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News Article
NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn
Patient Safety Learning posted a news article in News
The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023 -
News ArticleNHS trusts in England have increased recruitment from low-income “red list” countries to make up for the post-Brexit loss of EU staff, despite a code of practice to safeguard health services in those developing countries. A report by the Nuffield Trust thinktank also identified shortages in vital specialist areas since Brexit, including dentistry, cardiothoracic surgery and anaesthesiology. It found that Brexit is still causing issues with the supply of medicines in Northern Ireland despite a change in the arrangements put in place by the EU last April. The report says that since 2021, the Northern Ireland protocol obliging EU trade rules to be followed in the region has led to a different set of medicines being available compared with the rest of the UK. Of the 597 products specifically approved by the Medicines and Healthcare products Regulatory Agency since Brexit, “only eight were also approved for Northern Ireland under the same name and company”. It also found that since 2021, 52 products had been granted marketing authorisation for Northern Ireland but not in Great Britain under the EU approvals system, including a painkiller from the Slovenian company Sandoz Farmacevtska Druzba designed to stop people dying from opiate overdoses. The Democratic Unionist Party (DUP) described the report as “deeply alarming”. Read full story Source: The Guardian, 7 January 2023
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News Article
Hospitals in England pay £5,200 for one agency doctor's shift
Patient Safety Learning posted a news article in News
Hospitals in England have paid out as much as £5,200 for a shift by a doctor through an agency, according to figures obtained by Labour through Freedom of Information requests. That is the latest in an intensifying debate over workforce shortages in the NHS in England. Labour blamed the high agency fees on Conservatives, arguing they had failed to train enough doctors and nurses. A Conservative spokesperson said "record numbers" had been recruited. The most expensive reported shift was £5,234 - paid by a trust in northern England. This covers the agency fee and other employer costs as well as the money going to the doctor. The NHS Confederation said the "staffing crisis" was so "desperate" that NHS trusts were being forced to pay large fees to make sure rotas were "staffed safely". Matthew Taylor, chief executive of the NHS Confederation, said: "Trusts are having to breach the caps on how much they pay for agency doctors because of the extremely high levels of demand they are facing for their services. "The staffing crisis is so desperate that they either pay these fees or find that their rotas cannot be staffed safely, leading to reduced services for patients. This is particularly true in parts of the country where the NHS can struggle to recruit new staff." Read full story Source: BBC News, 12 December 2022 -
News Article
NHS productivity lags as recruitment fails to keep pace with demand
Patient Safety Learning posted a news article in News
The NHS in England faces an uphill struggle to improve productivity as it confronts record waiting lists, with data suggesting that an increase in staff numbers alone will not transform its performance. Creaking infrastructure, a sicker population and a reliance on less experienced staff are hampering the health service’s attempts to treat people in greater numbers than before the pandemic, according to health experts. This difficult context is casting a shadow over the government’s goal that hospital waiting lists should be falling by the next election. Read full story (paywalled) Source: Financial Times, 1 June 2023 -
News Article
NHSE expands overseas recruitment drive
Patient Safety Learning posted a news article in News
NHS England has expanded its drive to increase overseas recruitment, introducing funding for trusts to hire more types of health professionals from abroad. Employers are now able to use national NHS England funding to recruit physiotherapists, therapeutic radiographers and operating department practitioners from overseas. Until now, within allied health professionals, the scheme has only covered diagnostic radiographers, occupational therapists and podiatrists. None of the professions are on the government’s shortage occupation list. NHSE said it decided to expand the AHP scheme to more staff groups where it had decided there were NHS shortages, and others where it had identified there was global availability of staff. For example, it said other groups such as prosthetics professionals still could not be recruited from abroad as there is limited international supply. Read full story (paywalled) Source: HSJ, 30 May 2023 -
News Article
NHS England workforce plan delayed amid rumours of cost issues
Patient Safety Learning posted a news article in News
