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Content ArticleDespite the constant pressures and chronic shortages, the number of nurses leaving the NHS had flatlined over recent years. Now our analysis of new data shows there has been a large increase in nurses leaving the NHS, and that this trend is being driven by younger workers. The last year's data (June 2021 - June 2022) saw a 25% increase in the number of NHS nurses leaving their role, with an additional 7,000 leaving compared to the previous year. The largest increase in numbers leaving was seen among the younger nurses, two thirds of leavers were under 45 years of age. In this article, Jonathon Holmes explores why there is a sudden increase in vacancies.
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News Article
Social care ‘on its knees’ as vacancies hit record high
Patient Safety Learning posted a news article in News
Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals. New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22. This is the highest on record according to the charity Skills for Care, which has collected the data since 2012. Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”. At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade. Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”. He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets." Read full story Source: The Independent, 11 October 2022 -
Content ArticleThis report from Skills for Care provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.50 million people working in it. Topics covered include recent trends in workforce supply and demand, employment information, recruitment and retention, demographics, pay, qualification rates and future workforce forecasts.
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News Article
Four of UK’s top countries for nurse recruitment on WHO ‘red list’
Patient Safety Learning posted a news article in News
Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used. Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022. All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers. Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer. But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees. Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”. “It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said. “This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce. “They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.” Read full story Source: Nursing Times, 4 October 2022 -
News Article
Record number of NHS staff hand in resignation
Patient Safety Learning posted a news article in News
The latest NHS workforce figures have shown that a record number of staff voluntarily resigned from their jobs during the first quarter of this financial year. According to the data, almost 35,000 NHS workers resigned voluntarily, which was up from 28,105 during the same period in 2021, and 19,380 in 2020. It is also higher than in any equivalent first quarter over the last 10 years. The most common reason for leaving during quarter one of 2021-22 was ‘work-life balance’, with almost 7,000 NHS workers citing this as their reason for leaving their jobs. Close to 2,000 NHS workers also left in the same period in search of a ‘better reward package’, with almost 1,000 reporting ‘incompatible working relationships’. In it unclear from the NHS digital data whether they left the NHS altogether. Read full story (paywalled) Source: HSJ, 3 October 2022 -
News Article
‘Perilous’ shortage of homecare workers leaves patients trapped in hospitals
Patient Safety Learning posted a news article in News
A “perilous” shortage of homecare workers is the biggest reason thousands of people are languishing longer in hospital than needed, driving up waiting lists and making people sicker, figures reveal. Almost one in four people unable to be discharged – sometimes for weeks – were trapped in hospital because they were waiting for home care, as agencies hand back contracts because staff are quitting owing to low pay, leaving 15% of jobs vacant. A fifth of people unable to be discharged were also waiting for short-term rehabilitation and 15% were waiting for a bed in a care home, according to analysis of data obtained using freedom of information requests and public records by Nuffield Trust and the Health Foundation. It estimated that in April this year, one in six patients were in hospital because of delayed discharge, and the discharge of patients with a hospital stay of more than three weeks was delayed by 14 days on average. “People are ending up in hospital for malnutrition and dehydration, problems which, even if you supported people a little bit at home, would stop,” said Jane Townson, the director of the Homecare Association. “More providers are having to turn down work than usual and some are having to hand back people because they can’t do it.” Read full story Source: The Guardian, 3 October 2022 -
News Article
Record number of nurses quitting the NHS
Patient Safety Learning posted a news article in News
Record numbers of nurses are quitting the NHS in England, figures show. More than 40,000 have walked away from the NHS in the past year - one in nine of the workforce, an analysis by the Nuffield Trust think tank for the BBC revealed. It said many of these were often highly skilled and knowledgeable nurses with years more of work left to give. And the high number of leavers is nearly cancelling out the rise in new joiners that has been seen. There were just 4,000 more joiners than leavers in the year to the end of June. But a Department of Health and Social Care spokesman said progress was being made and the government was already halfway to meeting its target to increase the numbers of nurses working in the NHS in England during this Parliament by 50,000. He said a workforce strategy would be published soon, setting out how the NHS will continue to recruit and retain nurses in the coming years. Read full story Source: BBC News, 30 September 2022 -
Content ArticleNursing is the single largest profession in the NHS, but it suffers from substantial staffing shortages. This analysis from Billy Palmer and Lucina Rolewicz for the Nuffield Trust reflects on the rate at which the health service is losing nurses, and considers the reasons why.
