The NHS is necessarily labour intensive, and having a fully trained workforce with the right skills, in the right place, at the right time, is fundamental to the efficient and effective provision of healthcare.

In 2016 the Health Foundation produced a report, Staffing Matters; Funding Counts, (available here), which raised concerns that staffing shortages were compromising the ability of the NHS in England to deliver services.  One year on, the situation appears to have worsened according to the latest report from The Health Foundation – Rising pressure – the NHS workforce challenge.

This report revisits the workforce pressures facing the NHS, focussing particularly on two areas; the impact of the removal of the NHS nursing bursary, and staff retention.  Their analysis highlights a drop in the number of trainee nurses coupled with high staff turnover and workforce instability.  This leads the report to conclude that current NHS workforce planning and policy for England is not fit for purpose.

The analysis highlights the following key concerns:

  • Although the NHS workforce increased by 2% in the financial year 2016/17, it was not a uniform increase – Managers and Consultant numbers rose, but the number of full time equivalent (FTE) nurses (0.2% decrease) and FTE GPs (0.7% decrease from December 2016 – June 2017) fell.
  • This decrease in nursing numbers has been compounded by an increase in hospital admissions and a fall in the number of Community Nurses and Health Visitors. This could potentially undermine progress made since the Francis Report and impact on the success of the Five Year Forward View.
  • There are concerns that the government promise of 21,000 new mental health posts by 2020 is not achievable, or can only be achieved through employing staff without the necessary skill mix.
  • A recent HEE report showing that 11% of nursing posts in mental health are vacant
  • 2017 saw a fall of 1,220 students starting undergraduate nursing degrees in England with a sharp decline in the number of older students. (The number of 18-19 year olds increased)
  • In the first 6 months of 2017 only 38 GPs were recruited from overseas against a Government target of 2000 over the next 3 years

The report concludes that there needs to be a cohesive and proactive approach taken to workforce planning and policy making.  At present there appears to be a disconnect between identifying workforce needs and funding decisions, with the report quoting many examples of this, such as the announcement of 1,500 additional medical student places without full consideration of the overall impact on training budgets or future staff costs and mix .

To read the full report from the Health Foundation please click here