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Content ArticleThis toolkit from NHS Employers aims to support the reduction in turnover of international staff in the NHS by improving their experience at work. It is hoped that this will then enable them to stay, thrive and build lasting careers in the NHS. It is for line managers and employers and should be used alongside the International Recruitment Toolkit and the Improving Staff Retention Guide to support your overall approach to recruiting and retaining international and domestic staff. The good practice principles and examples throughout can be applied to all professions.
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Content ArticleThis is the first national ambulance volunteering strategy, produced by the Association of Ambulance Chief Executives. It recognises the important role volunteers play in the ambulance service and outlines a national approach to volunteering that will be adopted between January 2023 and May 2024. The strategy covers mission, vision, principles and measures of success.
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Content ArticlePeter Griffiths and Chiara Dall'Ora, in this BMJ Editorial, discuss the staffing shortages in the NHS and what needs to be done.
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News Article
GPs each seeing 15% more patients, BMA says
Patient Safety Learning posted a news article in News
The average number of patients each individual GP is responsible for has increased by 15%, or around 300 people, since 2015, the BMA has said. This is due to the ‘slow but steady haemorrhaging’ of GPs over the last few years, which has led to pressures on services growing ‘even more acute’, it suggested. The Association’s statement comes in response to the latest GP workforce data – published by NHS Digital (10 February) – which showed that 188 FTE GPs left between December 2020 and December 2021. Dr Farah Jameel, chair of the BMA’s GP committee, said the figures are the direct result of an ‘over-stretched’ and ‘under-resourced’ NHS. She said: ‘Family doctors, exhausted and disenchanted, feel as though they have no choice but to leave a profession they love because of chronic pressures now made worse by the pandemic. Workload has dramatically increased, there are fewer staff in practices to meet patient needs.’ Insufficient staffing is particularly concerning as the backlog for care continues to grow, she suggested, with many GPs believing ‘the day job is just no longer safe, sustainable or possible anymore’. The NHS and the Government must work to retain current staff as its ‘immediate priority’ and must urgently refocus on retention strategies as a key enabler for the NHS’ recovery. She said: ‘The Government has repeatedly argued that the number of doctors is growing, but this isn’t the reality for general practice, and it begs the question: how many more have to go before something is finally done about it? Our NHS is the people who work in it, and without them, the entire system and provision of patient care is under threat.’ Read full story Source: Management in Practice, 11 February 2022 -
News Article
7,469 research nurses and midwives across the UK and Ireland, new census reveals
Patient Safety Learning posted a news article in News
There are at least 7,469 research nurses and midwives across the UK and Ireland working within all areas of healthcare, reveals a landmark new census initiated by a group of NIHR 70@70 Senior Nurse & Midwife Research Leaders. The census, incorporating responses from research nurses and midwives across all four UK nations and the Republic of Ireland, reveals nurses and midwives are working at every level in healthcare from Bands 5 – 9 in the UK, and from staff nurse to Directors of Nursing or Midwifery in the Republic of Ireland. This suggests there are opportunities to join the profession at every level, with continued potential for career progression. Clinical research nurses and midwives are a specialist workforce, with knowledge, skills and expertise in both clinical practice and research delivery. The census shows that: 33.7% reported working in joint posts, for example as a clinical research nurse for part of their role as well as a clinical nurse specialist; 72% are working within a single disease/area specialism; 28% reported covering multiple disease areas. NIHR Director of Nursing & Midwifery Professor Ruth Endacott said: “This census reveals the true breadth and depth of our research nursing and midwifery community. We know there are scores of people working incredibly hard day and night helping to bring us new treatments and medicine alongside their healthcare colleagues but we now have a much clearer idea of the size of the workforce. Research nurses and midwives are making a difference to the health of people across the UK and Ireland." Read full story Source: National Institute for Health Research, 9 February 2022 -