NHS leaders have raised concerns about the delay to the long-awaited workforce plan, after the health secretary, Steve Barclay, refused to give a deadline for its publication and with rumours suggesting it is considered too costly. The plan, which was expected to be published on Tuesday, appears to have been delayed, according to the deputy chief executive of NHS Providers, Saffron Cordery. Barclay blamed the pandemic and “various things that have been happening in recent years” for the delay during broadcast interviews over the weekend. He had previously promised that the plan to increase the number of doctors and nurses would be published before the next general election. Cordery said the plan, which aims to fix the UK’s crumbling healthcare system by plugging chronic staff shortages but which has already been postponed from last year, was needed “as quickly as possible”. Until this weekend NHS Providers – which represents all England’s hospital, ambulance, community and mental health trusts – had believed publication of the plan was “imminent”. Cordery suggested that the failure to release it could be linked to the need for funding. Read full story Source: The Guardian, 29 May 2023 -
News ArticleBritain’s reliance on foreign nurses has reached “unsustainable” levels, the government has been warned as new analysis reveals that international recruits has accounted for two thirds of the rise in numbers since 2019. Ministers have repeatedly promised to boost the domestic supply of health staff amid warnings that reliance on international workers leaves the NHS at the mercy of global labour markets. Overall, a fifth of the UK’s nursing, midwifery and nursing associate workforce originally trained overseas. The figures will reignite concerns that nations such as the Philippines, traditionally a key source for the NHS, are being increasingly targeted by countries including Germany and Canada. Senior NHS leaders fear the health service could be left in a precarious position if increased competition results in nurses choosing alternative destinations, resulting in a shortfall for the UK. The health service in England already has one post in ten vacant. Read full story (paywalled) Source: The Times, 18 May 2023
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News Article
Ministers told to set out plan for hiring mental health nurses in England
Patient Safety Learning posted a news article in News
UK ministers must set out how to recruit and retain thousands more mental health nurses to plug the profession’s biggest staff shortage, healthcare leaders are warning. Mental health nurses account for nearly a third of all nursing vacancies across England, resulting in overstretched services that are struggling to deliver timely care, according to research carried out by the NHS Confederation’s mental health network. Sean Duggan, the network’s chief executive, said: “Mental health leaders and their teams are pulling out all the stops in what are very constrained circumstances, but they cannot be expected to solve this staffing crisis alone. “The knock-on effect means that the mental health crisis the nation is facing will in turn become a crisis for the whole healthcare system and the country. This relentless pressure on mental health staff cannot be allowed to continue with the ultimate impact being on the patients who most need that care.” Read full story Source: The Guardian, 16 May 2023 -
News Article
Discrimination ‘biggest cause of staff leaving’
Patient Safety Learning posted a news article in News
Discrimination and inequality are bigger factors for staff wanting to leave acute trusts than burnout, new analysis of this year’s NHS staff survey has found. Researchers at LCP compared 12 summary indicators within the survey to answers on intention to leave, to build a “relative importance model” to explain “nearly 85% of the variation in intention to leave”. LCP said: “Approximately 30 per cent of that explained variance is attributable to the diversity and equality score (compared to less than 10 per cent attributable to the burnout summary indicator score).” Natalie Tikhonovsky, an analyst in LCP’s Health Analytics team, said: “Our analysis reveals a grim picture of low satisfaction levels and higher staff turnover rates currently facing the NHS acute sector. Understanding what is driving this will be key to the success of the government’s new workforce plan and to the overall aim of reducing steadily increasing wait lists.” Read full story (paywalled) Source: HSJ, 28 April 2023 -
News ArticleA leading surgeon says a major drop-out rate of trainee doctors is "an accident waiting to happen" for the NHS. Nigel Mercer was tasked with prioritising surgery across the NHS during the pandemic when services were under intense pressure. His biggest fear with what he sees as an up to 40% drop-out rate is whether there will be enough doctors to replace his generation of medics. The government said the majority of trainees go on to work in the NHS. "[But] at the moment everyone is so fed up with the system," Mr Mercer said Concerns over pay and conditions are leading many trainees to consider moving to other countries, he said. "You can get much more pay over in Australia and New Zealand and we reckon it's now 40% of medical graduates who are going to leave after their training and that's criminal," he continued. "That's an accident waiting to happen, but if we don't produce high-quality paramedical staff there won't be the ability to train anybody. Read full story Source: BBC News, 12 April 2023
