The NHS is sounding the alarm – will anyone listen?
Every week – often even everyday – a new headline appears in the media relating to significant threats facing the NHS. Maternity scandals, financial troubles, potential industrial action concerning pay-rise disputes, ambulance failures and catastrophic A&E waiting times have all been highlighted over the past few weeks. Indeed, just recently there were headlines stating that the NHS is facing “the greatest workforce crisis” in its history, with the level of vacancies posing a real risk to patient safety. The NHS is clearly in desperate need of urgent intervention but, so far, the government has failed to provide a sense of direction.
Quite simply there are not enough doctors, nurses, surgeons, therapists, scientists, clinical assistants, paramedics or midwives to see the number of patients who need them, to prevent their health deteriorating, sometimes very quickly and fatally. The toll on patients is rising quickly, but the toll on staff is shocking too. Demoralised and overwhelmed, their welfare is under huge strain. The NHS has tens of thousands of vacancies and struggles to retain staff as much as recruit them, but the sad truth is, even if every post was filled, it would still be too little to meet the demand, and still leave the UK with one of the smallest healthcare workforce to population ratio’s in Europe.
Sounding the alarm this time and producing a swathe of headlines, is a report published by the cross-party Commons Health and Social Care Select Committee. Informed by the Nuffield Trust, the report suggests that NHS Digital has grossly underestimated the extent of the staffing crisis, with the Trust asserting that around 50,000 nurses and 12,000 doctors need to be recruited; significantly more than originally predicted.
The report highlights the lack of action by the government – in particular, that it has chosen to delay the already overdue workforce strategy plan until the autumn. The magnitude of the problem is difficult to overstate given that it impacts virtually every aspect of care. Fundamentally though, as the report explains, persistent understaffing means ultimately more costs further down the line as “patients present later with more serious illness.”
Responding to the report, Sir Andrew Goddard, president of the Royal College of Physicians, said:
The report is unequivocal that workforce shortages are having a negative impact on staff wellbeing and development and are creating risks to patient safety. It is clear that there is an urgent need for better workforce planning informed by patient demand, something the RCP has long called for. We agree with the committee that without this many of the challenges facing the NHS will remain unresolved.
Given the sheer scale of the challenges facing the NHS, it is perhaps surprising how little attention the prospective prime ministerial candidates have afforded it during the Conservative Party leadership election. However, with the final two (Rishi Sunak and Liz Truss) set to battle it out until September, the NHS is starting to creep on to the leadership agenda, albeit at a worryingly slow pace.
Sunak promises to make reducing waiting lists (now at a record 6.5 million) his “number one public service priority” if he becomes prime minister and to convene a “vaccine style taskforce” to “cut bureaucracy and waste, and drive radical reforms.” More recently, Sunak announced that he would introduce a £10 fine for patients who repeatedly miss GP or hospital appointments. That said, he has not provided any insight into addressing the workforce crisis and given Truss’s only stated intervention seems to be to scrap the 1.25% social care levy, problems seem unlikely to subside anytime soon.
Given that there have been two Health and Social Care Acts under Conservative governments that were meant to be widely reforming, the promise of reform is unimaginative and irrelevant to how many staff the government have failed to recruit or retain. Bureaucracy bashing makes a good headline but will do very little to rectify the issues facing the NHS today.
For health communicators, this NHS crisis will become all-consuming with little sign of imminent relief. As a result, the primary focus for health communicators must be to forge and maintain local relationships with their communities, patients and staff. Transparency and honesty about the pressures and the efforts to ameliorate these relationships are essential. Mutual local support, respect and understanding are crucial qualities to be nurtured and prized while national policy and the higher taxes that are paying for them become the focus and explanation of dissatisfaction. Locally, heroic efforts at every level of the NHS are happening every day to keep patients and staff safe; let’s not forget that every week millions of people are brilliantly cared for.
But the pressure is now more than skin deep and cutting into the bone. Taxes have gone up to pay to reduce the pressure and waits, and if that outcome fails to appear soon, people will be looking to political leaders for explanations, returning the NHS to the centre of the political battleground as a general election draws closer. That’s never a great environment for great policy development, but any form of an all-out offensive on its principles by opportunistic political actors is likely to be tantamount to political suicide. Throw in doctors and nurses unions preparing for strike action over the ongoing pay dispute, and the government refusing any form of cash injection (meaning any further increase in pay will have to be found from the current budgets) and more waves of Covid, the potential for normality returning to the NHS looks like a distant prospect.
Written by Ed Clements, Account Executive