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News Article
NHS trusts in England offered extra funding to recruit overseas nurses
Patient Safety Learning posted a news article in News
Health service trusts in England are to be given additional funding to recruit nurses from overseas amid record staff shortages and increased demands. For nurses recruited between 1 January and 31 March 2023, trusts will be able to claim £7,000 per overseas nurse from NHS England. This is up to £4,000 higher than the financial support on offer during 2021-22. The move was unveiled by NHS Employers on its website last week and confirmed to Nursing Times by NHS England. NHS Employers said the additional funding reflected the rising costs of flights, accommodation and preparation costs for the nursing and midwifery objective structured clinical examination (OSCE). The OSCE forms part two of the Nursing and Midwifery Council’s test of competence and is a practical exam in which overseas nurses and midwives are tested on their clinical and communication skills. Responding to the move, Unison’s head of health, Sara Gorton, said: “Extra cash to tackle the chronic staffing shortages in the NHS is essential.” She warned that, until NHS staff vacancies ware addressed, there “will be a need for overseas recruitment”. “But it has to be done in the best interests of the individual workers,” she added. Ms Gorton highlighted ongoing concerns about unethical recruitment of nurses from overseas and the poor treatment many report facing. “Sadly, overseas nurses are still being exploited by unscrupulous care and health employers,” she said. “This is no way to treat those who come to offer the UK their help.” Read full story (paywalled) Source: Nursing Times, 27 September 2022 -
News Article
Why Coffey's NHS plan has left many unimpressed
Patient Safety Learning posted a news article in News
Tinkering around the edges, the King's Fund said. A few short-term fixes, according to the Health Foundation. And a plan that will have minimal impact, the Royal College of GPs added. These were just a handful of the reactions from those involved with the NHS. And they were not even from organisations usually at the front of the queue when it comes to criticising government policies. So why has Therese Coffey's first announcement as Health Secretary for England received such a negative response? The fact is the problems the health and care system are facing are deep-rooted. Much is made of the impact of the pandemic but the health service was already struggling before Covid hit. The pandemic has simply exacerbated the situation. At the heart of it all is a lack of staff. Addressing this is not easy and cannot be done overnight. It takes five years to train a doctor, three a nurse, which is why there is a big push on international recruitment at the moment. To free up GP appointments, pharmacists are being asked to take on some of their workload, while funding rules are being relaxed to allow GPs to use more of their money to recruit senior nurses. But there is nothing in the plan about where these new senior nurses are going to come from, which is why the Royal College of GPs has been so dismissive. It is a similar story for hospitals services, where accident-and-emergency waits, ambulance response times and the backlog in routine treatments such as knee and hip replacements have all worsened in recent years. Coffey is also introducing a £500m fund to get thousands of medically fit patients out of hospital as soon as possible. Local areas will decide how to spend the money and it could allow hospitals to pay for extra help at home for patients who need it. But it amounts to little more than a sticking plaster and is an approach already used to relieve the pressure during the pandemic. The real issue is the care sector is short of staff, with even more vacancies than in the NHS. Read full story Source: BBC News, 22 September 2022 -
News Article
One in four people could be left without a GP within a decade, doctors claim
Patient Safety Learning posted a news article in News
One in four people could be left without a GP within a decade, medics say. The forecasts from Doctors’ Association UK suggest 16 million people in England could be left without access to a family doctor, amid growing staffing shortages. Today the new Health Secretary is expected to set out plans to boost access to GPs, following warnings that public satisfaction is the lowest on record. Research by the Health Foundation suggests that the NHS will lose up to 8,800 full-time equivalent GPs by 2030 if current trends continue. On Wednesday, Doctors’ Association UK said this could leave one in four people without access to a GP. Dr Lizzie Toberty, GP lead for the Doctors’ Association UK, said the workload of a family doctor now placed “unrealistic demands” on them. She said: “GPs will cut their hours, quit the NHS, or quit the country. We fear patients will suffer the same ‘postcode lottery’ for seeing their GP as many do now with getting an NHS dentist.” Read full story (paywalled) Source: The Telegraph, 21 September 2022 -
News Article
Adult social care in England is in crisis, say Tory council leaders
Patient Safety Learning posted a news article in News
Adult social care in England is in serious crisis, Tory council leaders have warned the government, as it faces a £3.7bn funding gap and a growing staffing shortage that has brought many local care providers to the brink of collapse. The intervention by the County Councils Network, which represents 36 mainly Tory-run authorities, comes amid widespread local government concern over the increasing fragile state of social care. Care costs have accelerated recently, fuelled by unexpected wage and energy inflation. “We face the perfect storm of staffing shortages, fewer care beds, and higher costs – all of which will impact on individuals waiting for care and discharges from hospital,” said Martin Tett, the Tory leader of Buckinghamshire county council. Cathie Williams, the chief executive of the Association of Directors of Adult Social Services, said: “Too many people are missing out on vital care and support – we estimate that over half a million people are waiting for assessments, care, or reviews. With over 165,000 staff vacancies, this is only set to get worse. ” A government spokesperson said: “The health and social care secretary is focused on delivering for patients and has set out her four priorities of A, B, C, D – reducing ambulance delays, busting the Covid backlogs, improving care, and increasing the number of doctors and dentists. Read full story Source: The Guardian, 21 September 2022 -
Content ArticleWith Liz Truss becoming the new Prime Minister today after winning the Tory leadership contest, what are the health and care commitments from the 2019 Conservative Party Manifesto that she inherits? Mark Dayan, Lucina Rolewicz and Jessica Morris explore the progress of the main health and care promises that were made. Which are on course to be delivered and which are not?