News ArticleChildren with mental health problems are dying because of failings in NHS treatment, coroners across England have said in what psychiatrists and campaigners have called “deeply concerning” findings. In the last five years coroners have issued reports to prevent future deaths in at least 14 cases in which under-18s have died while being treated by children’s and adolescent mental health services (CAMHS). The most common issues that arise are delays in treatment and a lack of support in helping patients transition to adult services when they turn 18. Coroners issue reports to prevent future deaths in extreme cases when it is decided that if changes are not made then another person could die. Dr Elaine Lockhart, the chair of the Royal College of Psychiatrists’ faculty of child and adolescent psychiatry, said the findings were “deeply concerning” and every death was a tragedy. She said there were too often lengthy delays and services were under strain as demand rises and the NHS faces workforce shortages. “In child and adolescent mental health services in England, 15% of consultant psychiatrist posts are vacant,” Lockhart said, calling for more support, investment and planning to grow staff levels. Read full story Source: The Guardian, 3 February 2022
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News Article
Patients 'wait two years' for check-ups as dentists drop NHS work
Patient Safety Learning posted a news article in News
NHS dentistry is "hanging by a thread" with some patients facing two-year waits for check-ups, the British Dental Association has said. Department of Health data analysed by the BBC shows almost 1,000 dentists working in 2,500 roles across England and Wales left the NHS last year. One woman told how she had been in pain for more than a year while waiting to have root canal surgery. NHS England said patients who most needed care should be prioritised. Pamela Carr, 58, from Carlisle, has been looking for an NHS dentist to fix her root canal since November 2020. "I've become used to the pain," she said. "I can't afford the private care, and I've tried every practice within 30 miles. I phoned NHS England too." "They said there's nothing they can do because there are no NHS dentists. That was the end of the conversation." Clinical Commissioning Group North Cumbria, which covers the area, lost 4% of its dentists in the last year. The worst-affected area was NHS Portsmouth CCG, which lost 26% of its NHS dentists over 12 months. At least 10% of NHS dentists were lost in 28 other English CCGs. Read full story Source: BBC News, 19 January 2022 -
News Article
Omicron blocks thousands of overseas doctors joining NHS
Patient Safety Learning posted a news article in News
Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases. The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”. It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs. Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.” Read full story (paywalled) Source: HSJ, 6 January 2022 -
News Article
Fix NHS staffing crisis to tackle waiting lists backlog, warn MPs
Patient Safety Learning posted a news article in News
A long-term plan to fix the staffing crisis in the NHS is needed to cut record waiting lists for treatment, the government is being warned. Currently, nearly six million people in England are waiting for routine operations and procedures - many of whom are in pain. A report from MPs says the government needs to address staff shortages - or NHS workers will quit. There have been repeated warnings over the length of hospital waiting lists in England. As of September 2021, a record 5.8 million patients were waiting for surgery - such as hip or knee replacements - with 300,000 waiting more than a year compared with just 1,600 before the pandemic. In the autumn Budget, the government announced an extra £5.9bn for the NHS in England to help clear the backlog. This was on top of another funding package in September to create an extra nine million checks, scans and operations. But in its report published today, the Commons health and social care select committee said the health service was hugely understaffed and was facing an "unquantifiable challenge" in tackling the backlog. Jeremy Hunt, the former health secretary who now chairs the committee, said the NHS was short of 93,000 workers and there was "no sign of any plan to address this". He described the staffing crisis as "entirely predictable", adding: "The current wave of Omicron is exacerbating the problem, but we already had a serious staffing crisis, with a burnt-out workforce." "Far from tackling the backlog, the NHS will be able to deliver little more than day-to-day firefighting unless the government wakes up to the scale of the staffing crisis facing the NHS." Read full story Source: BBC News, 6 January 2022 -
News Article
How hiring district nurses may reduce pressure in the NHS
Patient Safety Learning posted a news article in News
