NHS England already facing a staffing crisis, but it will accelerate in the next five years unless urgent action is taken to “a vicious cycle of growing shortages and declining quality”, says a new report.
It’s already well-established that the NHS is operating with a shortfall in GPs and nurses, but the analysis by think tanks the Nuffield Trust, Health Foundation and King’s Fund says that without an extra £900m spent on training the situation will get much worse.
It predicts that the nurse shortage will triple from around 30,000 at present to 108,000 in the next 10 years, and is calling for 5,000 more nurses to start training each year by 2021, although that will only tackle half the deficiency. Measures also need to be taken to reduce the drop-out rate from the profession and to encourage newly-qualified nurses to join the NHS.
Similarly, there are around 3,000 vacant GP positions at the moment, and that is expected to swell to 7,000 in five years and 11,000. The report says government efforts to encourage the number of GPs in training will not tackle the issue.
Among the recommendations – which are extensive – is the introduction of a £5,200 grant for living expenses to nurses in training, and covering the costs of tuition fees to help triple the number of nurses training as postgraduates.
Around 5,000 nurses would still need to be recruited from abroad each year, but that is three times the current number and is under serious threat from Brexit and a global shortage in nurse numbers, say the think tanks.
One of the big problems is the proposed £30,000 minimum salary for migrants posited in a government white paper last year, and the report recommends that “wide exceptions” be made to that for NHS workers, while visa costs incurred by NHS trusts for migrant workers should be refunded.
The only solution for the GP shortages will be to develop multidisciplinary teams drawing on the skills of other health care professionals such as pharmacists and physiotherapists, and to create a “regulated profession of physician associates” to take the pressure of doctors. That is also a major undertaking however and will requires, for example, the recruitment of 6,000 physiotherapists.
Other recommendations are for £250m of the proposed £900m to be spent on developing workforce skills, initiatives to close gender and ethnic pay gaps in the NHS, and encouraging staff retention for example by letting those near retirement age transition to part-time work.
“The workforce is the make or break issue for the health service and unless staffing shortages are substantially reduced the recent NHS long-term plan can only be a wish list,” says Anita Charlesworth (pictured below), director of research and economics at the Health Foundation.
“If the NHS is to have access to the skilled health workers it needs, the government must stop seeing funding for the workforce as a cost to be minimised and prioritise investment in training more staff.”