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Take a look at a selection of our recent media coverage:

NHS staff more likely to be bullied by patients and colleagues if disabled or of ethnic minority

25th March 2024

NHS staff who are black or minority ethnic (BME) face more harassment, bullying and abuse by patients, patients‘ families, the public and other staff members, according to NHS England figures.

Around 30% of BME staff were harassed, bullied or abused by patients, patients‘ families or the public in 2022, compared to 26.8% of white staff. In the same year, 27% of BME staff experienced the same from colleagues, compared to 22% of white staff.

The figures have been released as part of the NHS workforce race equality standard 2023, which looks at how trusts are addressing race and inequalities.

NHS England said there was ‘continued evidence’ of ‘sustained improvement’ since 2016 when the first report was published, with the total number of BME staff at very senior manager level up 61.7% since 2018 (from 201 to 325).

However, it added there was still work to be done. Although the percentage of BME board members increased in all seven integrated care system (ICS) areas of England – in London, the Midlands, North East and Yorkshire, North West and South West – the gap in representation between board and workforce widened because the increase in BME representation was slower than the growth in the wider workforce.

The NHS workforce disability equality standard report 2023 was also published this week, which found that disability declaration rates by NHS staff had improved in 2023 by 19.9%. But, 33.2% of disabled staff reported experiences of bullying, harassment or abuse from patients, service users or the public. Some 16.1% reported this from managers and 24.8% from colleagues.

Health secretary, Victoria Atkins, said: ‘I want to see the NHS recruit and retain brilliant people from all backgrounds. It is important that the NHS at all levels represents the people it cares for, and I welcome progress in appointing more black and minority ethnic staff to senior positions and better representation of disabled people in the NHS workforce.’

Deputy chief executive at NHS Providers, Saffron Cordery, said: ‘Trust leaders remain dedicated to improving working conditions for ethnic minority and disabled staff, but substantial challenges persist, including in relation to supporting career progression and tackling harassment, bullying and abuse.

‘While ethnic diversity in the NHS workforce has increased, the speed at which this is happening at board level, particularly among executives, is not keeping pace with overall diversity of the workforce. This has led to a stark disparity in board representation.’

She added: ‘These report findings, along with the latest NHS staff survey showing ethnic minority and disabled staff are more likely to experience abuse from patients and the public, underline the need for urgent action to ensure staff feel safe.’

The NHS staff survey, published earlier this month, revealed widespread reports of discrimination and sexual harassment by patients and colleagues during the past year.

A version of this article was originally published by our sister publication Healthcare Leader.

NHS Staff Survey shows recovery from pandemic but raises concerns over sexual harassment

13th March 2024

By some indices, the NHS workforce appears to be recovering from the impact of the Covid-19 pandemic, according to the newly-released NHS Staff Survey 2023, but concerns were raised over issues with sexual harassment identified in a new survey question.

Across England, over half of the 700,000 surveyed staff (55.17%) reported that they now look forward to going to work – the best result since 2020.

Some 69.02% reported being enthusiastic about their job, which was, again, the best result since 2020 but remains around six percentage points lower than in 2019. Enthusiasm amongst medical and dental staff increased following four consecutive years of decline on this measure, the results showed.

When it came to the issue of wellbeing, staff reported experiencing less pressure at work than before, with the work pressure sub-score having improved in 2023 after a sharp decline between 2020 and 2021 and little change in 2022.

A total of 46.71% said they were able to meet all the conflicting demands on their time at work, however this remained lower for medical and dental staff (34.44%) than for many other staff groups and over 12 percentage points lower than the average.

