The NHS in England is facing its ‘greatest workforce crisis in history’, according to a damning report from MPs.
The Commons Health and Social Care Committee’s report found that England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, posing a serious risk to patient safety.
The committee predicts that an extra 475,000 jobs will be needed in health and an extra 490,000 in social care by the early 2030s. In the meantime, hospital waiting lists reached a record high of almost 6.5 million in April.
The cross-party committee said the government’s refusal to “do proper workforce planning” meant it was not able to tackle the Covid backlog, exacerbating waiting times.
Industry body Care England told the committee that social care workforce planning was an “unaddressed afterthought”, despite the care sector being a similar size to the NHS workforce.
The government claimed in response that workforce targets – with the exception of recruiting 6,000 more doctors in general practice – were either met or on track to be met. However, the report said many stakeholders had argued the targets themselves were “inadequate, inappropriate and insufficiently ambitious”.
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A further finding of the committee is that NHS pension agreements mean senior doctors are forced to reduce their working hours because they need to “taper” their income to fall beneath the tax relief threshold – the Royal College of Surgeons of England told the committee that this was causing some doctors to retire early, which was in turn impacting waiting lists and staff retention.
Maternity services are one of the areas under the most acute pressure, according to the committee. Earlier this year, the Ockenden review urged maternity units to introduce minimum staffing levels after a shocking number of avoidable deaths in failing NHS trusts.
Pay is also a crucial factor, the report found. More than 17,000 jobs in care fall below the minimum wage, according to government analysis. It called for HMRC to be more proactive in enforcing this.
Alongside staff shortages and long waiting lists, bullying rates are a concerning factor in NHS retention rates and should be a priority for workforce leaders.
“Poor behaviour amongst staff is a major issue, especially in the NHS, where bullying rates remain very high,” the report said. “Discrimination and harassment stemming from the race, gender, and sexuality of staff are an issue which we have chosen to highlight when looking at the overarching inequalities in the workforce.”
According to the 2021 NHS staff survey, more than one in four NHS staff have experienced an incident of bullying in the preceding 12 months.
Committee chair, former health secretary Jeremy Hunt, said understaffing needed to be a top priority for the new prime minister.
“Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long term plan by the government to tackle it,” he said.
“We now face the greatest workforce crisis in history in the NHS and in social care with still no idea of the number of additional doctors, nurses and other professionals we actually need.
“NHS professionals know there is no silver bullet to solve this problem but we should at least be giving them comfort that a plan is in place.”
Danny Mortimer chief executive of NHS Employers, said: “Health leaders are beyond worried that the government has shown a sustained reluctance to act decisively on NHS and social care staffing and echo the committee’s concerns that the lack of long term planning and investment risks the government’s plans to tackle the waiting list backlog and poses a serious risk to both staff and patient safety.
“This lack of long-term planning and investment is reinforced by the committee’s expert panel in their related report which rates government progress on key workforce commitments as ‘inadequate’.
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“Our political leaders now need to be brave enough to tell the truth and be honest with the public about the scale of challenges facing social care and health and tackle workforce planning and investment head on. It is time for a reality reset on the NHS.”
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