NHS staff shortages ‘biggest driver of burnout’

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Health authorities should publish transparent accounts of staff shortages and requirements to help address resourcing problems that have contributed to a burnout issue among workers, MPs have said.

The Health and Social Care Committee described the NHS’s workforce planning activities as “at best opaque and at worst responsible for the unacceptable pressure on the current workforce which existed even before the pandemic”.

Its report on workforce burnout and resilience in the NHS and social care says that Health Education England should be required by law to publish transparent, objective and independent reports on workforce shortages and resourcing needs over the next five, 10 and 20 years, including an assessment of whether sufficient numbers of staff are being trained.

“The emergency that workforce burnout has become will not be solved without a total overhaul of the way the NHS does workforce planning,” the report says.

“After the pandemic, which revealed so many critical staff shortages, the least we can do for staff is to show there is a long term solution to those shortages, ultimately the biggest driver of burnout. We may not be able to solve the issues around burnout overnight but we can at least give staff confidence that a long term solution is in place.”

It adds that without an accurate projection of workforce requirements for the next decade, staff shortages will endure, to the detriment of both employees and the people they care for.

The NHS Staff Survey and any social care equivalent should include an overall wellbeing measure so that employers and national bodies can understand how staff are feeling and take appropriate action, it says.

“We welcome the additional support provided to health and care staff during the pandemic. However, we conclude that such additional support will need to be maintained during the recovery period and beyond to stop further staff from leaving,” the report says.

“Furthermore simply offering support services, however important, is not on its own enough. The Department [of Health and Social Care] and employers need to ensure that those services are accessible to all and used by all who need them. This will require removing barriers to seeking help, and embedding a culture where staff are explicitly given permission and time away from work to seek help when it is needed.”

It recommends that integrated care systems – partnerships between NHS organisations that coordinate services to meet health needs within a local area – be required to facilitate access to wellbeing support for NHS and social care workers, and that they are accountable for the accessibility and take-up of those services.

“We further recommend that the level of resources allocated to mental health support for health and care staff be maintained as and when the NHS and social care return to ‘business as usual’ after the pandemic; and that the adequacy of resources allocated to that support be monitored on a regular basis,” it says.

Other recommendations include:

  • the development of a strategy for the creation of “Freedom to Speak Up Guardians” in social care. The guardians, who facilitate staff feedback, currently exist in the NHS
  • a review of the role of targets across the NHS, in order to balance the operational grip they have against the risks of inadvertently creating a culture which deprioritises care of both staff and patients
  • the Department of Health and Social Care working with stakeholders to develop staff wellbeing indicators on which NHS bodies can be judged
  • a dedicated people plan for adult social care, which includes commitments on diversity and inclusion
  • continued monitoring of the impact of Covid-19 on the NHS and adult social care workforce.

Responding to the report’s findings, the Royal College of Nursing’s acting general secretary and chief executive Pat Cullen said: “The unprecedented demand on nursing staff during the pandemic has had a huge impact on their own wellbeing. But, as this report shows, the cracks in the systems designed to look after nursing staff appeared years ago.

The unprecedented demand on nursing staff during the pandemic has had a huge impact on their own wellbeing. But, as this report shows, the cracks in the systems designed to look after nursing staff appeared years ago” – Pat Cullen, Royal College of Nursing

“The Department of Health and Social Care needs to prevent more nursing staff ‘burning out’ or leaving the profession entirely by boosting recruitment and retention. The forthcoming Health and Social Care Integration Bill provides an important opportunity to address this by making population-based workforce assessments and overall safe staffing levels of the whole health and care system a legal duty for the health secretary.”

Deputy chief executive of NHS Providers, Saffron Cordery, said: “We wholeheartedly agree with the findings in this report, which will come as no surprise to trust leaders who have repeatedly raised concerns about workforce burnout in the NHS. Our survey of trust leaders last year found 99% were concerned about current levels of burnout across the workforce.

“For some time, we have been calling on the government to embrace a longer-term approach to workforce planning, and to work with the NHS to deliver a fully costed and funded workforce strategy.”

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