Is hiring more district nurses the smartest way to tackle the NHS care crisis as overstretched staff claim they are quitting hospitals due to intolerable pressure? District nurses are the unsung backbone of the NHS – going in to people’s homes to perform everything from wound dressings to support at the end of life. Yet what was once a thriving district nurse workforce has, over the past decade, been decimated. An ever-increasing caseload, limited resources and far more complex and challenging health needs have left them burnt out and fed up. As a result, they’re leaving in droves – at a time when we need them more than ever. The number of people dying at home is up by one third since before the pandemic, and those who do make it into hospital for care are discharged faster than ever to free up beds, long before they’ve made a full recovery. Ministers have tabled some ambitious ideas to address the vital need for at-home care, including a wave of new community health hubs, or more video appointments. But none are a quick fix, nor are they proven to solve the problem. Recruiting more district nurses could help alleviate these pressures, say experts, as well as tackling what threatens to be a spiralling crisis in community care. But this might be harder than it sounds. Read full story Source: Mail Online, 13 November 2021 -
News ArticleVacancies for nurses and midwives in Scotland have increased by almost 20% in just three months, new figures show. Official figures revealed that at the end of September the whole time equivalent (WTE) of 5,761.2 posts were unfilled across the NHS – a rise of 18.9% from the WTE total of 4,845.4 that was recorded at the end of June. The rise in vacancies comes at the same time as health service staffing reached a record high, with the NHS employing the equivalent of 154,307.8 full-time workers as of September 30 – 5.2% higher than a year ago. However, opposition leaders warned the health service, which is coming under ongoing pressure as a result of the coronavirus pandemic, is facing a “staffing crisis” this winter. Scottish Labour health spokeswoman and deputy leader Jackie Baillie said: “Across our NHS services are on the brink of collapse, and things will only get worse as the cold weather bites. “This staffing crisis at the heart of this catastrophe has unfolded entirely on Nicola Sturgeon’s watch and will jeopardise the ability of services to remobilise and cope with demand. “Looking at the state of services in Scotland, we can all only hope we don’t get sick this winter.” Read full story Source: The Independent, 8 December 2021
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News Article
Treasury’s dead hand over NHS policy is the biggest patient safety threat
Patient Safety Learning posted a news article in News
Patients are dying in the backs of ambulances or on trolleys in A&E while others languish in beds unable to be discharged due to the collapse in social care. Others waiting in pain are desperate to get a bed for much-needed surgery. While there are many ingredients mixing together to create the current NHS crisis, a widespread shortage of nurses, doctors and other essential staff is one of the major contributory factors. Many in the NHS reacted with disbelief on Tuesday after 280 MPs voted with the government to reject a bid to force through better workforce planning for the NHS. Former health secretary Jeremy Hunt had pulled together a coalition of health organisations and charities who backed his proposal which demanded ministers draw up and publish workforce plans every two years. Mr Hunt’s amendment fell victim to the fear of the cost of actually training enough doctors and nurses to work in the NHS. The Treasury’s dead hand over NHS policy has and continues to be one of the biggest patient safety threats in the UK. As Mr Hunt told MPs, the costs are borne not only from huge bills for locum doctors and nurses who earn incredible pay working alongside exhausted full-time staff, but also in the safety failures caused by staff shortages. Exhausted nurses will make mistakes. One nurse cannot safely look after a ward of 16 elderly patients. A doctor can only see one patient at a time in A&E. Speaking to MPs, Mr Hunt pleaded with the Commons to offer some hope to the NHS workforce. He said NHS staff were “exhausted” but also “daunted” by the challenges they were seeing. He added: “All they ask is one simple request, that they can be confident we are training enough of them for the future.” Read full story Source: The Independent, 23 November 2021 -
News Article
Trust in staffing crisis as eight ICU nurses quit in just two weeks
Patient Safety Learning posted a news article in News