Professor Em Wilkinson-Brice, director for staff experience and leadership development at NHS England said: ‘It is really encouraging that the experience of NHS staff at work improved over the past year, even as they faced near record levels of pressure including the busiest summer recorded in A&E, as well as managing the disruption of industrial action.‘

And Dr Navina Evans, chief workforce, training and education officer at NHS England, said: ‘While there is still more to do, it is good news that less than 12 months on from the publication of the NHS Long Term Workforce Plan staff are happier at work than last year thanks to initiatives such as flexible working hours, clinical support squads to help menopausal women at work, and human resources stay advocates.‘

However, Dr Emma Runswick, deputy chair of the British Medical Association council, noted that ‘while there have been some small positive changes made in certain aspects from staff shortages to time pressures, it’s imperative to differentiate between “improvements” and what is deemed as satisfactory or acceptable’.

Dissatisfaction with pay increases among medical staff

The NHS Staff Survey arrives at a time of ongoing workforce shortages, mounting pressures and widespread dissatisfaction with pay.

While satisfaction with pay recovered to levels similar to 2021 across a number of staff groups, the survey found only 32.05% of medical and dental staff were satisfied with their pay. This adds to the persistent decline over the last three years and is 23 percentage points lower than in 2020.

Dr Runswick said: ‘The vast majority of medical and dental staff (68%) are dissatisfied with their pay, all while clearly struggling with unacceptable workloads, unreasonable time pressures, and inadequate resources.

‘The Government must recognise the urgent need for fair pay and systemic improvements to support and prioritise the wellbeing of our invaluable healthcare workforce.’

Staff report discrimination and sexual harassment

The survey results also revealed widespread reports of discrimination and sexual harassment by patients and colleagues.

Discrimination hit a record high, with one in 12 staff (8.48%) having reported facing discrimination from patients, service users, their relatives or other members of the public, up from 7.20% in 2019. This rose to 9.07% for people who reported personally experiencing discrimination from managers, team leaders or colleagues, up from 7.68% in 2019.

However, overall, staff were reportedly increasingly likely to feel their organisation respects individual differences such as cultures, working styles, backgrounds and ideas (70.63%). This measure is up two percentage points since 2021.

This was the first time the NHS Staff Survey ran a question on sexual harassment, and the results showed that 8.67% of staff said they had faced sexual harassment from patients, patients’ relatives, or other members of the public within the last year.

In fact, more than 58,000 NHS staff reported experiencing ‘unacceptable’ levels of unwanted sexual behaviour from the public.

The survey also found 3.84% of staff faced unwanted sexual behaviour from staff or colleagues.

The sector responds

Commenting that these figures are very distressing, Dr Evans said: ‘Such conduct should not be tolerated in the NHS. That is why the NHS launched its first ever Sexual Safety charter last year which provides clear commitments to improve reporting on unacceptable behaviour, as well as appointing more than 300 domestic abuse and sexual violence leads who will review and improve trust policies for reporting of sexual harassment.

Medical leaders condemned the survey findings on sexual harassment. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: ‘Discrimination or abuse of any kind must not be tolerated – anywhere, ever. Everyone has a responsibility to call it out.

‘Such behaviour is abhorrent and in a clinical setting, utterly disrespectful to our hardworking NHS staff and to patients receiving or waiting for medical attention. Staff are most effective when they feel psychologically safe in a workplace.

‘NHS staff cannot walk away when someone needs help – being harassed or feeling vulnerable should never be considered “part of the job”.’

Professor Vivien Lees, vice president of the Royal College of Surgeons of England (RCS England) and lead on sexual misconduct, said: ‘Gathering this data is an important step as it gives us a better picture of the scale of the problem.

‘It is essential that staff members feel empowered to report instances of misconduct without fear of reprisal or negative impact on their career progression. They also need to feel confident that reports will be believed.’

She added: ‘RCS England is committed to a zero-tolerance approach to sexual misconduct, and we will actively work to eradicate this behaviour in surgery and healthcare.’

Coinciding with the publication of the NHS Staff Survey, the Royal College of Physicians and Surgeons of Glasgow launched its 10-point action plan aimed at tackling sexual misconduct in healthcare.

10-point action plan to address sexual misconduct in healthcare launched by RCPSG

A 10-point action plan aimed at tackling sexual misconduct in healthcare has been launched by the Royal College of Physicians and Surgeons of Glasgow (RCPSG).