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Content Article
In a recent report, the Professional Standards Authority (PSA) for Health and Social Care sets out its view on the biggest challenges affecting the quality and safety of health and social care. In this blog, Alan Clamp, PSA's chief executive, summarises these challenges and the possible solutions. You can also read Patient Safety Learning's reflections on the PSA report here.- Posted
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News Article
Unfilled consultant posts pose key risk to patient safety - Irish Medical Council
Patient Safety Learning posted a news article in News
Unfilled specialised medical consultant roles and an over-reliance on overworked, internationally trained graduates for non-consultant hospital doctors are among key risks to patient safety identified by the Irish Medical Council. The council, which is the regulatory body for the medical profession, sets out the risks to healthcare for the first time in its workforce intelligence report that breaks down the make-up of the medical register and explains why doctors are leaving the health system. More than a third of all clinically active doctors are on the general register, which is a key risk to patient safety because consultant and specialist roles are not being filled and “a considerable proportion” of non-consultant hospital doctors are required to perform the duties of consultants. The report found that the majority of non-consultant hospital doctors are trained overseas and that the health system overly relied on these doctors who reported being “overworked, undervalued, experiencing discrimination and unable to access specialist training.” “Aside from the individual impact on the doctors, the treatment of international medical graduates has serious implications for patient safety,” the council said. In another risk identified by the regulatory body, more than a quarter of doctors reported working more than 48 hours a week, in breach of the European Working Time Directive. This has further serious implications for patient safety,” the council said. Read full story Source: Irish Times, 1 September 2022 -
News Article
Ministers to make it easier for foreign nurses and dentists to work in NHS
Patient Safety Learning posted a news article in News
Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK. The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care. Barclay believes thousands of extra health professionals will come as a result of new rules making it easier for medical regulators to register those who have qualified abroad. If the change proves successful it will help pave the way for more nurses and dentists coming to work in Britain from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia. However, critics claim the policy is a stop-gap that is no substitute for ramping up the supply of homegrown staff and risks worsening the lack of health workers in other countries that are struggling with shortages of their own. Read full story Source: The Guardian, 5 September 2022 -
Content ArticleThe NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
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News Article
NHS vacancies in England at ‘staggering’ new high as almost 10% of posts empty
Patient Safety Learning posted a news article in News
The number of posts lying vacant across the NHS in England has reached a “staggering” record high of 132,139 – almost 10% of its planned workforce. The number at the end of June was up sharply from three months earlier when there were 105,855 vacancies, quarterly personnel figures show. NHS leaders said the huge number of empty posts showed why the health service is in a state of deepening crisis, with patients facing long waits for almost every type of care. The previous highest number of vacancies for full-time-equivalent staff was 111,864, recorded at the end of June 2019. The new number represents 9.7% of the NHS’s planned staffing levels – a new high. As recently as March 2021 there were 76,082 vacancies. Danny Mortimer, the chief executive of NHS Employers, said: “These figures paint a bleak picture. A jump in nearly 30,000 staff vacancies – equivalent to the entire staffing of a large NHS hospital – show an alarming trend across the NHS of rising levels of vacancies.” Read full story Source: The Guardian, 1 September 2022 -
Content Article“The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff, writes Richard Murray in this article for the Independent.
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Content ArticleIn this blog for The King's Fund, Richard Murray examines the issues that are pushing the NHS into crisis and causing the lowest levels of public satisfaction since the 1990s. The primary cause of this emergency is the workforce crisis, an existing trend that has been accelerated by the Covid-19 pandemic. He examines the approaches that have been taken to similar crises in the past, and highlights the importance of the workforce plan that is due to be released by NHS England and Health Education England towards the end of the year.