Eight highly skilled intensive care (ICU) nurses have resigned from one trust in the past two weeks and more could follow, a leading nurse has warned. More resignations expected as working conditions remain unsustainable Belfast Health and Social Care Trust in Northern Ireland has confirmed it is redeploying non-specialist nursing staff to fill the gaps in staffing on ICU wards, with experienced ICU nurses expected to provide supervision. RCN Northern Ireland director Rita Devlin said the college has heard others at the trust are ‘considering their position’. "These are highly skilled nurses who are difficult to replace and this is a very worrying situation," she said. "Nursing staff are doing everything they can to keep services going, but it is not sustainable to work under such pressure for long periods of time without a break." The resignations come just months after it was revealed that 182 nurses and 50 healthcare assistants had quit their jobs at the trust between January and July. Read full story Source: Nursing Standard, 23 November 2021 -
News Article
Staffing agencies triple rates as care homes and NHS fight over nurses
Patient Safety Learning posted a news article in News
Nursing shortages are allowing “profiteering” staffing agencies to triple their rates, care leaders have warned, raising the risk of vulnerable patients being forced to move care homes and increasing the burden on the NHS. The crisis is forcing some nursing homes to become standard residential care homes without support for people with chronic diseases. The shortage also makes it harder for NHS hospitals to discharge patients. Some hospitals have redeployed their own staff into nursing homes to free beds in hospitals. In other places, NHS trusts are competing for staff with care providers. Geoff Butcher, director of Blackadder Corporation, which runs six homes in the West Midlands, said that he paid nurses about £19.50 an hour, slightly higher than the NHS rate of £16.52. “Two of our nurses resigned recently and they’ve gone to an agency for £35 an hour,” he said. “And that agency then came to us and said we can have these staff back at £52 an hour. They want £95 an hour for those nurses on a bank holiday nightshift. It’s utterly unaffordable. “Because the NHS can’t recruit they are having to use these agencies as well. So the NHS is bidding against us, therefore they’re pushing the rates up, and the whole thing has gone into a completely crazy spiral. The agencies are just grossly profiteering out of it." Read full story Source: The Guardian, 14 November 2021 -
News Article
Nursing leaders point to ‘untenable’ health and care conditions in England
Patient Safety Learning posted a news article in News
Nursing leaders have highlighted 10 pressures on health and social care services which they say have created “unsustainable, untenable” conditions. A report from the Royal College of Nursing (RCN) said members working across health and social care in England dispute statements that the current situation in health and care is sustainable. NHS hospital waiting times is listed as one of the 10 indicators with the report referring to this issue as “clearly a symptom of an unsustainable system”. The report, 10 Unsustainable Pressures on the Health and Care System in England, refers to “corridor care” – time spent on trolleys in hospital corridors before being admitted to a hospital bed. “We are clear that delivery of care within inadequate environments such as that frequently referred to as ‘corridor care’ or ‘corridor nursing’ is fundamentally unsafe and must not be normalised,” the report says. The 10 pressures also include high COVID-19 infection rates, NHS nursing workforce vacancy rate, social care workforce vacancies and NHS elective/community waiting times. The report says: “Action needs to be taken to retain as many nursing staff as possible in light of serious staffing vacancies, as well as high levels of exhaustion and burnout. Read full story Source: The Guardian, 15 November 2021 -
News Article
Jeremy Hunt warns NHS spending ‘will unravel’ without workforce plan
Patient Safety Learning posted a news article in News
Former health secretary Jeremy Hunt has warned extra funding for the NHS “will unravel quickly” without the extra doctors and nurses needed. The health committee chair said today that the lack of any mention of workforce training budgets in the Chancellor’s speech on Wednesday was “the big gap” in news for the NHS. Before the budget, Mr Hunt, who served as health secretary for six years and who has accepted he did not do enough to increase staffing levels in the NHS, said a workforce plan for the NHS was needed. In the budget documents, released after the Chancellor Rishi Sunak had finished speaking, the Treasury confirmed only that it would continue to fund workforce training and repeated existing promises around 50,000 extra nurses. But many experts including the Health Foundation and think tanks as well as NHS leaders have said what is needed is a properly costed long term workforce plan so that the NHS can train enough staff to meet future patient demand. Read full story Source: The Independent, 28 October 2021 -
