How will workforce challenges change the NHS?

The people who work in the NHS are its greatest asset and are key to delivering high-quality care. As you learned in Week 2, the NHS is the largest employer in England, with 1.4 million people working in the health service. However, the NHS workforce is in crisis with a vicious cycle of shortages and increased pressures on staff, both of which have been made worse by the pandemic.

In order to recruit more nurses, GPs and other health professionals, more staff need to be trained in the UK. The government has re-introduced nursing student bursaries to help with living costs and increased the number of medical school training places. There are some promising signs of increased numbers of people in training, with record numbers of medical and nursing students in 2021. In the government’s 2019 manifesto, one of their key commitments was to have 50,000 more nurses working in the NHS by 2024, by recruiting new nurses and retaining existing staff, and there are also positive signs of progress towards this target with 26,000 extra nurses in the NHS since 2019.

However, these measures alone are not enough: given the time it takes for new staff to be trained, the NHS also needs to recruit staff from outside the UK. NHS England’s post-pandemic recovery plan recognises this and it pledged to recruit 10,000 international nurses by April 2022. To enable international recruitment, the UK’s immigration policy needs to build on the streamlined health and care visa process and arrangements for mutual recognition of qualifications with other countries.

Despite all these positive signs, there are still concerns about staffing levels and the number of vacancies in the NHS. Even though the NHS is currently on course to hit the target of 50,000 more nurses by 2024, this still isn’t having a meaningful impact on the nursing shortage with the vacancy rate showing little change.

Source: The King’s Fund

So far, we have been talking about nurses, midwives and hospital doctors. The picture is different in primary care where there are major difficulties in attracting and retaining GPs. The government has acknowledged that the manifesto pledge to have 6,000 more GPs in England by 2024 is not on track and similarly the NHS target to fund 26,000 additional roles to ease the pressure on general practice is unlikely to be achieved by 2023.

The NHS also needs to ensure that it keeps newly qualified and current staff within the health service. Even before the pandemic, almost 60% of staff who left the NHS did so voluntarily. While this figure includes people taking retirement or the end of contracts, the fastest growing reason that people leave is in order to improve their work–life balance. In the 2022 NHS staff survey, almost 45% of staff have been unwell due to work-related stress. While this number has fallen slightly in the past year, this figure still remains above pre-pandemic levels of work-related stress in the NHS which was 40% in 2019.

The NHS must focus on becoming a more attractive employer by tackling bullying and discrimination, offering more opportunities for flexible working, and creating cultures in which staff want to work and build their careers.

Workforce shortages across both health and social care are putting NHS services under significant strain. These shortages not only affect the staff who deliver care but also the roles required to keep the NHS running, including leaders and managers. These vacancies have a knock-on effect: they increase the pressure on existing NHS staff and lead to high levels of stress, absence and people leaving their roles.