Opinion

Getting serious about staffing

07 November 2018

James Lazou, research officer at Unite, considers the prospect of a long-term NHS workforce plan.

NHS Workers iStock

The NHS in England has finally started to look at long-term planning of its workforce. At least, that’s the theory. First, Health Education England published its workforce strategy, Facing the facts, shaping the future, and more recently NHS England has set about consulting on developing a long-term plan for the NHS.

Such moves are welcome, but the proof will be in whether any concrete outcomes will be delivered.

The NHS is facing a staffing crisis. Long-term demographic pressures have been compounded by a combination of wasteful reorganisations and the worst financial settlement in NHS history. The public sector pay cap, the abolition of bursaries, and Brexit have all made this worse. The government must take ownership of the mess that the NHS is now in.  

Recruitment crisis

The NHS is struggling to recruit and retain staff. We regularly hear of cases where staff have faced increased workloads and staff shortages, which have been plugged with underqualified or down-banded staff.

On page 36, Unite lead professional officer Dave Munday looks at the state of health visiting and the rapid decline since 2015 in health visitor numbers. Other professions such as school and mental health nursing face similar challenges.

Throughout this period, Unite made it clear that these policies were doing considerable damage. It is without any pleasure that we now face the crisis that we predicted.

So what needs to be done?

The NHS needs long-term investment to reverse much of the damage. It needs funding for training. NHS bursaries need to be reintroduced and there must be legislation on safe staffing levels and regulation to prevent de-professionalisation of NHS roles.

There must be further clarity on NHS pensions, long-term increases to pay and protection for NHS terms and conditions. Those staff that have been outsourced must be brought back in-house, and their pay and conditions brought back in line with NHS standards.

A workforce strategy must also tackle the serious impact of the UK leaving the EU and protect European workers who are now caught in the middle.

Many of the pressures on the NHS result from wider failures in public policy – issues such as poor housing and insecure work drive health concerns such as stress and mental ill health. To improve the NHS, we need to improve public services. Prevention is better than cure, and improved public health policy must be at the core of this.

That sounds like a long shopping list but remember, sensible investment in health increases the money available to spend. WHO research (2017) shows that spending on health generates a two- to four-fold return of positive economic growth per unit spent. In other words, health spending creates a virtuous circle – more healthy people, less demand for costly acute services and more money in the public coffers. Let’s hope those working on the long-term plan are listening. 

  

Infographic - Workforce Strategy is needed

Image Credit | iStock

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