The plan includes a range of measures to support healthcare professionals, from providing education and training on recognising and taking appropriate action on sexual misconduct, to strengthening the College Code of Conduct and supporting the collection of data on inappropriate behaviours.

The launch coincides with the publication of the NHS Staff Survey, which highlights sexual harassment as an issue within the NHS, and was informed by the findings of an independent report by the Working Party on Sexual Misconduct in Surgery (WPSMS).

This independent report entitled ‘Breaking the Silence: Addressing sexual misconduct in healthcare‘, which was published in September 2023, detailed the findings of a survey distributed to members of the surgical workforce in the UK and the Republic of Ireland.

It revealed that two thirds of female respondents (63.3%) reported having been the target of sexual harassment from colleagues, along with just under a quarter of men (23.7%).

Almost 30% of women reported being the target of sexual assault in the last five years.

Mike McKirdy, president of the RCPSG, which has more than 16,000 members in the UK and internationally, called the WPSMS findings ‘bleak‘ and said the Royal College was ‘appalled by these statistics‘ on sexual misconduct and wanted ‘to ensure that every member of our extended College community feels safe and respected in their place of work‘.

The 10-point action plan therefore ‘sets out the measures we are taking to help tackle inappropriate behaviours wherever they may occur‘.

He added: ‘The 10-point action plan is not an exhaustive list – we will continue to work with Fellows and Members to listen, and hear, what other actions we might take.‘

Professor Christine Goodall, dean of the Faculty of Dental Surgery and the RCPSG’s representative on the Working Party on Sexual Misconduct in Surgery, said: ‘Sexual misconduct and inappropriate behaviours affect every area of healthcare.

‘We believe that medical Royal Colleges have an important role to play in building safer communities, and by showing leadership, healthcare professionals can help to drive the change that is needed in society more generally. It is incumbent on us all to speak out if we witness inappropriate behaviour and to properly support those who come forward to report it.’

Since the publication of the WPSMS report, the Royal College of Surgeons of England (RCS England) has ‘redoubled our efforts to stamp out sexual misconduct, sexual harassment, and sexual assault’ in healthcare.

Professor Vivien Lees, vice president of RCS England and lead on sexual misconduct, said: ‘We have written to NHS Trusts that haven’t yet signed the NHS sexual safety in healthcare charter, encouraging them to do so as soon as possible.

‘RCS England is actively lobbying accountable government and NHS organisations on the Working Party on Sexual Misconduct in Surgery recommendations including the need for reforms of reporting and investigation processes.’

METEOR project shows EU hospital clinicians ready to quit as retention issues continue

Almost one in 10 doctors across the European Union (EU) intend to leave their profession, according to a new cross-sectional study from the EU-funded METEOR Project, highlighting widespread retention issues.

Researchers from the METEOR Project – which collects scientific knowledge on job retention of healthcare workers in Europe to develop policy recommendations to increase job retention – asked 381 physicians and 1,351 nurses at hospitals in Belgium, the Netherlands, Italy and Poland about their intention to exit the profession or leave their current hospital, and the factors influencing their decisions to quit.

The results showed 9% of doctors and nearly 14% of nurses declaring an intention to leave their profession, citing low job satisfaction, growing depersonalisation and emotional exhaustion as the primary factors.

The survey also revealed 16.3% of doctors and 8.4% of nurses are considering leaving their current jobs. Factors impacting nurse and physician retention in hospitals highlighted job dissatisfaction, lack of career development and poor work-life balance as the main determinants of intention to leave,, which the researchers suggested can ‘help governments and hospital administrators combat the trend’.

Laura Maniscalco, co-author of the study and research fellow at the University of Palermo (UNIPA), said: ‘Many doctors want to leave their current workplaces because of the management and personal issues. In the high-stress environment of a hospital, they can face challenges in terms of work-life balance or conflicts that can result in bullying.

‘Additionally, the ineffectiveness of the management system and understaffing can force them to work in areas outside of their expertise, leading to role conflicts and reducing opportunities for career advancement.”

