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Staff shortages now outweigh funding fears in NHS

Rising concern over the growing NHS ‘workforce gap’ among trust chairs and chief executives

Louise Prime

Tuesday, 29 November 2016

Many NHS leaders’ concerns about staff shortages now outweigh their fears over funding, according to survey results released this morning. The NHS Providers’ poll found that barely a quarter of trust chairs and chief executives in England feel confident they have the right staff numbers and skills mix to deliver high quality care. The BMA warned that with the NHS desperately needing more doctors, it cannot afford to stop recruiting from overseas as the government has proposed.

NHS Providers has conducted the largest ever survey of NHS trust chairs and chief executives, with 172 responses from 135 hospitals, mental health, community and ambulance trusts. It revealed that just 27% of leaders are confident they have the right staff numbers, quality and skill mix to deliver high quality health care for patients and service users; and only 22% say they are confident about having the right staffing levels in six months’ time. NHS Providers said this means that for many NHS leaders, worries over the workforce gap are now an even bigger and more urgent problem than lack of funding.

The survey showed that:

  • Trusts are struggling with shortages in key specialties and rising pressure on staff. More than half (55%) of chairs and chief executives are “worried” or “very worried” about whether their trust has the right numbers, quality and mix of staff to deliver high quality healthcare. Respondents commented: “This concerns me more than the money” and “Brexit has caused drying up of recruitment from the rest of Europe”.
  • There is much good care being delivered, but also clear evidence of service quality starting to deteriorate; only 10% of trust chairs and chief executives are “confident” or “very confident” they can maintain the level and quality of services over the next six months with the resources available.
  • Trusts are missing nearly all of their key performance targets. Fewer than a third (30%) of trust chairs and chief executives expect performance against these targets to improve over the next six months.
  • Trusts are leading NHS transformation, but fewer than one in 10 trust chairs and chief executives are confident their local area is transforming quickly enough to provide sustainable care and financial balance.

NHS Providers chief executive, Chris Hopson, warned: “We need to listen carefully to frontline leaders when they say that the NHS is now running a much higher level of risk ... Trusts are having to cope with the fallout from a social care system that has reached a tipping point and parts of general practice that are rapidly becoming overwhelmed.”

He pointed out that complex transformation will take time against all the other pressures on the NHS, and called for a clear plan on how to close the gap between NHS funding and what it is being asked to deliver.

BMA council chair Dr Mark Porter commented: “Patients are waiting longer for the appointments and treatment they need. The NHS desperately needs more doctors and cannot afford to stop recruiting from overseas as the government has proposed.” He went on: “It is crucial that sustainability and transformation plans are not just a disguise for further cuts. Any plans about the future of the NHS must be drawn up in an open and transparent way, and have the support and involvement of clinicians, patients and the public from the outset.”

Nuffield Trust chief executive Nigel Edwards added: “In particular, the current combined pressures of increasing patient demand and strained finances are making it very difficult to recruit into areas such as general practice and A&E departments in some parts of the country. Anecdotally, Brexit is making the problem worse.”

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