NHS workforce planning ‘not fit for purpose’

National policy and planning for the NHS workforce in England is not fit for purpose, a new Health Foundation report has revealed.

Rising pressure: the NHS workforce challenge has analysed trends in the NHS workforce and found increasing cause for concern, including that the NHS workforce increased by two per cent in the year to April 2017, although this masks critical variations including a rise in managers and consultants but a drop in nurses and GPs.

The report also found that increasing admissions and decreasing nurse numbers risks overstretching nurses and undermining progress made in nurse numbers since the Francis report, and outside hospitals there have been declines in community nurse and health visitor numbers.

Additionally, the Health Foundation has warned that the government has promised 21,000 new posts in mental health by 2020, but there are reservations about whether the target is achievable, or will provide staff with the right level of skills.

Also of concern is the fact that 1,220 fewer students had started undergraduate nursing degrees in England this year, based on data from the end of the university clearing round. While the number of 18 and 19 year olds increased, there has been a big fall in older students.

And although the government is aiming to recruit 2,000 GPs from overseas over the next three years, the report has highlighted that only 38 were recruited in the first six months of 2017.

Increasing workforce instability in the NHS, caused by a high turnover of staff, is costing the NHS both financially and reducing continuity of care for patients. This varies across the country, with the annual leaver rate at some trusts hitting 30 per cent. At these trusts huge amount of time, money and management effort is required on recruitment, just to maintain the same headcount, the Health Foundation says.

Further consequences of the lack of coherent workforce planning can be seen in the muddled implementation of the switch from bursaries to student loans for nurse training, which was intended to allow the number of student nurses to expand. However, there has been a drop of 1,220 in the number of students starting undergraduate nursing courses this year. The report identifies the two biggest reasons for this as the poor implementation of the reforms, and even poorer communication from government departments.

Significantly, there has been insufficient focus on the specific needs of older applicants, who until 2017 accounted for 40 per cent of the total number.

Anita Charlesworth, director of research and economics and the Health Foundation, said: “There is a growing gap between rhetoric about the government’s ambitions to grow the NHS workforce, and the reality of falling numbers of nurses and GPs.

“This year has been characterised by a series of one-off announcements and initiatives, beset by unrealistic timescales and no overall strategy.

“The challenges and risks ahead for the NHS are well known, and must be met by collective action, led by the government, to put in place a coherent strategy to provide a sustainable workforce for the NHS.

“With winter approaching and staffing numbers in critical areas once again declining, the NHS will be relying on the efforts of its staff to meet the inevitable rising pressures. But in the long-term, both the people working for and the people using the NHS deserve better.”