We must secure overseas recruitment, report says

Uncertainty over international recruitment is threatening safe, high quality care for patients, a major report has warned.

NHS Providers’ report, There for us: a better future for the NHS workforce, says there are no domestic ‘quick fixes’ to the severe workforce shortages in the NHS, and that any significant reduction in the number of overseas staff in the next few years is likely to have a serious and damaging impact on services for the public.

The report criticises the slow, disjointed response from the Department of Health and its arms-length bodies to the NHS’s growing workforce challenges.

It calls for urgent steps to ease intolerable pressures on front line staff, and to develop an NHS workforce fit to meet the growing and changing needs of the population.

The report provides an overview of where the workforce challenges are greatest, how these have developed, and what needs to be done to address them.

It includes findings from a new survey of NHS mental health, community, ambulance and hospital trusts. Chairs and chief executives from 51 per cent of NHS trusts responded to the survey.

The main findings are: 66 per cent said workforce concerns were the most pressing challenge in delivering high quality care; 85 per cent said it would be important to recruit from outside the UK in the next three years; Brexit was seen as the main barrier to recruitment outside the UK over the next three years, with 38 per cent mentioning this issue; when asked for the biggest challenges to recruitment and retention at their trust, 60 per cent of chairs and chief executives cited work pressure and 38 per cent pay and reward; and 90 per cent were doubtful that approaches taken by the Department of Health and its arms-length bodies would help them to recruit and retain the staff they needed.

The analysis describes a growing ‘workforce gap’ which is harming the quality of care, it warns that there are no ‘quick fixes’ to improve the supply of UK-trained staff yet the outlook for international recruitment is uncertain, and trust leaders are frustrated that these problems have developed over a number of years ‘in plain sight’ and that NHS system level leadership has been unable to develop appropriate solutions.

The report makes recommendations aimed at the government, the Department of Health and its arms-length bodies, regulators and professional associations. These include: set out a fully funded plan to end the pay cap during this parliament; urgently confirm the right to remain for the 60,000 EU staff working in the NHS; commit to a future immigration policy that allows trusts to fill posts that cannot be taken by the domestic workforce; work with trusts to set up an international recruitment programme they can opt into; and a clear-sighted strategy to develop the health and care workforce the country requires with skills to meet growing and changing needs.

It also recommends greater clarity on the timetable to grow the domestic supply of clinical staff, and backup options should initial plans not succeed as has happened in the past; a set of short-term stop-gap solutions to address immediate workforce shortages; and much greater coherence in workforce strategy, eliminating the current approach and developing the right national/local relationship.

The report also sets out what can be done at trust level to make the NHS a great place to work. These include the importance of tackling bullying, developing new roles, improving productivity and providing greater flexibility for staff.

Chris Hopson, chief executive of NHS Providers, said: “The staff and skills shortages we now see reflect a fundamental failure at national level on workforce strategy. We don’t have enough staff with the right skills and we’re asking far too much of our existing staff. NHS trust leaders are telling us there are no quick fixes to improve the supply of UK-trained staff, and the outlook for international recruitment is uncertain.

“These problems have developed in plain sight which clearly shows the existing approach is flawed.

“The government must deliver certainty for EU staff. It should reassure them that their commitment to the NHS is greatly valued and will continue to be welcome. It should also provide assurance on immigration policy so trusts can continue to recruit overseas while we strengthen our workforce here.

“We need a coordinated workforce strategy with clear goals in sight that match the realities of demographic pressures and new approaches to care.

“A better future for the NHS workforce is within our grasp, but we need a commitment from government and national bodies, first to recognise the gravity and urgency of the challenges we face, and then to act.”