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Staff burnout could derail the NHS’s drive for efficiency

Think tank says health service must reconnect with staff

Jo Carlowe

Tuesday, 02 June 2015

Staff burnout could derail the NHS efficiency drive and its move to a seven-day service.

This is the message from The Nuffield Trust, which in a new briefing, published today, warns that plans for an unprecedented £22 billion in savings and seven day working by 2020 will not be realised unless the health service reconnects with staff and develops their skills to better meet changing patient needs. 

The think tank’s report highlights the growing trend of hospitals relying on agency staff, problems recruiting and retaining GPs and a rise in staff sick leave due to stress. 

The Nuffield Trust argues that these factors, together with the continued effects of holding down staff pay, suggest that disengagement and burnout could hamper progress at a time of immense pressure on the NHS. 

Nuffield Trust Chief Executive Nigel Edwards said: “The NHS needs to hit very ambitious efficiency targets, at the same time as fundamentally changing the way care is delivered and moving to a seven day service. That can only be done if it has the right staff in the right places. Yet there are not enough staff to fill gaps in key areas, and we are seeing clear signs of stress and disengagement.

“Already, the health service has been thrown off course by the massive bill for agency staffing because it can’t get enough permanent nurses to join hospital trusts. Solving these problems doesn’t just mean pledging more doctors and nurses. We need to use those we have more intelligently, so that they’re more ready to deal with the growing number of older people with very complicated health issues.”

The briefing outlines ten priorities for the government on health and social care, making the case that the NHS’s Five Year Forward View plan, centred on combining GPs with specialists, is the right approach. It also argues that the government needs to bring in its pledged £8 billion funding increase at a steady pace, rather than holding it back to the end of the parliament. And it describes the focus on the four hour A&E target at the expense of other goals as "distorting hospital priorities and wasting time". 

Commenting, The Royal College of Emergency Medicine, says it disagrees that the four hour A&E target should be scrapped. 

Dr Clifford Mann, President of the College said: “The four hour standard is as relevant today as it was 10 years ago. It has been, and remains one of the most effective targets in any health care system. Front line doctors and nurses would regard any attempt to relegate the standard as misguided and harmful.” 

Last year, The Council of the College voted unanimously to maintain support for the four hour standard.  The College argues that the four hour standard is the only “metric currently able to hold providers and commissioners to account”, and says such a move would be associated with “a rapid and entirely predictable decline in performance as occurred when the standard was revised from 98% to 95% in 2010.”

* Health and social care priorities for the Government: 2015–2020. Policy Briefing. Nuffield Trust, June 2015.

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