Having more staff is ‘not enough’, the NHS needs to become ‘a better place to work’

Failure to make improvements risks the delivery of the NHS Long Term Plan.

Matt Bodell
3 June 2019
Hospital bed

There are approximately 40,000 nursing and 10,000 medical vacancies in England alone.

As well as growing staff numbers the NHS needs to rapidly become a much better place to work, a new report has warned.

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The Interim NHS People Plan, developed collaboratively with NHS managers, unions, the Academy of Medical Royal Colleges, the Royal College of Nursing (RCN), and the British Medical Association (BMA), argues that, in addition to recruiting extra staff, much more needs to be done to improve staff retention and transform ways of working.

Despite a recent small increase in staff numbers, there are approximately 40,000 nursing, nearly 10,000 medical and 110,000 social care vacancies in England alone.

Recruit, retain, develop and train.

The report sets out what the NHS needs to do in order to recruit and retain enough staff and focuses on three key areas – recruiting more staff; making the NHS a great place to work; and equipping the NHS to meet the challenges of 21st century healthcare.

  • Immediately increase the number of undergraduates studying nursing.
  • Quickly grow the number of nurses and doctors recruited from overseas.
  • Increase the number of nursing associates to 7,500.
  • Offer a career route from healthcare support worker to registered nurse.
  • Increasing the number of placement areas for student nurses and nursing associates.
  • Launch a new campaign, in conjunction with Mumsnet, to inspire more nurses to return to practice.
  • Allow better access to flexible working and career development opportunities.
  • Ensure more support and development for frontline NHS managers.
  • Address concerns over the NHS Pension scheme.
  • Expand the NHS Digital Academy.
  • Doubling the size of the NHS Graduate Trainee scheme.
  • Develop new models of multi-disciplinary working to integrate primary and secondary care.

The report warns that failure to make these improvements risks delivery of the ambitions in the Long Term Plan, given ever increasing and changing patient demand.

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‘Changing the way people work’.

Speaking ahead of the launch, Chair of NHS Improvement Dido Harding said:  “We haven’t waited for this plan to be published. Practical action has already started.  NHS trusts have already identified over 5,500 extra clinical placements for undergraduate nurses, which put us on track to expand nurse undergraduate places by 25% in September.

“The NHS is its people. This plan clearly acknowledges the workforce challenges the service faces. I want frontline NHS staff to know that we have heard their concerns about the pressures they face and we are determined to address them.

“The NHS needs more staff to meet the ambitions for patients set out in the NHS Long Term Plan. But that, on its own, is not enough. We need to change the way people work in the NHS to recognise the changing needs of patients and to create a modern, caring and exciting workplace that should be the best place to work in England.

“This will take time but this interim plan sets out a clear direction of travel and commits to the immediate actions available to us.”

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Additional funding is needed.

But, the Royal College of Nursing’s said they would “reserve final judgement until funding levels and practical details are revealed.”

Patricia Marquis, the RCN’s Director in England, added; “This document begins to tackle the real issues but many will reserve final judgement until funding levels and practical details are revealed.

“The NHS – and the people who use it – deserve a detailed solution to the current crisis, including a new legal framework on accountability for the workforce. When there are 40,000 unfilled nurse jobs in England, we need to see urgency from Ministers.

“To attract the very best professionals into nursing and the NHS, it must be a world class employer that pays fair salaries, pensions and demonstrates the flexibility employees increasingly need and expect.”

The Health Foundation, an independent health thinktank, commented; “NHS leaders are operating with one hand tied behind their backs as decisions on critical issues such as pension reform, investment in training and development and financial support for student nurses are delayed by central government. And restrictive migration policies will only act as a further barrier to addressing the workforce crisis. Without at least 5,000 nurses from abroad each year, NHS staffing shortages will increase.”

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‘Securing the future of our NHS.’

Health and Social Care Secretary, Matt Hancock said: “We are securing the future of our NHS for generations to come with record investment through our Long Term Plan, but there’s no question: we need more staff and a more supportive culture to make that plan a reality.

“The interim people plan is the first step. It sets out plans to train more, hire more, and retain more staff. The NHS will take immediate action over the coming year to lay the foundations to grow a future workforce that can truly deliver the highest-quality care to patients from the cradle to grave.

“We must also make the NHS an employer to be proud of. We want to eradicate blame culture, deliver massively improved mental health provision and provide greater protection from violence and harassment.

“The success of the health service is rooted in the incredible people who dedicate themselves around the clock and we must show our staff the NHS values them as much as they value their patients.”

A full People Plan will follow this interim Plan, translating this national vision into detailed, costed action plans, alongside a detailed implementation plan for the NHS Long Term Plan as a whole.

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