Government slammed over ‘marked reluctance’ to act on workforce shortfalls

by Seamus Ward

25 July 2022

Persistent understaffing and the government’s refusal to carry out detailed workforce planning is threatening attempts to recover the NHS backlog, and poses a serious risk to patient safety, MPs have said.

NR_JeremyHunt LIn a report, the Commons Health and Social Care Committee said the NHS and social care faced ‘the worst workforce crisis in their history, compounded by the absence of a credible government strategy to tackle the situation’. A workforce strategy with short- and long-term workforce projections was promised for spring this year, but this has now been pushed back until the autumn. The publication of any numbers will be subject to ‘cross-government agreement’, the committee added.

MPs said the government has shown a ‘marked reluctance’ to act decisively. There is a shortfall of 12,000 hospital doctors in the NHS in England, together with more than 50,000 nurses and midwives. Its research suggests that an extra 475,000 posts in health and 490,000 jobs in social care will be needed by the early part of the next decade.

Though the government had committed to delivering a further 6,000 GPs, their numbers have fallen by 700. At a hearing before he resigned as health and social care secretary, Sajid Javid told the inquiry that his department was not on track to recruit the additional family doctors.

A separate report from the committee’s expert panel rates the government's progress on hitting its workforce commitments as inadequate.

The MPs singled out several problems that have not been addressed adequately. These include what they call the ‘national scandal’ of NHS pension arrangements, which they said led to senior doctors cutting hours or avoiding extra sessions. Though some progress had been made through the reform of the pension tax taper rate, further changes were needed to avoid early retirement of consultants from the NHS.

A year ago, the committee concluded that 2,000 midwives and 500 obstetricians had to be recruited to maintain maternity safety, but the health department had failed to give a deadline when the shortfall in midwives would be addressed.

Flexible working

The committee made a number of recommendations, including ensuring that all NHS staff have the same flexibilities in their working arrangements as locum or agency staff. Reforms were needed to the health and care visa scheme to meet the needs of care providers, the cap on international medical students should be lifted, while administrative barriers to recruiting international medical graduates should be streamlined.

Newly qualified doctors should be banned from full-time locum work for two years post qualification. And changes in abatement rules were needed as they currently prevent retired nurses working additional hours.

The report also called for all temporary staff to be given access to NHS training, enabling them to increase their skills. A greater skill set would make them available for a wider range of shifts. The committee had been told that if every bank member did one more shift a month, it would add a further 10,000 full-time equivalents into the workforce.

Committee chair Jeremy Hunt (pictured) said: ‘Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it.

‘We now face the greatest workforce crisis in history in the NHS and in social care with still no idea of the number of additional doctors, nurses and other professionals we actually need. NHS professionals know there is no silver bullet to solve this problem, but we should at least be giving them comfort that a plan is in place. This must be a top priority for the new prime minister.’

Miriam Deakin, NHS Providers interim deputy chief executive, said the report again highlighted the shortfall in staff faced by health and social care.

‘Many staff face unsustainable workloads and burnout as they strive to bring down waiting lists and treat patients as quickly as possible in the face of ever-growing demand,’ she said.

‘The government’s failure to fully fund this year’s pay package will make it even harder to recruit and keep the health workers we so desperately need. And unless we fix our underfunded and stressed social care sector, inextricably linked with the NHS, we will continue to struggle with major knock-on effects for health services.

‘The answer is staring everyone in the face: the government must come up with a fully-funded, long-term workforce plan for the NHS.’