Domenica Matranga, a professor at the UNIPA and co-author of the study, added: ‘Our research suggests that nurses may [also] no longer find their job rewarding or valued. This issue is connected with relatively low salaries, tough working conditions and, of course, the physical and emotional pressure caused by the pandemic.‘

This latest study adds to ongoing research highlighting and addressing the pressures on clinical workforces across the EU and UK.

Recommendations to enhance the wellbeing of doctors in Europe were published in November 2023 as part of a new policy from the Standing Committee of European Doctors. These aimed to improve patient care, professional excellence and overall job satisfaction and included focusing on adequate staffing and workload management, embracing a people-focused working culture, championing mentoring and peer support networks and supporting doctors as parents and carers.

Staff retention and mental health issues have also been noted amongst UK clinicians in recent months. A survey of 1,958 NHS health professionals from across the UK in September highlighted understaffing as a main factor pushing healthcare workers to leave the NHS.

A UK surgical workforce census report published in January 2024 found that 61% of respondents cited burnout and stress as the main challenge in surgery due to excessive workloads, and 50% of respondents across all career grades indicated that they considered leaving the workforce in the past year. 

And last summer NHS chief executive Amanda Pritchard acknowledged that the NHS was seeing higher levels of sickness among staff compared to pre-pandemic, particularly due to poor mental health and anxiety, some of which she said was ‘directly related to what people have been through over what was an extraordinarily difficult few years’.

The turnover crisis comes as the healthcare sector struggles with an existing shortage of medical personnel. Projections from the World Health Organization indicate that in six years Europe will need 18.2 million healthcare workers to meet the growing demand for healthcare services driven by an ageing population and increased prevalence of chronic diseases.

As a result, the authors of this latest METEOR Project study are urging healthcare managers across the EU to ‘devise effective retention strategies, taking into account job satisfaction, work engagement, and a positive working climate’, adding that ‘such internal policies are crucial, given the difficulty of finding replacements for departing professionals’.

Calls for high-intensity theatre and protected research time in major new report

16th February 2024

Introducing a national programme of weekend high-intensity theatre lists to reduce backlogs and offering hospital consultants protected time for research are among the recommendations outlined in a major new report.

In its ‘Report into the state of health and social care in Britain today’, the Times Health Commission called for high-intensity theatre lists to be launched once a month in 50 hospitals to get through a week’s worth of planned operations in a day and create seven-day surgical hubs.

It also outlined incentivising NHS staff to take part in research, and put the case for research to their patients, by giving 20% of hospital consultants and other senior clinicians 20% protected time for research.

These two recommendations form part of the report’s 10-point plan for the Government to transform the NHS.

To support the plan’s development, the Times Health Commission visited hospitals, care homes, GP surgeries and research laboratories in the UK, Japan, Denmark, Israel, Ireland and Spain to source examples of best practice.

The commissioners then established three core principles to underpin the report and recommendations, which they said are ‘pragmatic, practical, deliverable and could be taken up by any political party or government’.

The principles are rebalancing the health system away from hospitals and a putting greater emphasis on prevention and community care, reforming social care to reduce overcrowding in hospitals and give patients better support, and enabling the system to become more personalised and predictive through the use of technology.

Supporting the workforce

The Commission called for doctors, nurses and midwives who stay in the NHS for three years to have their student debt cut by 30%, rising to 70% for those still working after seven years, and 100% after 10.

It said the health services must become a ‘much better employer’ in ways that go ‘beyond health settlements’, including affordable staff canteens, night transport and on-site childcare.

The requirement for junior doctors to rotate across the country must also end to better balance work and family, it said.

Other recommendations included creating digital health accounts or ‘passports’ for patients to book appointments; order prescriptions; view records, test results or referral letters; and contact clinicians.

And establishing a National Care System with the aim of giving everyone the right to appropriate support locally and in a timely fashion. This should be delivered by a mixture of the public and private sectors, the report said.