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News ArticleThe NHS in England needs a massive injection of homegrown doctors, nurses, GPs and dentists to avert a recruitment crisis that could leave it short of 571,000 staff, according to an internal document seen by the Guardian. A long-awaited workforce plan produced by NHS England says the health service is already operating with 154,000 fewer full-time staff than it needs, and that number could balloon to 571,000 staff by 2036 on current trends. The 107-page blueprint, which is being examined by ministers, sets out detailed proposals to end the understaffing that has plagued the health service for years. It says that without radical action, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years. However, the Guardian understands that the chancellor, Jeremy Hunt, is playing a key role in behind-the-scenes moves by the Treasury to water down NHS England’s proposals to double the number of doctors that the UK trains and increase the number of new nurses trained every year by 77% – because it would cost several billion pounds to do that. A senior NHS leader said: “Jeremy Hunt has been very resistant to the numbers in the workforce plan. The Treasury and Hunt don’t want numbers in it. They want it to be not very precise. They want the numbers to be projected in a different way that would be less expensive and to not commit to training specific numbers of doctors, nurses and others. “While intellectually Hunt gets it, and emotionally he gets the patient safety argument, it seems that his priority, if the government has any financial headroom, is to use that for tax cuts or giving the army more money rather than training more doctors, nurses and speech and language therapists. Read full story Source: The Guardian, 26 March 2023
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Content ArticleNHS trusts have often reported emergency department doctors having low levels of satisfaction and high rates of burnout, leading to a high turnover. In 2017, Brighton and Sussex University Hospitals (BSUH) and Western Sussex Hospitals merged to form University Hospitals Sussex NHS Foundation Trust. The Trust found that the organisation of shifts at Royal Sussex County Hospital (RSCH) and Princess Royal Hospital (PRH) and lack of flexibility were adding to the strain already felt by doctors working in the high pressure emergency department. To combat the pressure consultants and other doctors were under, the Trust implemented a system to help improve rota design and flexible working. The hope was that the system would help the trust retain and recruit staff, whilst saving locum costs and improving patient care.
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Content ArticleYou can now watch the recording of the Nuffield Trust event: 'Does the rush for new types NHS staff have a dark side?'
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Content ArticleIn this article, HSJ's Annabelle Collins reflects on the increasing number of NHS staff quitting their jobs and the risk to patient safety of 'corridor care'.
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Content ArticleThe brief focuses on the nursing workforce at a time when a global pandemic is raging across the world. The year just ended—2021— has seen unprecedented damage inflicted on health systems and on the nursing workforce. The year just begun—2022— marks no change in the continuing relentless pressure of the pandemic on individual nurses, and on the global nursing workforce. This brief was commissioned by the International Centre for Nurse Migration (ICNM). It provides a global snapshot assessment of how the COVID-19 pandemic is impacting on the nursing workforce, with a specific focus on how changing patterns of nurse supply and mobility will challenge the sustainability of the global nursing workforce. It also sets out the urgent action agenda and global workforce plan for 2022 and beyond which is required to support nurse workforce sustainability, and therefore improve health system responsiveness and resilience in the face of COVID-19.
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Content ArticleThis report from the International Council of Nurses is intended to give an overview of the continuing challenges faced by nurses, highlight the potential medium- to long-term impacts on the nursing workforce, and inform policy responses that need to be taken to retain and strengthen the nursing workforce.
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Content ArticleHow have the numbers of doctors in the NHS who come from the EU and the European Free Trade Association changed since the Brexit referendum in 2016? And do certain specialties face particular problems? Martha McCarey and Mark Dayan take a closer look at what’s happened since the vote.
