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13th July 2023
Doctors and other healthcare professionals from the EU can continue to join the NHS workforce for the next five years without taking additional tests, following a recent UK Government review.
The law enabling this, named ‘standstill provisions’, came into effect on the day the UK left the European Union, and the health secretary was required to review it from January 2023 and decide a way forward.
The Department of Health and Social Care (DHSC) concluded that the provisions will remain in place ‘for a temporary period of five years’, meaning EU qualified healthcare professionals can continue to register with their UK regulator without further assessment.
An average of more than 4,000 EU doctors, nurses, midwives, pharmacists, dentists and other healthcare professionals join the NHS annually, according to the DHSC.
The department’s data analysis also showed that while the number of applications from EU professionals was generally lower over the last two years than in 2019, the number has been increasing since 2021, and the doctor and nursing regulators received the most across each year.
A consultation, which included the GMC, found that a majority of stakeholders wanted the standstill provisions to remain ‘in the short-term’ in order to ‘avoid operational issues’ if they ended this year.
The DHSC said retaining the provisions ‘will support the department’s ambition to attract and recruit overseas healthcare professionals, without introducing complex and burdensome registration routes’.
EU doctors and other healthcare professionals may only need to take language skills tests and checks on fitness to practise, where necessary, in order to register with their relevant regulator and work in the NHS.
The Government long-term workforce plan recognises ‘the skills and dedication of staff who have come here from around the world’, it sets out plans to increase the number of home-grown staff with a doubling of medical school places to 15,000 by 2031 to reduce reliance on overseas recruitment.
A version of this story was originally published by our sister publication Pulse.
4th July 2023
The NHS in England saw 27 million days lost to staff sickness absences in 2022 – equivalent to losing 74,500 full-time staff, including 2,900 doctors and 20,400 nurses, across the year, a new analysis has shown.
The briefing paper published by the Nuffield Trust for the BBC, which analysed NHS Digital staff sickness data, warned the number of staff absences within the health service reached ‘unprecedented and sustained’ highs between January and December 2022.
Staff sickness absences increased by 29% in 2022 compared to 2019, which equalled an average of 17,000 additional staff off sick on each day.
It added that the NHS in England was now facing ‘a new normal of sickness absence’ in hospitals and community services, as staff sickness soared post-pandemic.
‘This increasing burden of sickness absence is thought to be contributing to higher costs and disruption for NHS providers, fuelling additional stress for remaining staff, and is a major push factor for staff leaving, leading to further disruption for patients and services,’ those behind the paper said.
Dr Billy Palmer, senior research fellow at the Nuffield Trust, said that the health services was ‘grappling with a difficult new normal when it comes to staff sickness leave’.
He added: ‘The increasing numbers taking time away from work feeds into a seemingly unsustainable cycle of increased work leading to burnout and then more people choosing to leave.’
While respiratory illness and infections conditions remained common reasons for sickness absence, in 2022 the NHS lost around six million days due to anxiety, stress and burnout, accounting for a quarter of all sick days.
Indeed, this analysis of NHS data adds to a wide pool of evidence that NHS staff are increasingly suffering from work-related stress. In the NHS annual staff survey, over half (57%) of staff reported going into work despite not feeling well.
Latest census data from the Federation of the Royal Colleges of the Physicians in the UK showed that one in five (19%) of consultant physicians are at risk of burnout.
And a report by the Institute for Fiscal Studies in August 2022 looking at staff retention in the NHS acute sector showed that compared to those that have not had absences, an NHS consultant missing three days of work for mental health reasons is 58% more likely to leave three months later.
Health reasons are increasingly a cause for staff to leave the NHS, with the Nuffield Trust highlighting that the number of NHS staff pointing to health as the reasons for leaving their role has more than tripled in the decade to 2022. This includes an increase of 52% since 2019.
Meanwhile, the NHS Long Term Workforce Plan, published on Friday, said that ‘significant workforce shortages and rising demand for care are increasingly stretching NHS staff’ and that ‘we are seeing more staff absent from work due to mental ill health than ever before’.
The plan outlines a host of measures focusing on training, retention and reform to tackle the issue of understaffing and support the wellbeing of NHS employees, which it hopes will shore up the workforce and reduce absences.
