The effect of the rising cost of living on NHS staff

Almost daily we hear or read about people struggling to make ends meet as the price of just about everything spirals upwards.

Public sector workers are among millions at the sharp end of the rising cost of living. A new survey by NHS Providers has unearthed heart-rending stories of nurses skipping meals to save cash to buy their kids' school uniforms and hospital staff queuing at workplace food banks because they can't afford basic necessities.

Lots of NHS staff are even struggling to meet the cost of getting to work.

Our survey, published on the eve of the cap on typical household gas and electricity bills rising to £2,500, is not just timely but a vital insight into how NHS trusts, their staff, patients and the communities they support are feeling the effects of rising prices.

Every trust which responded reported concerns about the mental, physical and financial wellbeing of staff as a result of the cost of living.

Miriam Deakin    Co-Director of Development and Engagement

We approached NHS trust chairs, chief executives and other board directors. Every trust which responded reported concerns about the mental, physical and financial wellbeing of staff as a result of the cost of living, on top of the psychological impact of the pandemic and high levels of work-related stress.

One trust leader said: "For some staff this is the final straw psychologically after two years of COVID-19."

Food banks and debt counselling are just some of the ways in which trusts are helping staff to cope with financial hardship. Trusts have called it a 'tipping point' for the workforce. All NHS staff have been given below-inflation pay awards this year by the government, leaving them worse off in real terms.

The survey found that:

• 71% of trust leaders reported that many staff are struggling to afford to travel to work;
• 69% said the cost of living is having a 'significant or severe' impact on their ability to recruit lower-paid roles such as porters, cleaners and healthcare assistants;
• 61% reported a rise in mental health sickness absence;
• 81% are 'moderately or extremely' concerned about staff's physical health;
• 95% said that the cost of living increases had significantly or severely worsened local health inequalities;
• 72% said they have seen more people coming to mental health services due to stress, debt and poverty;

Following a number of years of pay restraint with below inflation pay awards, the rising cost of living is a key factor affecting the morale of health workers, and the NHS is finding it harder than ever to recruit and retain staff. Two in three trust leaders reported a 'significant or severe' impact from staff leaving to work in sectors such as pubs, restaurants and shops for better pay. Vacancies across NHS trusts reached more than 132,000 recently, an all-time high. More than two in three said the cost of living is having a significant or severe impact on their ability to fill lower-paid jobs while it's getting harder for them to recruit, where there is competition from other industries, in facilities, IT and HR too.

Trust leaders welcomed the government's recent announcement that they and other public service providers will receive the same help as businesses with soaring energy bills.

Miriam Deakin    Co-Director of Development and Engagement

Alongside workforce pressures, rising costs have put pressure on trusts' budgets across a range of other expenditure. Trust leaders welcomed the government's recent announcement that they and other public service providers will receive the same help as businesses with soaring energy bills although they remain concerned about what may happen when the six month period of relief runs out. Increased gas and electricity costs threatened to be a tipping point for trusts already hit hard by inflation, which is eating away at NHS budgets.

Trusts are worried too about the impact on the public of the rising cost of living, especially on older people and children in less affluent communities. The vast majority of trusts said that the cost of living had significantly or severely worsened local health inequalities. Almost three in four (72%) have seen an increase in people coming forward with mental health problems due to stress, debt and poverty, and a rise in cases of poverty-related conditions.

"We anticipate a huge increase in demand due to increased rates of anxiety, depression and domestic violence in the communities we serve,” one trust said.

We know the link between deprivation and poor health, and the impact of inequality on people's mental and physical state.

Cost of living pressures are too big and extensive to be left to local NHS trusts to solve on top of everything else they are confronted by.

Trusts are hubs at the heart of their communities and will do everything they can to treat the consequences of poverty on the health of the population.

Miriam Deakin    Co-Director of Development and Engagement

The conclusion from our survey findings about the impact of the increase in cost of living on NHS staff, patients and communities is the need for urgent, joined-up national action to support what trusts are doing, in particular for managing the logistics and cost of such efforts, backed up by a long-overdue, long-term, fully costed and funded workforce plan to guarantee that the NHS can recruit and retain the staff it so desperately needs.

We also need the government to support the health of the most deprived communities and commit to addressing wider factors to reduce poverty and its effects on people's health.

Trusts are hubs at the heart of their communities and will do everything they can to treat the consequences of poverty on the health of the population, leading and coordinating local efforts with public sector and other partners to support people in these tough times.

But the best way to make health services truly sustainable for the future is to ensure that more people are supported to live in good health for longer.

This blog was first published by Public Sector Focus.