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News Article
Government defends medical student number cap
Patient Safety Learning posted a news article in News
Questions are being asked why the government is sticking to its cap on medical and dentistry places. A shortage of doctors and other medical staff has been described as the biggest challenge facing the NHS. But the number of places at UK medical schools are capped - in England this year there are 7,500 places. England's Education Secretary James Cleverly told the BBC that you can't just "flick a switch" to increase the capacity to train more doctors. Medicine is one of a handful of courses where numbers are limited by the government, because the cost is heavily subsidised. In 2020 and 2021 the government lifted the cap on numbers, which last year led to more than 10,000 places being accepted. But this year the cap in England is being reintroduced. Mr Cleverly told the BBC that the nature of highly technical, vocational courses like medicine meant increasing the number of places was far from straightforward. "To increase those numbers you would also need to increase the capacity in training institutions, both in universities and in hospitals. "It is not something you can just flick a switch and significantly increase the capacity to train. "The increases have got to be funded, they are technical and expensive courses and we need to understand the balance of requirements between these courses and other courses that the government is supporting financially." Read full story Source: BBC News, 18 August 2022 -
News Article
Midwife numbers fall in every English region, figures show
Patient Safety Learning posted a news article in News
The number of midwives has fallen in every English region in the past year, figures show. Numbers dropped by around 600 on top of a longstanding shortage of more than 2000 midwives, according to analysis of NHS Digital data by the Royal College of Midwives (RCM). The RCM said more investment is needed in maternity services to ensure the safety and quality of care, as "even the smallest falls are putting increasing pressures on services already struggling with shortages, worsened by the pandemic". Dr Suzanne Tyler of the RCM said midwife numbers had "fallen significantly over the past year on top of already serious shortages" in England. Dr Tyler said: "The falls across the regions are compounding the difficulties employers are facing to recruit and keep their midwives. "We are raising these issues because we want women to get the best possible care and midwives to not only stay in the profession, but to encourage others to become one. "These figures must shock this moribund Government into action for the sake of women, babies, their families and staff." Read full story Source: Medscape, 16 August 2022 -
News Article
NHS too reliant on overseas recruits, says union
Patient Safety Learning posted a news article in News
The NHS in England is increasingly reliant on doctors and nurses recruited from outside the UK and EU, analysis has found. Some 34% of doctors joining the health service last year came from overseas, a rise from 18% in 2014. The government said overseas recruitment had always been part of its strategy, but unions have warned it is an unsustainable way of recruiting in the long-term. Patricia Marquis, Royal College of Nursing (RCN) director for England, said ministers must do more to reduce the "disproportionate reliance" on international recruits. The government is funding an additional 1,500 undergraduate medical school places each year for domestic students in England - a 25% increase over three years. However, last week a report by MPs concluded the large number of unfilled NHS job vacancies, about 110,000 in total, was posing a serious risk to patient safety. Danny Mortimer, chief executive of NHS Employers, said it was "high time for the government to commit to a fully-funded, long-term workforce plan for the NHS" to tackle "chronic workforce shortages". Read full story Source: BBC News, 5 August 2022 -
News ArticleMidwife numbers are reaching a dangerous level which could put lives at risk, as records show more staff leaving than joining the profession for the first time in a decade. As a record number suffer burnout and leave, the figures from NHS Digital for 2021/22 show almost 300 more staff abandoned midwifery than joined the service, with 3,440 leaving and only 3,144 coming in. Analysis of the data showed a record 551 resigned in 2021 because of a lack of work-life balance. Midwives working in NHS trust maternity units typically work 12-hour shifts, but many work longer for no additional pay to cover staff shortages and to keep services running. The Royal College of Midwives (RCM) says members are "at the end of their tether' and 'physically and emotionally burnt out" Joeli Brearley, chief executive of campaign group Pregnant Then Screwed, said: "We don't have enough midwives, and those we do have are underpaid, undervalued and overworked." "This is a problem that has been communicated to the Government repeatedly for years. It is putting the lives of women and their babies in danger and causing untold damage to their mental and physical health. The Government needs to get a grip of the situation urgently before there are more tragedies." Read full story Source: Daily Mail, 1 August 2022 .
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Content ArticleThe House of Commons Health and Social Care Select Committee has published a report highlighting the current health and social care workforce crisis in England. The 'Workforce: recruitment, training and retention' report, which calls for a robust workforce strategy, states that within the NHS in England there’s a shortage of over 50,000 nurses and midwives, while in April this year hospital waiting lists reached an all-time high of almost 6.5 million.