A Department of Health and Social Care spokesperson said: ‘We are hugely grateful to NHS staff for their hard work and their health and wellbeing is of paramount importance.’
The spokesperson insisted that the NHS absence data analysed by the Nuffield Trust is ‘not necessarily representative of a broader trend, given the unprecedented impact of the Covid pandemic’.
They added: ‘For those staff that need it the NHS provides physical and mental health support – including targeted psychological support and treatment.’
A version of this story was originally published by our sister publication Nursing in Practice.
26th June 2023
The long-term NHS workforce plan will be published later this week and will be ‘one of the most significant announcements in the history of the NHS’, the UK Prime Minister has said.
Speaking to the BBC on Sunday, Rishi Sunak said the 15-year plan will make sure that ‘we can hire the doctors, nurses and GPs that we need, not just today, but for years into the future, to provide the care that we all need’.
The plan will represent ‘the largest expansion in training and workforce in the NHS is history’ but will also ‘draw on the latest innovations and techniques to streamline the process from classroom to clinic, because it’s right that healthcare adapts and evolve as our needs change’, he added.
Mr Sunak said: ‘This is the NHS’s plan. And it’s right that we back them to do it and it will mean people can have confidence that the doctors and nurses and GPs that we will need will be there and then we can reduce our reliance on foreign-trained healthcare professionals.’
Admitting that workforce recruitment efforts may ‘take time’ to have an impact for patients, he said taking a longer-term approach was ‘the right thing to do’.
‘Governments should make the right long term decisions for the country. It has never been done before. People have always said the NHS needs a long-term plan. So we hire more doctors, more nurses, more GPs, and yes, as you say, it takes five, 10, 15 years for these things to come through. That doesn’t mean it’s the wrong thing for me to do because I’m focused on doing the right long-term things for the country.’
The long-awaited workforce plan is expected to announce a doubling of medical school places and a greater focus on bringing in new NHS staff – including doctors – via apprenticeship routes. It is not known what plans it will set out to retain existing NHS staff, many of whom are currently in dispute with Government over workload and funding.
This story was originally published by our sister publication Pulse.
Image courtesy of 10 Downing Street.
13th June 2023
A chronic shortage of NHS radiographic professionals, coupled with anticipated surges in demand for heart and kidney scans due to the hot weather, will put patients’ lives at risk this week, the Society of Radiographers (SoR) has warned as it urges members in England to vote for strike action.
Already overstretched radiography teams will be putting in excessive hours to meet a rise in A&E visits caused by the current spell of hot weather, and patients arriving into A&E during this time will have to wait significantly longer for vital scans and diagnosis before their treatment can progress, says the SoR.
Hot weather typically means more cases of heatstroke, heart failure and kidney problems, as well as cuts, sprains, fractures and respiratory problems, which similarly need the attention of radiographic professionals, the Society adds.
Dean Rogers, executive director of industrial strategy and members relations at SoR, said: ‘Doctors and nurses cannot do their jobs without radiographic professionals.
‘Our members are dangerously overstretched. Even when the NHS is not facing increased demands because of the hot weather, nine out of 10 patients will need to see a radiographer, and waiting lists are growing.’
On 19 July 2022 – the hottest UK day on record – there were 638 excess deaths, and 496 excess deaths the following day, according to the Office for National Statistics. The July 2018 heatwave led to a record 2.2 million patients visiting A&E departments in a single month – the highest number since records began in 2010.
Vacancy rates for diagnostic radiographers have risen from 12% to 13% in the last year, and the SoR states that pressure on the radiographic workforce is growing due to widespread training and retention issues.
The SoR is urging its members to vote yes in favour of strike action. Launched on 7 June 2023, its ballot will close at 5pm on 28 June. This follows an indicative ballot in April 2023, in which members voted to reject the Government’s 5% pay offer and non-consolidated lump sum for 2022/23.
Mr Rogers added: ‘We know low pay and poor conditions are forcing radiographers out of the workforce, and they are not being replaced in adequate numbers. Vacancies are running at a minimum of 10 per cent and that’s even with radiographers working considerably more than their contracted hours to ensure that their patients receive the best-possible care.
‘That’s why we’re currently balloting our 20,000 members in England for better pay and working conditions. Every day, the crisis deepens, and this week’s weather will only increase the intolerable pressure on an already overstretched NHS. Our members deserve better. Our patients deserve better.’