News ArticleWhite doctors applying for medical posts in London are six times more likely to be offered a job than black applicants, figures released under the Freedom of Information Act show. The new data also show that white doctors are four times more likely to be successful than Asian candidates or candidates from a mixed ethnic background. The figures were uncovered by Sheila Cunliffe, a senior human resources professional who works in workforce transformation across the NHS and the wider public sector. Cunliffe sent freedom of information requests to all 18 NHS acute trusts in London asking for a breakdown by ethnicity for 2020-21 of the numbers of applicants for medical jobs, shortlisted candidates, and candidates offered positions. Twelve of the 18 trusts shared their full unredacted data with The BMJ on all grades of job applications. Across these 12 trusts, 29% (4675 of 15 853) of white applicants were shortlisted in 2020-21, compared with 13% (2041 of 15 515) of black applicants, 14% (8406 of 59 211) of Asian applicants, and 15% (1620 of 10 860) of applicants of mixed ethnicity. Overall, 7% (1148) of white applicants were offered jobs, compared with 1% (188) of black applicants, 2% (1050) of Asian applicants, and 2% (188) of applicants of mixed ethnicity. Cunliffe said that the findings were just one indicator of the barriers that applicants from ethnic minorities faced. “The racism some of these results point to will be replicated in the day-to-day lived experience of staff working within the trust,” she said. “NHSEI [NHS England and NHS Improvement] need to look at data in a more detailed way and, where needed, set out to trusts their clear expectations and targets for improvement.” Read full story Source: BMJ, 13 October 2021
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News ArticleOverseas-trained nurses have been told they can join the temporary coronavirus register without undertaking a formal “clinical assessment” in an attempt to bolster the NHS workforce as the third covid wave surges. The Nursing and Midwifery Council confirmed on Tuesday that it has invited the additional nurses in a bid to “strengthen workforce capacity in the immediate period and coming weeks”. It comes as the number of covid inpatient admissions rises sharply across the country, with London and the South East of England badly hit. At the start of the pandemic last year, the NMC asked former nurses who had left within the last three years to join the emergency covid register as cases grew. Unison union’s national nursing officer Stuart Tuckwood believed the move will help deal with “severe” staffing shortages, but warned they must be “supported and supervised” by fully registered nurses to ensure patient safety. Read full story (paywalled) Source: HSJ, 6 January 2021
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News Article
Nurse gaps must be considered in NHS winter planning, warns RCN
Patient Safety Learning posted a news article in News
Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned. Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe. “It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available” Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter. Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone. These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted. The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added. Read full story (paywalled) Source: Nursing Times, 9 November 2020 -
News Article
End NHS staff shortages now, Boris Johnson told
Patient Safety Learning posted a news article in News
Doctors, nurses and NHS bosses have pleaded with Boris Johnson to spend billions of pounds to finally end the chronic lack of staff across the health service. The strain of working in a perpetually understaffed service is so great that it risks creating an exodus of frontline personnel, they warn the prime minister in a letter published on Wednesday. They have demanded that the government devise an urgent plan that will significantly increase the size of the workforce of the NHS in England by the time of the next general election in 2024. Their intervention comes after the latest NHS staff survey found that growing numbers of them feel their work is making them sick and that almost two-thirds believe they cannot do their jobs properly because their organisation has too few people. NHS poll shows rising toll of work stress on staff health The letter has been signed by unions and other groups representing most of the NHS’s 1.4 million-strong workforce, including the Royal College of Nursing, British Medical Association and Unison. NHS Providers and the NHS Confederation, which both represent hospital trusts, have also endorsed it, as has the Academy of Medical Royal Colleges, a professional body for the UK’s 240,000 doctors. Read full story Source: The Guardian, 21 April 2021 -
News Article
Maternity units told to meet target staffing levels by next April
Patient Safety Learning posted a news article in News
