• 86% reported an increased demand for OT services within the previous 12 months.
• 79% stated that people were presenting more complex needs due to delayed interventions.
• 78% said that their team wasn’t large enough to meet the demand.
• 63% felt they were too busy to provide the level of care they’d like.
• 59% rated their work-related stress as 7 or above on a scale of 1 to 10, with 10 being the highest level of stress.

Key recommendations

• Governments must recognise that investment in the NHS and social care is critical to a healthy population and therefore economic growth. Investment in the OT workforce must be matched to service and demographic need, not just in the NHS but in social care as well.
• Capacity should be built within primary and community health and social care services, to ensure people receive advice and help early on, rather than when in acute need or with increased complexity due to delayed intervention. 

"We’re churning patients out faster and faster, older, frailer and more complex, but given no time to rehab or improve them, knowing that they will likely get readmitted again in a few days. That is disheartening when there is so much we could do if we were given a day or two, or there were more services in the community."

The statement reads as follows (the full list of signatories can be found on the National Voices website):

We have come together as a coalition of patient charities and professional bodies to call on the Government to commit to a serious, comprehensive and fully-resourced response to workforce challenges across health and care, which are now badly impacting people’s experience of health and care.

The current workforce crisis has been developing over decades across the health and care system. While the COVID-19 pandemic and its aftermath have left many staff feeling burnt out, challenges with recruitment and retention across health and care long pre-date the pandemic. They have real, life and death, implications for people and communities up and down the country. 

The impacts of the workforce crisis are felt from cradle to grave, and from diagnosis, through treatment to after care. Gaps in General Practice, secondary care, community-based support, mental health services, and social care impact across every patient group, and are particularly felt in already underserved communities. Too often the debate on staffing health and care happens without people who use these services in the room. 

As patient groups we are vocal about the changes we want to see in health and care, including when we need more or better from our health and care staff. But we also know that the changes we want can’t be delivered by staff who are under-supported, over-stretched, and (increasingly) planning to leave. We need an NHS that works for everyone, but we will not get that as long as it is underfunded and under-resourced.

The Government’s response on workforce to date has been far from proportionate to the scale of the challenges faced. As a result, people’s experiences of health and care are getting worse, and, as recent analysis of the British Social Attitudes survey demonstrated, confidence in the health and care system is faltering.

Together with professional bodies, we reject narratives that pit the workforce against the people who use health and care services. Many of us are, or will at some point be, both patients and staff members of these services. The health and wellbeing of our communities is enhanced when health and care services offer good work to local people.

It is critical that the long-anticipated NHS workforce plan is fully-funded, clearly sets out the workforce numbers required, and is built on the needs and aspirations of people who use health and social care services both now and in the future. It must be designed and delivered with the diverse range of people who work in health and care services and who use them.  

Health and care professionals must have the time, energy and training they need to deliver personalised care and support that focusses on what matters to us, rather than what is the matter with us. 

We ask the Government to treat this challenge with the urgency, seriousness and resource it deserves.

1. Annualised self-rostering/self-preferencing rotas so staff had more control over their working hours.
2. Introduction of a clinical fellow role with 25% non-clinical time to allow these staff to undertake other projects – for example, teaching medical students.

These two solutions were initially started for the A&E departments and then medical juniors whilst implementing the same systems but also allowing for continuity of ward care.

The Trust decided to use the HealthRota system, to implement an annualised system for consultants (using a period-of-activity contract), middle grades (using a combination of period-of-activity and hours contract) and junior rotas (using hourly contracts), alongside self-rostering or self-selecting preferences, with staff choosing the amount of clinical work they wish to do.

The Trust now benefits from 24/7 A&E consultant cover at Brighton, and cover between 8am and 10.30pm every day of the week at the Princess Royal Hospital. In five years, the Trust went from seven consultants and seven registrars on A&E (for two sites) to 23.8 full-time equivalent consultants and 20 registrars. In addition, the costs of using locum doctors have been massively curtailed. For example, before the annualised rota system was introduced, in A&E alone £1.3M was spent on locums at RSCH and PRH. For 2022-23, the only locum need has been for sickness cover.