NHS staffing shortages may hamper delivery of long-term plan

A report by the influential Public Accounts Committee suggests staffing shortages are the biggest challenge facing trusts and “one of the biggest threats to financial stability in the NHS”.

“Staff shortages are a clear threat to the delivery of the NHS Long Term Plan”

Meg Hillier

However, the committee found there was “little sign of the staffing shortfall improving”.

Its progress report on the current state of NHS finances highlights the fact that there are currently around 40,000 vacancies for nurses in the NHS in England.

Trust executives told MPs that the NHS workforce was the “critical enabler to delivering the transformation required” in the long-term plan.

But the committee found the government’s strategy to boost numbers – and the amount of funding available to support this – were as yet unclear.

“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,” said the committee’s report.

“Patients deserve a fully-funded workforce plan, based on the needs of the population”

Donna Kinnair

But it went on to suggest this was a “risky strategy”, especially when it came to relying on a surge in international recruitment.

“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,” said the report.

Meanwhile, uncertainty over funding for key areas including the education and training of nurses and doctors, adult social care, public health, and capital funding for buildings, facilities and equipment was also hampering the NHS’s ability to deliver the long-term plan, said MPs.

Funding announcements are expected in the government’s 2019 spending review in the autumn.

In addition, an NHS workforce implementation plan is currently being developed with an interim document due to be published imminently ahead of a full version to follow the spending review.

“This report rightly points to the ongoing risks of growing workforce challenges”

Saffron Cordery

However, the committee said it needed more information before then and requested an update from the Department of Health and Social Care (DHSC) by July this year “setting out how issues with the recruitment and retention of NHS staff will be addressed and reflected in the workforce strategy”.

“Staff shortages are a clear threat to the delivery of the NHS Long Term Plan and by July we expect to see evidence that government has a plan to address them,” said committee chair Meg Hillier MP.

The update should also clarify assumptions about funding to help services formulate local plans for making the long-term vision for the health service a reality, said the committee.

Other concerns raised by MPs include wide variations in the financial performance of trusts with some continuing to labour under huge debts.

Meanwhile, the committee suggested poorly maintained equipment and facilities were damaging patient care after cash earmarked for capital improvements by the DHSC had instead been diverted to cover shortfalls in revenue funding.

Meg hillier mp

Meg hillier mp

Meg Hillier

It also highlighted a need to improve understanding of the growing demand for NHS services and called for clarity on governance arrangements for new “integrated care systems”, which are supposed to drive forward change.

Ms Hillier said the concerns of frontline professionals had come through “loud and clear” during their inquiry.

“The Department of Health and Social Care and NHS bodies need to heed these voices and act now,” she said.

“If the NHS Long Term Plan is to be more than just an aspiration then government must engage fully with the detail and ensure necessary resources are directed to the right places,” she added.

The Royal College of Nursing stressed the need to investment in the profession and training for future nurses.

“Without a significant investment into nursing, and at least £1bn per year into higher education for nurses, the NHS will struggle to attract and retain the next generation of nurses and the government’s long-term plan will struggle to succeed,” said acting chief executive and general secretary Dame Donna Kinnair.

She said it was important to make it clear who was responsible for ensuring safe staffing levels.

Royal College of Nursing

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Dame Donna Kinnair

“Patients deserve a fully-funded workforce plan, based on the needs of the population,” said Dame Donna.

“To ensure that this is delivered, legal accountability for delivering safe staffing levels across health and social care needs to be built in to the system at the highest levels,” she said.

The organisation NHS Providers said it welcomed the committee’s “frank overview” of the NHS’s financial situation, including the emphasis on workforce.

“This report rightly points to the ongoing risks of growing workforce challenges. We will not achieve this vision while there are still over 100,000 staff vacancies across the NHS,” said deputy chief executive Saffron Cordery.

“We expect the upcoming workforce implementation plan to set out a direction of travel to improve staff retention and tackle these shortages through both overseas recruitment and a commitment to grow the domestic workforce in the longer term,” she added.

Alongside this, she also highlighted the need for “important decisions” about funding for training and other key areas in the forthcoming spending review.