NHS Providers says politicians must address rapidly growing concerns over the NHS workforce in the general election campaign. A combination of pay restraint, the impact of Brexit and the absence of a robust long term NHS workforce strategy are taking their toll. 

In a seven point policy paper, NHS Providers says that despite the longest and deepest financial squeeze in NHS history, trust leaders are now reporting that finding and keeping the right number of people with the right skills needed to deliver high quality care has become their biggest challenge. The growing workforce problems mean that NHS services are having to close unnecessarily, the timeliness and quality of care patients receive is being adversely affected and the burden on NHS staff is becoming unsupportable.

NHS Providers calls on whichever party is in government to work with NHS national bodies to agree and fund a long-term approach to workforce planning and to consider when and how to end pay restraint.

The document says demand for services is rising and patients' needs are becoming more complex. The gap between the demand for and supply of suitably trained NHS staff is growing.

NHS Providers calls on whichever party is in government to work with NHS national bodies to agree and fund a long-term approach to workforce planning and to consider when and how to end pay restraint.

The paper also calls for: 

• Funding which allows trusts to deliver the standards expected by patients and enshrined in law in the NHS Constitution
• Investment in social care: ensuring the extra money in the budget is used to ease pressure on the NHS, alongside a sustainable long-term funding solution
• Action to ensure words promising parity for mental health are matched by deeds. That means higher levels of investment and, critically, making sure that investment reaches the frontline
• Support for new ways of working and closer collaboration between health and social care so more people can be treated and supported closer to home. The priority must be quality of care rather than saving money, and the timetable must be realistic
• Establish the long-term funding needs of the NHS to ensure it can meet the increasing demands of an ageing population, as more baby boomers move into their seventies after 2020
• Recognise the economic value of the NHS as an organisation that provides employment, promotes research and ensures the UK life sciences sector is globally competitive

The chief executive of NHS Providers, Chris Hopson said: “Workforce concerns are now the number one NHS priority. Growing problems of recruitment and retention are making it harder for trusts to ensure patient safety. Unsustainable staffing gaps are quickly opening up in hospitals, mental health and community trusts and ambulance services.

“Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive. Significant numbers of trusts say lower paid staff are leaving to stack shelves in supermarkets rather than carry on working in the NHS. And we are getting consistent reports of retention problems because of working pressures in the health service causing stress and burnout.

Years of pay restraint and stressful working conditions are taking their toll. Pay is becoming uncompetitive.

“At the same time, trusts are reporting that the uncertainty surrounding Brexit, and the failure to reassure EU nationals about their long-term future, mean that vital recruitment from EU countries is dropping rapidly.

“Yet all the evidence shows that staff who are happy and motivated provide better care. NHS Trusts want to see strategic solutions in place dealing with pay, the supply and demand of staff, retention and training. But they tell us they see no sustainable long term plans in place.”

Four examples of NHS workforce shortages and the impact they have include: 

• Insufficient mental health nurses leading to delays in treatment, people taking longer to recover, and as a result care is more expensive and patient experience is worse
• Insufficient A&E consultants leading to greater risk to patient safety, more people not being seen within the four hour standard and a much greater burden on junior doctors in  training
• Insufficient paramedics leading to unsustainable pressure on many ambulance services and trusts having to ask existing staff to work demanding levels of overtime or employ more agency staff; and
• Insufficient community nurses which means it will be very difficult to deliver the Five Year Forward View Vision of moving care away from hospitals into the community, closer to home.

'Investing in success – NHS priorities for the new government' presents in more detail the state of the NHS provider sector, and what trusts need from politicians over the next parliament.

Director of policy and strategy Saffron Cordery blogs about the workforce issues behind the paper.