Risks to patient safety due to staff shortages have also recently been highlighted by oncology professional organisations in an open letter to the health secretary.
30th May 2023
Burnout, retirement and a reliance on locum staff are among a host of concerns raised in a new report from the Royal College of Emergency Medicine (RCEM), which urges the UK Government to take action to support and maintain the emergency medicine (EM) workforce.
The report, entitled ‘Emergency Medicine Workforce in England’, published on 28 May, reveals the extent of the capacity and staffing issues experienced by emergency departments, which is having a negative impact on staff morale and retention, as well as on patient care.
For example, there should be one whole-time equivalent consultant for every 4,000 annual attendances, but the report states that this ratio currently stands at 1:7052. What’s more, some 45% of the total EM workforce is made up by trainee doctors, posing a potential threat to service provision, especially out of hours.
Another particularly pressing issue, the RCEM notes, is the ageing pool of consultants employed within emergency departments. Some 29% of its consultant members are now aged over 50. Many are doing fewer hours during this stage of their careers, and ‘with a third of the workforce approaching retirement age at the same time, we may witness a mass exodus of experienced senior clinicians’, the report states.
These issues have resulted in an overreliance on locum staff, which takes a significant percentage of the wage bill.
Highlighting that the system is stretched beyond capacity and requires the next generation of EM doctors to bolster it, the RCEM’s president Dr Adrian Boyle said: ‘You have to keep the topping up the team, and that is why we are urgently calling on the Government to commit to ensuring there will be at least 120 extra training places for EM doctors every year for at least six years.’
This recommendation from the report, which would see more than 700 new trainee EM doctors being trained between 2024 and 2030, aims to help achieve safe staffing levels, ease pressure on existing staff and support capacity and resilience in emergency departments.
Dr Boyle concluded: ‘We are still waiting for the long-promised NHS workforce plan. And it is becoming increasingly important that this is published as soon as possible to avoid the crisis in the NHS worsening; and that it contains specific numbers, details and costings. Nothing less would be a disservice to our members, their colleagues, to patients and the public.’
Staffing shortages are being seen across the UK and Europe, with a mass-exodus of hospital and healthcare staff being widely reported. In the UK, the much-anticipated NHS workforce plan has indeed been delayed once again as rumours circulate around its prohibitively high cost.
The Government’s long-awaited NHS workforce plan appears to have been delayed as rumours circulate that it is too expensive.
According to deputy chief executive of NHS Providers Saffron Cordery, the plan, which was expected for publication today (30 May), has been delayed further.
Speaking on BBC Radio 4’s Today programme, Ms Cordery said the plan will require ‘a very significant commitment of funding’ from the Government.
Health secretary Steve Barclay declined to provide a deadline for publication during interviews over the weekend, according to The Guardian.
The workforce plan, which has already been delayed from last year, is expected to put forward solutions to address NHS understaffing, including expanding medical school places and potentially training apprentice doctors directly on the job.
Ms Cordery said: ‘We know that when it comes, it will be a very significant commitment of funding from the Government because what we’re talking about is setting out the number of training places and the number of staff that the NHS needs over the next decade or so.’
Of the delay, she added: ‘What everyone has been calling for, and what Jeremy Hunt committed to in his autumn statement last year and indeed talked about in the spring budget, was a fully-funded and fully-articulated workforce plan for the NHS.
‘So I think that we are talking about something to do with the funding of this plan.’
The Times has also reported that disagreements over cost, which is believed to be in the tens of billions, have delayed publication of the plan.
A senior NHS source was quoted by the newspaper as saying that Prime Minister Rishi Sunak and chancellor Jeremy Hunt ‘can’t agree the financial commitment’ and that it ‘was all set to go this week and now the PM wants to run through it in detail’.
In March, reports of the plan revealed it would highlight that the health service is already operating with 154,000 fewer full-time staff than it needs and that number could balloon to 571,000 staff by 2036 on current trends.
The leaked report also said that without ‘radical action’, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years.
There have recently been calls from cancer professional organisations highlighting capacity and workforce challenges compromising patient safety and quality of care.
A version of this story was originally published by our sister publication Pulse.
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