, Andy will outline some of the initiatives he has proposed to support Greater Manchester's NHS staff and the work they do, including:
The QNI is the oldest professional organisation for nurses in the UK. We are in touch with practice through our network of more than 1100 Queen’s Nurses working in a wide variety of roles, covering practice, policy, research and education, and our Community Nurse Executive Network of Chief Nurses of community provider organisations.
Through our QNI networks and direct contact with frontline practitioners, we have developed a good understanding of the key issues in recruitment and retention of the nursing workforce: our intelligence has provided us with both quantitative and qualitative information as well as case studies of what works well in the community and primary care. The QNI perspective will be shared, along with the strategic recommendations for increasing recruitment and retention in the nursing workforce.
Construction of The Bridgewater Hall commenced on 22 March 1993, but the idea of a new concert hall for Manchester dates back to the reconstruction of the Free Trade Hall in the 1950s after wartime bomb damage. The Free Trade Hall was home to the city’s famous Hallé orchestra and also hosted rock and pop concerts. However, despite holding great public affection, the 1850s Free Trade Hall was ill-equipped to respond to the rising standards of service and acoustic excellence demanded by performers and audiences.