The report‘s 10-point plan

  1. Creating digital health accounts for patients via the NHS app
  2. Introducing weekend high-intensity theatre lists to get through a week of planned operations in a day to reduce waiting lists
  3. Reform the GP contract to focus on wider health outcomes
  4. Write off student loans for doctors, nurses and midwives who stay with the NHS for a decade
  5. Introduce no-blame compensation for medical errors with settlements determined according to need to ensure families get quick support
  6. A National Care System, equal to but different from the NHS, to administer care locally
  7. Guarantee mental health support is timely for children and young people
  8. Expand the sugar tax to cover salt and institute a pre-watershed ban on junk food advertising
  9. Incentivise NHS staff to take part in research
  10. Establish a Healthy Lives Committee legally bound to commit to increasing healthy life expectancy by five years in a decade.

Chair of the Times Health Commission Rachel Sylvester said: ‘Despite its huge challenges, there is enormous cause for optimism for our health service. The NHS and social care system must seize the extraordinary opportunities on offer in the modern digital world to empower patients, liberate clinicians, improve services, drive efficiencies and create a healthier Britain. Other countries have done it and so could we.’

The sector responds

Commenting on the report, Royal College of Physicians president Dr Sarah Clarke said: ‘At a time when the NHS faces significant demands, we welcome the Times Health Commission’s report. Its 10-point plan places an important focus on increasing and supporting the medical workforce, fostering an environment where existing staff can flourish, and taking an important preventative approach to tackling health inequalities and ill health.

‘We also welcome the inclusion of social care within the report’s recommendations for reform – social care must be staffed and funded as an equal partner to the NHS to deliver optimal care for patients.’

Also responding to the report, Professor Philip Banfield, British Medical Association council chair, welcomed its focus on staff retention and supported the student loan write-off recommendation.

However, he said: ‘The Commission sadly fails to make the obvious recommendation of restoring doctors’ pay, which would have a real impact on retaining clinicians. 

‘Without this, any meaningful hopes of addressing the near record-waiting lists will be dashed. Indeed, accelerated weekend theatre lists are all well and good, but the premium required to fund such activity risks detracting from essential investment elsewhere; doctors are already exhausted after working beyond their hours all week, already spread too thinly.’

Professor Banfield added: ‘There is a lot to unpack and consider in this report and its recommendations, but ultimately the ability to improve the state of the country’s health and services is bound by the Government’s will to act, and crucially, invest. This change must come from listening to the doctors and colleagues that give their all on the front line every day. We are the solution, not the problem.’

Matthew Taylor, chief executive of the NHS Confederation, who was a commissioner involved in the report, also called for greater Government funding to align with the report’s recommendations.

He said: ‘The NHS is recognised as one of the most efficient healthcare systems in the developed world, but we know that more can be done to improve productivity, and health leaders and their teams are always looking at ways to generate even greater efficiencies.

‘One of the crucial ways that this productivity challenge can be addressed is by providing the NHS with the capital investment it needs, which has not been covered in this comprehensive report. Specifically, in England, capital funding needs to increase to at least £14.1bn annually, a £6.4bn increase from the current level of £7.7bn. This is vital if we are to increase productivity and reduce waiting lists.’

In January 2024, a surgical workforce census report found that over half of the UK surgical workforce face problems accessing theatres, which is contributing to long waiting times for hospital treatment and excessive workloads.

Access and burnout challenges revealed in surgical workforce census report

30th January 2024

Over half of the UK surgical workforce face problems accessing theatres, which is contributing to long waiting times for hospital treatment and excessive workloads, according to a new census report.

The ‘Advancing the Surgical Workforce: 2023 UK Surgical Workforce Census Report’, revealed 56% of respondents found access to theatres was a major challenge, and this rose to 61% among all surgical trainees.

Some 47% of respondents said they believed that ‘system challenges’ had an impact on their ability to deliver their work, including balancing clinical and managerial responsibilities.

