The Prime Minister’s most recent coronavirus briefing on April 5th confirmed what many had been hopeful of hearing; that the UK was on track to meet all the criteria needed to progress onto the next state of the ‘roadmap out of lockdown’ plan, promising a slow easing of civil restrictions and an ultimate end to social distancing. This news has come as a blessing to many who’ve spent the best part of 2020 shielding or avoiding socialising with loved ones, and it comes by proxy of data confirming that hospital admission rates are steadily dropping in line with hopes and expectations.
But, before we begin to think retrospectively about the events of the past year, it is worth pausing to consider how the National Healthcare Service has been able to respond to the pandemic so effectively, and how we as a nation can ensure that this is not forgotten as we move into a ‘new normal’.
The NHS’ response to the pandemic
While the NHS, and those who work in it, have been the subject of resounding praise within much of the political and public discourse surrounding the UK’s handling of the Covid-19 pandemic, gaps in Governmental support prior to the outbreak of the virus in February 2020 meant that doctors, nurses and healthcare workers had to fight much harder to cope with the strain being placed on them. Boris Johnson’s winning election campaign, in which he famously promised to build “40 new hospitals” in the UK had begun to look shaky well before the pandemic took a grip of the UK. NHS Providers said only a fraction of the amount of money needed had been allocated to the project, and the Cabinet scaled the figure down from 40 to just six following Johnson’s election.
Prior to these promises, and the subsequent praise doctors, nurses and other staff members have received from the UK government in the wake of the pandemic, the NHS had been subject to severe labour shortages, which meant added pressures on existing healthcare professionals and hospitals even before the outbreak of the Coronavirus in February 2020.
Ongoing skills shortages
Doctors, nurses and paramedics (as well as several other medical specialists) are all listed on the Shortage Occupation List (SOL).
The SOL functions as a national resource, indicating a range of roles across the UK which are suffering from a ‘skills shortage’; in other words, the roles which cannot be filled with ‘domestic talent’ alone. Prior to the UK’s recent departure of the EU, ‘domestic talent’ included the full EEA labour pool. Now, this has shrunk to include British citizens and settled persons only.
Of the many medical roles included on the SOL, General Practitioners and Nurses are the most frequently cited. The PM’s election campaign promised to free up “50 million” more GP appointments and hire an additional 6,000 GPs in 2020. However, neither of these promises have come to fruition — with the immediate public health concerns brought about by the Covid-19 pandemic overshadowing other medical recruitment or retention drives. As such, doctor vacancies nationwide currently sit at 11,500 and the patient-to-GP ratio is the worst it has been in more than 50 years.
Similarly, the Party also promised an additional 50,000 more nurses during the lead-up to the General Election, a figure which was — again — changed to 31,000 in the following weeks. Although some progress was made in this area, The Health Foundation reported this December that 1 in 10 nurse positions were still vacant during the UK’s second wave of the pandemic.
The support of migrants
Ever since the Windrush generation were invited to the UK to help take on healthcare worker roles after WWII, international talent has helped to support and build the UK’s healthcare system.
Today, overseas nationals make up just over 13% of England’s NHS workforce, including those from outside and inside the EU. With both the nursing and doctor workforces still experiencing a huge shortfall, this talent was hugely important in helping to support the UK population during every wave of the Coronavirus last year. In fact, the PM himself personally named and thanked two international nurses who cared for him during his time in ICU with the virus, one originally from Portugal and another from New Zealand.
Just as during any other national crisis, non-British nationals have been at the forefront and working behind the scenes to help support and care for the British public and keep the NHS afloat during the height of the pandemic, despite a disproportionate number losing their lives as a result.
Going forward
The recruitment and retention of international General Practitioners and nurses, as well as other skilled healthcare professionals, in the NHS is of major importance going forward.
Despite many people’s understandable relief over the easing of civil restrictions, recovering from the events of the last year will take time and effort. We must not forget that the NHS is still drastically overburdened, with GPs and hospitals still under an immense amount of pressure to fight the direct and indirect results of the pandemic.
What’s more, there are also the long term implications of the UK’s departure from the EU to consider; in terms of labour shortages, Brexit has major implications. With the ‘domestic talent’ pool shrinking dramatically due to the immediate loss of new EEA jobseekers, the need for international doctors, nurses and other healthcare professionals will be even greater as we move into the future.
The Government has begun to make provisions designed to encourage all overseas nationals to take on roles in the UK’s NHS, including scrapping the NHS health surcharge for public healthcare workers and introducing a specially-designed ‘NHS visa’ to help grant easier access to healthcare roles. But these are small changes and much more needs to be done to acknowledge the strain the NHS and the people who work in it have been placed under during the unprecedented events of the last year. Policymakers will need to make further provisions to address this as we move into the next phase of restrictions-easing, and closer towards the ‘new normal’ many people are envisioning.
Dr Pooja Arora is a GP and the Chair of Arora Medical Education.