The cost of living crisis is forcing healthcare workers to walk away from the NHS in pursuit of better-paid jobs, trust leaders have warned.
As energy, food and transport costs rise, staff are skipping meals to feed their children or taking on second jobs, with some also struggling to make the journey to work, according to a new survey of NHS trusts in England.
Health workers are turning to the hospitality or retail sectors, placing further strain on an already overburdened NHS, leaders say. Two-thirds of surveyed trusts “report a significant or severe impact from staff leaving”, with services struggling to respond to rising operational pressures.
Miriam Deakin, director of policy and strategy at NHS Providers, which conducted the survey, said: “Increasing numbers of nurses and other staff, particularly in the lower pay bands, are finding they are unable to afford to work in the NHS.
“The squeeze on pay and the rising cost of living means they are having to make some very tough decisions. The sad fact is some can earn more working for online retailers or in supermarkets.
“Others are taking second jobs. We have heard of staff stopping their pension contributions and not being able to fill up their cars to get to work.”
The rising exodus of staff comes at a time of acute shortages in the NHS workforce; official data indicates there are 132,000 vacancies across trusts in England.
According to NHS workforce data titled “Reasons for Leaving”, a record-breaking 1,895 members took voluntary resignations for “better reward packages” in the second quarter of 2022 – equivalent to 157 every week. This is up from 1,076 at the beginning of 2020, or 89 every week.
NHS Digital said the data may include staff who moved internally but it acknowledged that other variables in the dataset take into account staff who are promoted or relocated within the NHS.
Ms Deakin said the “NHS already had a problem with vacancies and our fear is that will just get worse”.
One trust leader said there has been a large “exodus from our community”, particularly at the beginning of the year, with notable departures from the trust’s visitor nursing teams.
A second NHS leader, who runs a large ambulance trust, said the turnover of staff within the service’s call centres is usually at 12 per cent but has risen to as high as 45 per cent.
“That’s a real challenge for us,” they said. “[There have been departures in] administration roles as well. In IT we’ve seen a lot of staff move out of the NHS ... into higher-paid IT roles.”
A third trust leader said: “For some staff this is the final straw psychologically after two years of Covid.”
More than half (54 per cent) of trusts responded to the survey conducted by NHS Providers, covering every region of England.
Some 71 per cent of trust leaders reported that many staff are struggling to afford to travel to work; 69 per cent said the cost of living is having a “significant or severe” impact on their ability to recruit lower-paid roles such as porters and healthcare assistants; and 61 per cent reported a rise in mental health sickness absence among staff.
More than three-quarters (78 per cent) of trust leaders are extremely concerned about the mental wellbeing of staff given the psychological impacts of the cost of living and the pandemic.
“We have examples of staff who … can’t afford to travel to work [at the end of the month],” said one NHS trust leader from the east of England. “We’ve had to support staff with food vouchers as they are going without meals.”
Trusts fear that cost of living increases will make a challenging winter even harder as they face more demand for care exacerbated by worsening poverty levels, alongside increased staff shortages due to stress, illness and turnover – piling more pressure on overstretched services.
The cost of living crisis is also impacting the health of patients and the decisions they make in relation to accessing treatment, leaders say.
One trust leader described the recent “tragic case” of a pregnant mother and her partner who were forced to “pick and choose” which appointments they could afford to attend and “therefore coming into labour with uncontrollable diabetes and having quite poor outcomes”.
Of the trusts surveyed by NHS Providers, 72 per cent said they have seen more people coming to mental health services due to stress, debt and poverty, while 51 per cent said they have seen an increase in safeguarding concerns as a result of people’s living conditions.
Ms Deakin said: “The rising cost of living is harming people’s health and widening health inequalities.”
A government spokesperson said: “We know NHS staff are struggling with cost of living pressures, and we have given over 1 million NHS staff a pay rise of at least £1,400 in line with the recommendations of the independent pay review body.
“The government has also taken action to save a typical household an average of £1,000 a year on energy bills through a new ‘Energy Price Guarantee’ – protecting them from soaring energy costs.
“Frontline staff have access to 40 nationwide mental health and wellbeing hubs, backed by £45 million in 2022/23, and we have commissioned NHS England to develop a long-term workforce plan to recruit and retain more NHS staff.”
