The NHS is the fifth biggest employer in the world.
It employs 1.7 million staff (with the US Department of Defence employing 3.2 million, People’s Liberation Army China employing 2.3 million, Walmart employing 2.1 million and McDonald’s employing 1.9 million.
The Health Foundation has a new report looking at NHS staffing and highlights the ongoing fall in staff numbers. The report is called “A Critical Moment” and says that staffing in some key areas is a problem. The number of GPs is falling, and so is the number of nurses and health visitors working in community and mental health services.
The past year has seen modest growth in the number of full-time equivalent (FTE) staff, but this is against a backdrop of more than 100,000 vacancies reported by trusts, a figure projected to only rise over the coming years.
About half of the growth in NHS staff is among professionally qualified clinical staff. But growth is patchy. The professionally qualified clinical staff with the highest rates of growth were ambulance staff, hospital and community health service doctors, and scientific, therapeutic and technical staff, all of which grew by around 3% or more. By contrast, the number of midwives increased by less than 1%, while the number of nurses and health visitors increased by less than 0.5%.
While there has been continued growth in the number of hospital-based doctors, the number of GPs has fallen. The staffing model for primary care is changing, the number of nurses and other direct patient care staff such as Community Pharmacists and Physicians Associates working in general practice has been expanding.
Moving care from hospitals into primary and community health services has long been a policy goal and The NHS Long Term Plan continues to reflect this ambition. However, turning it into a reality on the front line remains elusive.
Although the overall number of nurses employed in the NHS has increased slightly, there are particular problems in key priority areas such as primary care and learning disabilities.
The number of nurses and health visitors working in community health services has continued its long-term decline, falling 1.2%
To address nursing shortages, the government has committed to increasing the number of nurses in training.
However, 2018 was the second year in a row in which the number of applications and acceptances for pre-registration nursing degrees in England fell.
Improving NHS staff retention is also a priority, but our analysis shows there has been no improvement in retention over the past year.
The NHS Long Term Plan recognises that the NHS workforce can be the enabler of its objectives.
However, if the existing workforce shortages and deficits continue, they will severely hinder progress.
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Nicola Strudley works two days a week as the manager for Healthwatch Wokingham Borough. Opinions expressed in this blog are her own