NHS maternity units have been told they have until next April to increase the numbers of midwives on wards to expected levels after a near £100 million investment. NHS England has told hospitals they must bring staffing levels for midwives up the levels needed to meet their planned demand from mothers and to ensure women get safe care. In a letter to NHS trusts, England’s chief nurse Ruth May said she expected hospitals to use their share of a recent £96 million investment by NHS England to boost staffing levels along with extra spending from local budgets. NHS England has carried out an analysis of demand and supply with Health Education England as part of a four year plan to boost the number of midwives. Hospitals are expected to set the level of midwives needed to deliver more one-to-one care and to try and ensure more than half of women see the same midwife throughout their pregnancy. Read full story Source: The Independent, 13 April 2021 -
News ArticleMaternity services are at risk because demoralised midwives are planning to quit the NHS, healthcare leaders have warned. A new report, carried out by the Institute for Public Policy Research, suggests 8,000 midwives may depart due to the “unprecedented pressure” of the coronavirus pandemic. Researchers, who surveyed about 1,000 healthcare professionals from around the country in mid-February, discovered that two-thirds reported being mentally exhausted once a week or more. Read full story (paywalled) Source: The Independent, 31 March 2021
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News ArticleA quarter of NHS workers are more likely to quit their job than a year ago because they are unhappy about their pay, frustrated by understaffing and exhausted by COVID-19, a survey suggests. The findings have prompted warnings that the health service is facing a potential “deadly exodus” of key personnel just as it tries to restart normal care after the pandemic. A representative poll of 1,006 health professionals across the UK by YouGov for the IPPR thinktank found that the pandemic has left one in four more likely to leave than a year ago. That includes 29% of nurses and midwives, occupations in which the NHS has major shortages. Ministers must initiate a “new deal” for NHS staff that involves a decent pay rise, better benefits, more flexible working and fewer administrative tasks, the IPPR said. “The last 12 months have stretched an already very thin workforce to breaking point. Many are exhausted, frustrated and in need of better support. If the government does not do right by them now, more many leave their jobs,” said Dr Parth Patel, an NHS doctor and IPPR research fellow who co-wrote its new report on how the NHS can retain and recruit more staff. Read full story Source: The Guardian, 30 May 2021
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News Article
Nursing crisis sweeps wards as NHS battles to find recruits
Patient Safety Learning posted a news article in News
Ministers are being warned of a mounting workforce crisis in England’s hospitals as they struggle to recruit staff for tens of thousands of nursing vacancies, with one in five nursing posts on some wards now unfilled. Hospital leaders say the nursing shortfall has been worsened by a collapse in the numbers of recruits from Europe, including Spain and Italy. The most recent NHS figures reveal there are about 39,000 vacancies for registered nurses in England, with one in 10 nursing posts unfilled on acute wards in London and one in five nursing posts empty on mental health wards in the south-east. Thousands of nursing shifts each week cannot be filled because of staff shortages, according to hospital safe staffing reports seen by the Observer. Patricia Marquis, England director for the Royal College of Nursing (RCN), said: “There just aren’t enough staff to deliver the care that is needed, and we now have a nursing workforce crisis. We should never have got into a position where we were so dependent on international nurses. We are on a knife-edge.” Read full story Source: The Guardian, 9 October 2021 -
News ArticleOne in 10 posts for consultant psychiatrists in England are vacant with growing waiting times for people needing mental health treatment, experts have warned. A census of the current situations across England by the Royal College of Psychiatrists has found there is just one psychiatrist for every 12,567 people in England. Health service bosses at NHS England have acknowledged there are an estimated 1.5 million people who are waiting for mental health support amid fears the situation will worsen as the effects of the Covid pandemic become clear. This is on top of the 5.6 million patients waiting for routine operations and treatments for physical illness. The Royal College said there was a shortage of 568 empty consultant posts in the NHS out of a total of 5,367 which it said meant patients would have to wait longer for treatment. In total there are 4,500 full time consultants working in the NHS. The highest rates of unfilled positions are in the fields of addiction, eating disorders and child and adolescent psychiatry. Read full story Source: The Independent, 6 October 2021