Access to theatre/operating lists, adequate support staff and admin support were listed as the top three responses to a question asking what would increase productivity.

The Royal College of Surgeons of England (RCS England) said the results show ‘too many staff are trying to navigate a system that often frustrates the delivery of surgical care, rather than enabling all members of the team to deliver services to patients in the most timely and efficient way’.

It added that the report ‘paints a stark picture of a surgical workforce working long hours and in stressful environments’.

Indeed, 61% of respondents cited that burnout and stress was the main challenge in surgery due to excessive workloads.

Some 67% of consultants reported always or frequently working beyond their contracted hours and 42% of respondents did not take their annual leave entitlements in the past year. 

The impact of these pressures is also revealed in the report as 50% of respondents across all career grades indicated that they considered leaving the workforce in the past year. 

And 64% of the 55-64 age group of consultant surgeons plan to retire in the next four years.  

Recommendations for improvement

The report was based on a survey of the whole surgical workforce that aimed to identify the key challenges facing surgical teams and inform workforce planning.

There were 6,348 responses to the census survey from different members of the surgical team, which is approximately 25% of the current workforce. Of the respondents, 54% were consultants, 25% were trainees, 10% were SAS surgeons, 5% were LEDs in surgery and 6% were part of the extended surgical team.

Led by the RCS England, it was supported by the Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of Edinburgh and the Federation of the Surgical Speciality Associations.

The report sets out three recommendations from the surgical Royal Colleges focusing on improving productivity, capacity and efficiency; ensuring sustainability within the workforce by focusing on wellbeing; and overhauling the surgical team structure with further integration of associate specialist and specialty (SAS) surgeons and locally employed doctors in surgery (LEDs).

It is hoped these recommendations will provide a basis for future comparative work to support the work of surgeons and the wider surgical team across the UK and help to reduce waiting lists.

‘Happy and fulfilled‘ surgical workforce

Tim Mitchell, president of the Royal College of Surgeons of England, said: ‘At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery.’

Commenting on the retirement data in particular, Mr Mitchell said: ‘This will create a significant loss of experienced surgeons who are key to helping bring NHS waiting times down and training our future surgeons.   

‘Tackling the challenges health services face hinges on having a happy and fulfilled workforce. We should not be losing any talented surgeons or surgeons in training because they do not feel valued, or they are denied the flexibility in their careers they require.  

‘There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.’

Mike McKirdy, president of the Royal College of Physicians and Surgeons of Glasgow, added: ‘The findings of this important report underline the intense challenges being felt by surgical teams across the UK.

‘In addition to increasing theatre spaces and staff to help drive down waiting lists, we must ensure that we protect training time for all members of the surgical team: without quality, ‘on-the-job’ training, we simply won’t have the surgical workforce we need for the future.

‘With alarming levels of burnout, it is also vital that we have a national focus on improving the wellbeing of our dedicated surgical teams.

‘The UK’s surgical Royal Colleges have a long history of working together to inform workforce planning. We are ready to work with the wider health system to drive positive change.’

On-call should be opt-in for senior doctors aged over 60, Royal Colleges advise

15th December 2023

Senior doctors should get flexible or part-time working options and from the age of 60 should opt into on‐call only if they wish to, according to joint guidance from the Royal College of Physicians (RCP), the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow.

The new ‘Later Careers 2023’ guidance aims to support senior doctors aged 50 and over – some 47% of the physician workforce – to continue working sustainably and help to mitigate the current NHS workforce crisis.

Supporting the retention of senior doctors in this way ‘brings benefits to patients, the individual doctor, the hospital, and the wider medical community‘, the RCP said.

The document is an update of similar guidance from 2018 and is based on findings from a survey of doctors aged 50 and over conducted in 2022 by the three Royal Colleges.

The guidance also advises that the appraisal of senior doctors should be ‘sensitive and proportionate to their working arrangements‘, and that clinical leads ‘should begin discussions about doctors’ intentions for the next 10 years as early as felt necessary’, and certainly by the time a doctor turns 55.

