The NHS is facing “the greatest workforce crisis” in its history which is putting patients at serious risk of harm, an influential group of MPs warns today.
In its report, the cross-party Commons health and social care select committee slams the “absence of a credible government strategy” on NHS-wide understaffing and criticises ministers for delaying a blueprint it says is urgently needed to address critical gaps in almost every area of care.
The hard-hitting report includes evidence showing that the staffing crisis in the NHS in England is even worse than official figures suggest. NHS Digital figures suggest that the service has vacancies for 38,972 nurses and 8,016 doctors. However, the real figures could be as high as 50,000 and 12,000 respectively, according to estimates the Nuffield Trust prepared for the MPs.
The trust’s analysis accords with the view of many frontline doctors and managers that some posts are not advertised, and thus not picked up by the statistical agency, because hospitals cannot afford to fill them, even if suitable doctors or nurses are identified.
“We now face the greatest workforce crisis in history in the NHS and in social care, with still no idea of the number of additional doctors, nurses and other professionals we actually need,” said Jeremy Hunt, the former health secretary – and failed Tory leadership contender – who chairs the committee.
Overworked, often-exhausted NHS personnel still recovering from the Covid pandemic “know there is no silver bullet to solve this problem but we should at least be giving them comfort that a plan is in place. This must be a top priority for the new prime minister.”
The NHS is emerging as a key issue in the contest between the former chancellor Rishi Sunak and the foreign secretary, Liz Truss, to become Britain’s next prime minister.
At the weekend Sunak highlighted the 6.6 million-patient backlog of NHS care, long delays patients face getting care and growing numbers of people forced to pay for private treatment “with a gun to their heads”. He said the state of the health service now constituted a national emergency and that its increasing inability to provide prompt, high-quality care is so serious that the service could “break”.
Truss has pledged to scrap the 1.25% rise in national insurance – the “health and social care levy” – that began in April and is expected to yield £12bn a year, mainly for the NHS. Her pledge has raised questions about how the government would fund the service properly.
The committee’s findings will prove uncomfortable for both candidates, especially its warning that the chronic lack of staff is a threat to both patients and health professionals.
“The persistent understaffing of the NHS now poses a serious risk to staff and patient safety, both for routine and emergency care. It also costs more as patients present later with more serious illness,” the report says.
“While shortages in any area pose patient safety risks, these are particularly pressing in maternity services,” the MPs add. They point out that the government last year accepted their recommendation that the NHS in England needs 2,000 more midwives and 500 more obstetricians in order to provide care that experts consider safe, given the risks involved in childbirth.
“However, despite this, the NHS in England lost 552 midwives between March 2021 and March 2022. We asked the secretary of state for a deadline by when the shortfall would be addressed but as yet no date has been set.” Pregnant women need that recruitment to occur so they can “have confidence their maternity services are heading towards safety”.
The MPs praise the Department of Health and Social Care (DHSC) for making progress towards delivering the 50,000 extra nurses by 2024 that Boris Johnson pledged in 2019. However, they also highlight the former health secretary Sajid Javid’s admission that another key NHS promise – to increase the number of GPs by 6,000 by the same date – will not be met.
They criticise the government’s “refusal to do proper workforce planning” and “marked reluctance to act decisively” despite the seriousness of the situation. Javid vowed last year to produce an outline of an NHS staffing plan by this spring but it did not appear and is now scheduled to emerge later this year. It is also unclear if it will include plans to hire specific numbers of extra staff.
Sam Higginson, the chief executive of the Norfolk and Norwich university hospitals NHS trust, said in a recent interview that it was operating with an 11% vacancy rate.
Amid a raft of recommendations for action, the MPs urge the Treasury to overhaul the rules regarding doctors’ pensions, problems with which are leading to experienced medics working less than they otherwise would – or even quitting. “It is a national scandal that senior doctors are being forced to reduce their working contribution to the NHS or leave it entirely because of NHS pension arrangements,” they say.
Responding to the committee’s findings, a DHSC spokesperson said: “We hugely value and appreciate the dedication and contribution of NHS and social care staff. We are growing the health and social care workforce, with over 4,000 more doctors, and 9,600 more nurses compared to last year, and over 1,400 more doctors in general practice compared to March 2019.
“As we continue to deliver on our commitment to recruit 50,000 more nurses by 2024, we are also running a £95m recruitment drive for maternity services and providing £500m to develop our valued social care workforce, including through training opportunities and new career pathways.
“We have commissioned NHS England to develop a long-term workforce plan to recruit and support NHS staff while they deliver high-quality, safe care to patients and help to bust the Covid backlogs.”