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Content ArticleThe King’s Fund and Engage Britain commissioned Bill Morgan, a former Conservative special adviser, to explore what can get in the way of ministers taking meaningful, long-term action to address NHS workforce shortages. In this report, he focuses on the role of politicians in workforce planning and delivery. The report sets out the scale of the workforce crisis and the impact that it has. It also considers the political reasons around why it has been so hard to fix and considers three factors that could contribute to tackling the current shortages: Transparency in workforce forecasts The establishment of an independent workforce-planning organisation Accepting the NHS’s historical reliance on recruitment from outside the UK as explicit future policy and planning accordingly
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Content ArticleThe workforce crisis engulfing the health and care system is well documented. In the NHS, increases in staff numbers are not keeping pace with demand for staff and services; in 2021/22, for the first time, the number of people working in adult social care in England fell, and there are now 165,000 vacancies. In this long read, Sally Warren, Director of Policy at The King's Fund, looks at a report by Bill Morgan, commissioned by The King's Fund and Engage Britain, to consider why politicians have failed to act, where only they can, to deliver the workforce that the health and care system needs. The article covers the following areas: Transparency in workforce planning assumptions Training and international recruitment Retention: it’s not just about pay More than a numbers game, getting the culture and leadership right Productivity and skill mix Action at all levels Service improvement ambitions matched to the available workforce
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Content ArticleThe General Medical Council (GMC) commissioned this research to understand the decision-making processes of doctors leaving the UK workforce to practise medicine overseas. This research built on previous work by exploring migration ‘decision journeys’ and the practical steps and considerations involved at each stage of the process.
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News Article
NHS Scotland in a perilous situation, says doctors' union
Patient Safety Learning posted a news article in News
Scotland's NHS is in "a perilous situation" amid a staffing and funding crisis, according to the chairman of the doctors' union. Dr Iain Kennedy said urgent action was needed to tackle workload pressures ahead of a potentially "terrifying" winter period. It comes after Scotland's health secretary Humza Yousaf admitted NHS Scotland was not performing well. Mr Yousaf told BBC Scotland it would take at least five years to fix. Dr Kennedy, who is chairman of the industry body BMA Scotland, said it was good to hear Mr Yousaf being honest about the scale of the problems, but added that "frankly we cannot wait five years" for things to improve. He told BBC Radio's Good Morning Scotland programme: "The NHS in Scotland is in a perilous situation and we have a particular crisis around the workforce - we simply do not have enough doctors in general practice and in hospitals. "We need more urgent action because the pressures and the workload have really shot up." Dr Kennedy has called on the government to publish a "heat map" showing where NHS vacancies are unfilled across Scotland. He said: "The public need to see transparency on where the vacancies are. We think that there are probably 15% vacancies across hospital consultant posts across Scotland. "Even the government admits to 7% and that we are at least 800 GPs short in Scotland - and I, and others, suspect we are probably well over that figure now." Read full story Source: BBC News, 31 October 2022 -
News Article
Nurses are working the equivalent of one day a week for nothing, research says
Patient Safety Learning posted a news article in News
Nurses are working the equivalent of one day a week for nothing, according to a study. Researchers from London Economics were commissioned by the Royal College of Nursing (RCN) to look at pay in England, Wales, Scotland and Northern Ireland since 2010. They found that the salary of an experienced nurse had fallen by 20% in real terms, based on a five-day week. Experienced nurses in England, Wales, and Northern Ireland would need a nominal pay rise of 45% by 2024-25 just to return their salaries to levels seen in 2010-11 in real terms, the research said. And such a pay rise would actually help the NHS save money in the long term, as it would be cheaper than hiring staff from overseas, according to the study. Dr Gavan Conlon, who oversaw the research, said that bringing staff in from overseas costs approximately £16,900 more annually than retaining a nurse, while using agency workers costs around £21,300 more per year. He said that about 32,000 nurses leave the NHS every year, many due to the failure of their pay to keep up with the rising cost of living. The RCN is balloting its 300,000 members for strike action, calling for higher pay and an effort by government to fill the hundreds of thousands of nursing vacancies across the country. Read full story Source: Sky News, 28 October 2022 -
News ArticleThe NHS is launching an effort to recruit tens of thousands of nurses to help fill the record number of vacancies that low pay, Covid and heavy workloads have created across the service. A multimedia blitz will try to raise nursing’s profile as a worthwhile career by featuring patients who benefited from nurses’ skills and dedication. NHS England’s “We are the NHS” campaign will use radio, social media and cinema advertisements to portray nursing as a varied and fulfilling role that can change people’s lives. It comes soon after NHS figures showed that the number of empty posts in nursing across hospitals, mental health, community care and other services had reached 46,828 – the largest number ever. That means that more than one in 10 nursing roles (11.8%) are unfilled across the service overall. While the NHS is short of almost every type of staff, service chiefs say the acute lack of nurses is a key reason why so many patients are waiting so long for A&E, cancer treatment and other care. Read full story Source: The Guardian, 24 October 2022
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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 -
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