Recommendations set out in the guidance include:

  • Making flexible or part‐time working options available to senior doctors
  • Consultants opting into on‐call only if they wish to after the age of 60
  • Employers embedding time for teaching for senior doctors’ job plans
  • Employers considering whether doctors need a full licence to practise to keep working in a teaching or examining role
  • Job planning as a department to ensure roles are complementary
  • Making appraisal of senior doctors sensitive and proportionate to their working arrangements
  • Employers remaining in contact with recently retired physicians or those not currently working.

The survey underpinning the guidance found that one in three consultants who are not yet retired express they wish to retire early.

But over half of respondents (58%) said they would delay retirement and continue to work if they could reduce hours and/or work flexibly.

RCP censor and consultant gastroenterologist Dr Harriet Gordon said: ‘Senior doctors are incredibly valuable to the NHS and have much to contribute clinically, but also in teaching and mentoring the next generation of physicians. 

‘Our survey showed that a large proportion of senior consultants have a strong interest in continuing working if it was possible to work more flexibly.

‘Considering the significant demands facing health services due to workforce shortages, this finding is encouraging. The guidance offers key recommendations that would support experienced hospital doctors to continue working sustainably in the NHS.‘

The Royal Colleges said they ‘will continue to promote this approach to governments and employers‘.

Senior doctors ‘at risk of burnout‘

Earlier this year, data showed that one in five (19%) of consultant physicians are at risk of burnout, and an NHS consultant missing three days of work for mental health reasons is 58% more likely to leave three months later.

In June, NHS England published its own guidance for retaining doctors in late stage career within the NHS and supporting them to stay well.

After the publication of NHS England’s long-term workforce plan in July, Amanda Pritchard admitted that there were no ‘specific costs’ associated with retention elements of the plan.

The senior doctor workforce is a major concern for the NHS and last month the UK Government offered a 4.95% investment in pay for this financial year, on top of the 6% uplift, in order to avert further strike action.

But a 2023 survey showed that pay increases alone will only have ‘a modest impact’ on NHS staff retention because the main problems are stress and high workload.

New report calls for priority investment in NHS staff mental health and wellbeing

11th December 2023

A new report from the British Psychological Society (BPS) is urging the Government to commit to further long-term funding for NHS staff mental health and wellbeing services, calling it ‘fundamental‘ for workforce retention, the delivery of the NHS Long Term Workforce Plan, and protecting patient care.

The BPS ‘Learning from the NHS Staff Mental Health and Wellbeing Hubs‘ report highlights the need for standards for staff mental health provision, amid concerns that staff struggling with their mental health could face a postcode lottery to access the support they need from a dwindling number of NHS Staff Mental Health and Wellbeing Hubs.

Set up in February 2021 to provide health and social care staff with rapid access to mental health support, ring-fenced Government funding for NHS Staff Mental Health and Wellbeing Hubs ended in March 2023, with integrated care systems (ICSs) either identifying short-term interim funding for their Hub for a defined period of time, or closing them.

The report highlights a data analysis from the Nuffield Trust showing six million sick days recorded for NHS staff due to anxiety, stress, depression and other psychiatric illnesses in 2022, with sickness absence associated with a higher likelihood of staff leaving the NHS.

And the same Nuffield analysis revealed that a consultant missing three days of work for mental health reasons is 58% more likely to leave three months later.

Further figures outlined in the BPS report showed demand for NHS Staff Mental Health and Wellbeing services is increasing.

Data from one hub recorded 404 people registering for one-to-one support between July 2023 and September 2023 – a 65% increase on the same period in the previous year during which 245 referrals were made – with one in five of those accessing one-to-one support identified as senior leaders.

BPS says its report aims to support health and care leaders make ‘crucial decisions‘ about future investment in local mental health and wellbeing services for their teams.

It cites evidence of the cost benefits for investment in mental health and wellbeing that shows an investment of £80 per member of staff in mental health support can achieve net gains of £855 a year through savings from absenteeism and presenteeism.

