The NHS started the pandemic with close to 100,000 vacancies across the service. As of the last report from NHS Digital, covering the period up to December 2020, it still has nearly 90,000
While the pandemic has taken a huge toll on the health workforce, these figures serve as a stark reminder that the problem of chronic workforce shortages is not new and that those shortages are not a direct result of the Covid-19 crisis but something more deep-rooted. A workforce that is not match fit in terms of numbers is something that has plagued the health service for years, and must finally be urgently addressed.
Of course, there has been welcome acknowledgement from the Government of the difficulties the NHS is facing around workforce, with a welcome focus on nursing numbers, visa extensions for health workers during the pandemic, resolution of contractual and pension issues, and the prioritisation of the health and wellbeing of staff in the phase 4 planning guidance. We have also seen the beginnings of an increase in applications to degree level courses for healthcare roles, not least in the areas of greatest risk such as mental health, which is encouraging.
Navina Evans, Prerana Issar, Lee McDonough, Rebecca Smith and their teams deserve our thanks for the work they have done to date to take action on these issues. But with choppy waters ahead, there is much more to be done, not least by Rishi Sunak and Boris Johnson.
What the health service needs urgently, as we, and our colleagues at the Academy of Medical Royal Colleges, NHS Providers, the Royal College of Nursing, UNISON and the British Medical Association, set out in a joint letter to the Prime Minister, is investment in growing workforce numbers – to the tune of billions of pounds.
The NHS desperately needs a fully costed and funded long-term workforce plan that addresses supply and vacancy issues, while continuing to improve services for patients. The Government must be clear about the workforce requirements for delivering the NHS Long Term Plan across different parts of the country, including detailing which staff groups need to be bolstered in particular.
Without this, the NHS will find itself in a position where it can never make up the lost ground, and it will lose the race to replenish staff numbers. We risk a situation where vacancies beget vacancies, as the staff remaining become ever more thinly stretched, with increasingly untenable workloads, making them more likely to leave.
Indeed, the results of the most recent NHS Staff Survey, published in March, show almost two thirds of NHS staff believe there are not enough people in their organisations to allow them to do their job properly, with more than 40% saying they feel unwell as result of their job – a figure that rises to half of staff working in frontline Covid care.
The NHS is already at risk of losing thousands of vital staff in the longer term, unless they are allowed to decompress and recover from the trauma of working through the pandemic. If they are not afforded this breathing space, there is a very real possibility of a knock-on effect on patients, which in turn means the huge backlog of treatment created by the Covid-19 crisis will take even longer to clear.
In our report, Putting people first: supporting NHS staff in the aftermath of Covid-19, we called on the Government to act now to avert a looming crisis in the workforce before it’s too late – especially as the country prepares for further easing of lockdown restrictions.
The NHS will not be able to bounce back from the crisis and enter full recovery mode unless health leaders have all the resources, they need to support their people. That includes tailored support for staff from black and minority ethnic (BME) backgrounds, on whom the pandemic has taken the greatest toll.
In Putting people first, we set out the actions needed to steer the NHS away from this cliff edge, beyond the immediate need to tackle vacancies: a period of rest and recovery for staff; continued national investment to enable NHS organisations to supplement local support to staff; recognition and reward for the contributions and sacrifices staff have made; and improving the day-to-day experiences of working in the NHS.
In the meantime, the Government must be honest with the public about the scale of the challenge ahead for the NHS and what that will mean for services – especially in light of the likely surge in need for mental health services, the demands of the vaccination programme, and the fact that the estimated 1.1 million people with long Covid will need treatment and care. It must also be honest about the cost and time it will take to train and educate more staff, and how much the health service will need to rely on international recruitment in the immediate term.
This year’s spending review is therefore crucial. Without a commitment to long term investment in the workforce, the government will struggle to meet its priorities, the NHS will not be able to repay the support shown by the public and our people will not be given the hope that the Prime Minister and Chancellor have a plan to fill the gaps in their teams.