While the medical workforce is growing, it is not growing fast enough. The British Medical Association (BMA) states that across primary and secondary care there are currently 2.8 doctors per 1000 people in England, while in other EU countries it is on average 3.7 per 1000 people. Even at the rate of growth being experienced, it would take until 2046 to catch up.
This shortage equates to a full-time doctor in the NHS currently undertaking 1.3 full-time equivalent roles, resulting in them working an extra 11-12 hours extra per week, while in a 2021 BMA survey, 52.5 per cent of doctors stated ‘insufficient numbers of staff to suitably treat all patients’ was one of the most important factors behind moral distress.
This statistic demonstrates how coronavirus has brought into sharp focus the need to address a widening skills gap within the NHS. With many experienced practitioners taking early retirement due to burnout and stress, and potential recruits turning away, can more be done to attract and retain our brightest and best?
A drain on talent fed into a staffing crisis which began pre-pandemic and persists to this day, which includes a shortage of 38,952 nurses, and recent research has suggested that by 2031 an additional 488,000 health care staff will be needed to help recover from the pandemic.
The shortfalls prompted the UK government to launch a huge recruitment drive, which in October was said by Westminster to have resulted in an extra 30,000 NHS staff since June 2020 and a surge in people applying for undergraduate healthcare degrees.
But the fact is, even if most of these potential doctors and nurses do eventually enter the workforce, there is the inevitable gap of several years before they are qualified. We can’t merely impotently wait for them to qualify – change must first come from within the health service to address the issues it faces.
And amid an exodus of experienced practitioners with wisdom and experience, the question being raised is who will be left to train, mentor and coach these new recruits? Could the healthcare industry be left with a skills shortage, as many other industries are currently facing?
Back in 2019 the NHS’s interim People Plan set out how England’s healthcare system would need to adapt to meet the ever-growing demands on it and how also to attract and retain the best staff. It stated that its problems were in part being created through staff shortages, stretched NHS finances, staff stress and burnout.
And some of its remedies to these issues? That the healthcare system needed to be a better place to work in by allowing flexible working patterns, creating a healthy, inclusive and compassionate culture, easing workloads, allowing a better work-life balance, and focusing on the physical and mental health and wellbeing of staff – much of which aligns with the expectations of attracting and retaining Gen Z talent.
The NHS’s solutions to its problems were given before the pandemic struck, with those now-familiar topics currently being addressed more broadly by employers looking to reintegrate their staff into a post-Covid working environment.
And so given the added emphasis to these factors since the NHS plan was published two years ago, along with the raising of the bar in terms of what is now expected from employers, if the NHS is to succeed in breeding a better working environment to both attract and retain staff it will perhaps have to be even bolder in its approach.
Greater support will be needed to encourage experienced individuals not to retire early, with management teams mindful of the traumatic experiences much of the workforce will have gone through during the pandemic and giving consideration to how allowing a flexible approach to working could benefit morale and wellbeing long-term.
Ensuring there is proper training, mentorship, and support programmes for new or inexperienced members of the workforce is also important both to attract the next generation into the workforce and also to make sure they are ready to meet the demands of our increasingly burdened health service.
And considering the shortages which have plagued the NHS for so long, perhaps something just as important is manpower planning. Better foresight would enable the health service to look at the age ranges of employees, and where they are in their careers, to identify where there could be future retirement surges and where future recruitment drives are needed, perhaps even 10-15 years in advance.
Ultimately if we fail to learn the lessons that have seen us on the back foot during a global health crisis, we risk repeating the same mistakes again.
Dr Clare Holt is programme lead for the MSc leadership in healthcare at Learna