Noting ‘more than 121,000 unfilled jobs across the NHS in England today‘, Saffron Cordery, deputy chief executive of NHS Providers, said: ‘Heavy workloads and huge pressure on stretched services are leading to lots of staff feeling worn out. The effects of financial pressures on trusts and the cost of living crisis on staff amid the longest period of industrial action in the history of the NHS’ history have compounded problems of high staff turnover.‘

As a result, the report makes a series of recommendations, including that:

  • ICSs provide long-term, ring-fenced funding for evidence-based, psychologically-led staff mental health and wellbeing services, complemented by further ring-fenced funding from the Department of Health and Social Care
  • NHS England develop national service standards for psychologically informed staff mental health wellbeing provision, including impact and evaluation measures
  • ICSs evolve and build upon existing NHS Staff Mental Health and Wellbeing Hubs infrastructure to support system-wide priorities and requirements.

Dr Roman Raczka, president-elect of the BPS, said: ‘The ambitious measures set out in the NHS Long Term Workforce Plan are not a quick fix.

‘Existing and future staff members deserve to work in an environment that gives them the support they need, to provide the safe, high-quality care they as health and care professionals are proud to give.

‘Put simply, NHS and social care employers cannot afford to ignore the mental health needs of their workforce, if they wish to create a system that’s fit for the future.‘

Stress and high workload confirmed as main reasons staff leave NHS

25th September 2023

Pay increases alone will only have ‘a modest impact’ on NHS staff retention because the main problems are stress and high workload, according to the findings of a recent survey.

The survey of 1,958 NHS health professionals from across the UK also highlighted understaffing are a main factor pushing healthcare workers to leave the NHS.

Researchers from the universities of Bath, Sheffield and Leicester wanted to assess ‘push factors’ behind decisions to leave the NHS, and whether these were ranked differently by profession and NHS setting, a year after exposure to the effects of the pandemic.

The survey, carried out in summer and autumn 2021, determined the relative importance NHS staff gave to eight factors as the key reasons for leaving NHS employment.

It was completed across acute, mental health, community and ambulance services by 227 doctors, 687 nurses/midwives, 384 healthcare assistants and other nursing support staff, 417 allied health professionals and 243 paramedics.

Each respondent was presented with two push factors at a time, for all combinations of pairings, and asked to indicate which of these two factors is the bigger influence on why staff in each job role leave the NHS.

The factors compared were staffing levels, working hours, mental health/stress, pay, time pressure, recognition of contribution, workload intensity and work–life balance.

The findings, published in BMJ Open, showed that health professionals ranked work-related stress, workload intensity and staffing levels as the primary ‘push factors’ underpinning decisions to leave the NHS.

This prompted the authors to suggest that pay increases alone may not be sufficient to fix NHS staff retention.

They concluded: ‘Rankings of leave variables across the different health professional families exhibit a high degree of alignment, at the ordinal level, and highlight the primacy of psychological stress, staff shortages and work intensity.

‘While increases in pay are transparently important to NHS staff, findings from this research suggest that enhancements in that domain alone may produce a modest impact on retention.’

They said that ‘an equivalent conclusion’ might be drawn with respect to the ‘current high-profile emphasis’ on increased access to flexible working hours as a solution within contemporary NHS staff retention guidance to employers.

The authors added: ‘Both have potential to do good, but there are grounds for inferring there is a risk that neither may deliver sufficient good to redress the high and rising exodus in the absence of attention to what present as more fundamental factors driving exit.

‘Importantly, scope for addressing the highest-ranked factors driving exit, in large degree, lies beyond the gift of NHS employers.’

RCGP chair Professor Kamila Hawthorne said: ‘This latest survey highlights the point that resolving the workforce issues in UK healthcare is not about pay alone – we can’t expect issues which have been decades in the making to be resolved overnight.‘

A version of this article was originally published by our sister publication Pulse.

EU doctors joining NHS workforce to have automatic recognition for at least five more years

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.