Staff shortages a 'major obstacle' to NHS financial viability, report finds

A report looking at the financial sustainability of the NHS has concluded that it will be impossible to deliver the long-term plan unless staff shortages across the healthcare sector are addressed.

NHS (Photo: Photofusion/Getty Images)
NHS (Photo: Photofusion/Getty Images)

The BMA says the report by the House of Commons public accounts committee (PAC) highlights ‘the clear reality that the NHS is continuing to struggle badly despite the political rhetoric from politicians’.

This comes as the latest workforce figures from NHS Digital revealed that general practice lost almost 1,000 partners in 2018, while the number fully-qualified full-time equivalent (FTE) GPs, excluding registrars, fell by almost 600 in the same period.

According to the PAC report, there are currently around 100,000 vacancies across the NHS, with staffing shortages considered ‘one of the biggest threats to financial sustainability in the NHS’, with ‘little sign of the shortfall improving’.

Workforce crisis

The report states that, while the NHS did balance its overall budget in 2017/18, the ‘top-level picture’ hides warnings signs that ‘the NHS’s financial health is getting worse’.

Although the long-term funding settlement for the NHS and the NHS long-term plan present ‘an opportunity to bring back stability to the health system’, the PAC concludes that it will be impossible to deliver the plan without first addressing staff shortages.

‘These staffing shortages present a major obstacle to the NHS’s financial viability and we remain concerned about how the NHS can suitably address these workforce shortages,’ the committee writes. ‘Should the NHS continue to lose staff at the current rate, or fail to attract enough employees from overseas, then the situation will rapidly reach crisis point.’

Overseas recruitment

GPonline reported earlier this year that NHS England’s international GP recruitment programme - which offered companies up to £100m to add 2,000 GPs to the NHS workforce by 2020 - had signed up just 34 doctors in three years.

The report continues: ‘The NHS appears to be banking on either drastically improving its retention rate, or attracting more employees from overseas in order to fill the gap. This is a risky strategy. There is no guarantee that enough staff will be recruited from overseas, particularly if working and residency statuses are complicated by the UK’s exit from the European Union.

The committee went on to voice concern that - although the long-term plan ‘recognises that the current number of vacancies is unsustainable’ - the Department of Health and Social Care (DHSC) and NHS England and Improvement had ‘painted an overly positive picture of the future financial sustainability of the NHS’ which ‘underestimated the challenges the NHS faces in delivering its long-term plan’.

Increased resources

BMA council chair Dr Chaand Nagpaul said: 'The health service is facing an ongoing financial struggle that is impacting directly on patient care, with widespread staff shortages that have left a staggering 100,000 vacancies unfilled. Patients are bearing the brunt of this failure, with lengthening waits at hospitals and GP practices, and delays in other forms of treatment...

‘To avoid a disastrous summer crisis, we need Ministers to grasp what is happening on the ground. The promised resource increases in the NHS long-term plan need to move from the realm of promises to that of reality, and crucially we need an explicit workforce strategy to address the shortages that are crippling services.'

The PAC has asked DHSC to ‘write to us by July 2019, setting out how issues with the recruitment and retention of NHS staff will be addressed and reflected in the workforce strategy.

The committee has also called on NHS England and NHS Improvement to set out - by September 2019 - how they will:

  • Help local bodies better understand the demand for services, what is driving that demand and how demand could be better met; 
  • Ensure that a better understanding of how demand is reflected in resource allocation; and
  • Ensure that activity plans of local bodies are realistic and take account of the needs of patients.

An NHS Improvement spokesperson said it was developing a 'people plan' - also known as the workforce implementation plan - which will 'set out how we will deliver a 21st century NHS for our rising and ageing population by growing the number of doctors and nurses'.

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