Stressed GP

Effects of the cost of living crisis and what needs to be done to stop them

Nurses skipping meals to save money to buy school uniforms for their children.

Hospital staff queuing at onsite food banks because they can’t afford basic essentials, and NHS workers struggling to meet the cost of the journey to work.

That’s what’s happening in NHS trusts today as rising cost of living pressures continue to make it harder for the key workers and carers we applauded during the pandemic to make ends meet.

Our survey shows the real impacts of the increase in cost of living on NHS staff, their patients and the communities they serve. 

Every one of the 160 NHS trusts which responded to a new survey by NHS Providers voiced concern about the mental, physical and financial wellbeing of staff as a result of the rising cost of living, with 61 per cent reporting an increase in staff absences due to mental health. 

"For some staff this is the final straw psychologically after two years of COVID”, said one trust leader.

Morale of health workers is deteriorating and the NHS is finding it harder than ever to recruit and retain staff.  

Vacancies across NHS trusts recently hit all-time high, at more than 132,000. Two in three trusts report a significant or severe impact from staff leaving for other sectors, such as hospitality or retail.  More than two in three said the cost of living is having a significant or severe impact on their ability to fill lower-paid jobs such as porters, cleaners and healthcare assistants. It’s getting harder for them to recruit, where there is competition from other industries, in facilities, IT and HR too. All NHS workers are seeing real terms cuts to their take-home pay with the recent below-inflation pay awards, following on from years of pay restraint.

And trusts are already seeing the damaging health consequences of financial stress among local people too.  Like the COVID-19 pandemic, the effects of the rising cost of living – such as increased fuel poverty – on many people’s health will be far-reaching and long-lasting.

"We anticipate a huge increase in demand due to increased rates of anxiety, depression and domestic violence in the communities we serve,” one trust told us.

The vast majority of trusts (95 per cent) said that the cost of living had significantly or severely worsened health inequalities in their areas. Almost three in four (72 per cent) have seen an increase in people coming forward with mental health problems due to stress, debt and poverty, and a rise in cases of poverty-related conditions. 

The financial squeeze so many people face today means more are seeking help from an NHS already under severe pressure. We know the link between deprivation and poor health, and the impact of inequality on people’s mental and physical state. Conditions such as diabetes and heart disease are more prevalent in the most deprived sections of society, made worse by poor diet and living conditions.  

Trust leaders are particularly concerned that the groups that will be hardest hit by the rising cost of living are those who already have worse health outcomes, including the most deprived communities, older people and children, ethnic minorities, and people with learning disabilities and mental health conditions.

As winter approaches, a combination of worsening public health, severe staff shortages and ballooning costs will only add to NHS trusts’ difficult task of managing the pressure on services and recovering care backlogs in challenging times.

In order to be equipped to meet these challenges, trusts need: 

  • national, coordinated support including a long-term, fully-funded workforce plan so that the NHS can recruit and retain the staff it needs;
  • realism from government and national NHS leaders about the direct effects the rising cost of living is having on performance and capacity;
  • government action to help improve the health of the most deprived communities; and
  • cross-government commitment to addressing the wider determinants of health over the longer term.

Urgent action and far-sighted measures are required to support NHS staff and the public during hard times otherwise the long-term costs for the NHS, society and the public purse will be high.

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NHE May/June 2024

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