It goes on and on and on, the roundabout, and there is nothing magic about it. Staff shortages, something that many nurses feel acutely every day, continue to spiral upwards. I hear talk that the UK needs a massive investment in recruitment if we are to avoid a recruitment crisis. The tenses are all wrong here. The UK already has a massive recruitment crisis. It is not waiting for it to happen, it has happened – ask any nurse. We are not ‘going to be’ short of thousands of nurses, GPs, doctors and dentists, we are short of them now. I think some ostrich heads need to come out of the sand.
The National Centre for Social Research (NatCen) undertook its last British Social Attitudes (BSA) survey between 7 September and 30 October 2022. NatCen asked a nationally representative sample (in England, Scotland and Wales) of 3362 people about their satisfaction with the NHS and social care services overall as well as 1187 people regarding their satisfaction with specific NHS services, and also their opinions on NHS funding. The BSA survey is seen as a ‘gold standard’ nationally, one that employs a robust methodology so as to explore public views on a wide range of issues (Morris et al, 2023).
Analysis undertaken by The King's Fund and Nuffield Trust (Morris et al, 2023) reveals that overall public satisfaction with the NHS has fallen to a record low of just 29% amid extreme public frustration associated with long waiting lists for care, lack of government funding and understaffing. In a previous survey, undertaken in 2010, the public expressed the highest level of satisfaction with our NHS ever recorded. Seventy per cent of respondents reported that they were ‘very satisfied’ or ‘quite satisfied’ with the NHS. But in the 2011 findings, satisfaction had fallen by 12 percentage points to 58%.
In England, our health service is currently operating with a deficit of 154 000 full-time staff. It has been estimated, based on current trends, that by 2036 this number could increase to 571 000 and recruitment alone will not fix this problem (Campbell, 2023). This projected vacancy rate equates to a third of the overall healthcare workforce as unfilled jobs. A sustainable and informed plan is urgently required to save our NHS. A robust workforce plan and funding is needed to prevent this car crash that is happening in slow motion. An independent, validated workforce modelling structure is needed, it has to be transparent and the number of vacancies in the NHS have to be published so that progress on workforce can be assessed and monitored.
Record numbers of staff in England leave the NHS every week, with many wanting to restore their work–life balance. This exodus of staff is impacting the quality of care and patients are already receiving poor care as a result of the workforce crisis (Shembavnekar et al, 2022). Staff shortages are damaging from a number of perspectives: patients, nurses, the economy. The public can see the damage caused and the findings of Morris et al (2023) are evidence of this.
Real efforts have to be made to address the major problems with staff retention. Many teams and services are witnessing colleagues leave or retire. This results in a loss of skill, experience and expertise. Conscious retention focuses on a commitment to offer conversations to staff who are leaving to support retention where possible. Although there is no ‘silver bullet’ solution to workforce shortages, there is desperate need for a comprehensive, fully funded and long-term workforce strategy. Retention has to be seen as fundamental, as just as recruitment is. For over 20 years there has been no clear plan to address the staffing crisis and the gaps that have been caused by those leaving the NHS. The UK political system must respond to this untenable ongoing situation.