As the government prepares to publish a long-term plan for the health service, the Nuffield Trust, King’s Fund and Health Foundation identified a current shortfall of more than 100,000 staff across NHS trusts.
They estimate that the gap between the number of staff needed and the number available could reach almost 250,000 by 2030. If the emerging trend of staff leaving the workforce early continues and the pipeline of newly trained staff and international recruits does not rise sufficiently, this number could be more than 350,000 by 2030, the think-tanks added.
The blueprint for how the NHS will spend an additional £20.5bn a year by 2023-4, expected to be published within weeks, must be clearly linked to a strategy to address the workforce crisis, otherwise it will simply be a wish list rather than a credible path to a sustainable future for the health service.
They are clear about the probable impact on patients of continuing shortages: Growing waiting lists, deteriorating care quality and the risk that some of the £20.5bn secured for NHS frontline services will go unspent.
Candace Imison, director of policy at the Nuffield Trust, said the NHS, which employs 1.2m staff, had a woeful track record in ensuring that the health service has the right numbers of staff it needs in all the right places. Unless the NHS plan put in place urgent and credible measures to shore up the workforce in the short and longer term it risked being a major failure, she cautioned.
The researchers cite a range of reasons for the shortages, including the fragmentation of responsibility for workforce issues at a national level; poor workforce planning; cuts in funding for training places; worryingly high numbers of doctors and nurses quitting before retirement age; and the effect of immigration policies worsened by Brexit.
Britain’s departure from the EU had created additional risks in both the short and medium term, they warned. Between July 2017 and July 2018, 1,584 more EU nurses and health visitors left their roles in the NHS than joined.
Central investment in education and training has dropped from 5 per cent of health spending in 2006/7 to 3 per cent in 2018/19. Had the previous share of health spending been maintained, investment would be £2bn higher, they calculate.
As the government also prepares to publish a green paper on social care, the organisations say that many of the same issues are affecting the social care workforce. Vacancies in adult social care are rising and stand at 110,000, with about one in 10 social worker and one in 11 care worker roles unfilled.