NHS England staffing crisis: shortage of GPs, nurses and midwives poses ‘serious risk to patient safety’

Persistent understaffing in the NHS is creating a serious risk to patient safety, MPs have said in a damning report.

The cross-party Health and Social Care Committee said health and social care services in England face “the greatest workforce crisis in their history” and the government has no credible strategy to make the situation better..

What did the report say? 

Research from Nuffield Trust shows that NHS England is short of 12,000 hospital doctors and over 50,000 nurses and midwives.

Maternity services are “under unsustainable pressure” and the number f full-time equivalent GPs also fell by more than 700 over three years to March 2022.

Projections suggest an extra 475,000 jobs will be required in health, and an extra 490,000 jobs in social care by the early part of the next decade.

The report said: “In the face of this, the government has shown a marked reluctance to act decisively.

“The workforce plan promised in the spring has not yet been published and will be a ‘framework’ with no numbers, which we are told could potentially follow in yet another report later this year.”

“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 illnesses.

“But most depressing for many on the frontline is the absence of any credible strategy to address it.”

“The result is that many in an exhausted workforce are considering leaving — and if they do pressure will increase still further on their colleagues”.

The report goes further by saying that staff are under pressure and the NHS loses millions of full-time equivalent days to staff sickness caused by anxiety, stress and depression. It also states some simple things are not in place, such as access to hot food and drink on shifts and flexible working.

The report also criticises NHS pension arrangements which are leading to senior doctors reducing their working hours owing to facing hefty tax bills. More needs to be done on social care worker pay to stop people leaving, it adds.

How has the government responded? 

The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff.

MPs say that progress has been made towards a target of recruiting 50,000 nurses, but that the government is set to miss its target to recruit 6,000 more GPs - something promised in the Conservative Party Manifesto.

Health and Social Care Committee chairman and Tory MP Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said: “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.

“NHS professionals 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.”

MPs criticised the government and NHS England for failing to set out when safe staffing in maternity would be reached - a failure that “demonstrates a lack of responsibility” and “is absolutely unacceptable”.

Extra staff would be needed to keep up with rising demand as the population gets older and healthcare becomes more complex.

Concern about maternity services was also shown, as more than 500 midwives were revealed to have left the NHS between March 2021 and March 2022.

The committee said conditions were “regrettably worse” in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to keep existing workers.

A Department of Health and Social Care spokesperson said: “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 recruiting 50,000 more nurses by 2024, we are also running a £95 million recruitment drive for maternity services and providing £500 million 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.”

What has the NHS said?

Danny Mortimer, chief executive of NHS Employers, which is part of the NHS Confederation, said the report “once again highlights the extent of the workforce crisis now facing both the NHS and social care”.

He said tens of thousands of staff vacancies “at the last count and an exhausted workforce present one of the greatest challenges to the recovery of the economy and the return of safe, high-quality health services for all”.

Mr Mortimer added that health leaders are “beyond worried that the government has shown a sustained reluctance to act decisively on NHS and social care staffing and echo the Committee’s concerns that the lack of long-term planning and investment risks the government’s plans to tackle the waiting list backlog and poses a serious risk to both staff and patient safety”.

Patricia Marquis, the Royal College of Nursing’s director for England, said the report’s findings show “in the starkest of detail the workforce crisis across the whole of health and social care in England”.

She said: “That persistent understaffing in all care settings poses a serious risk to staff and patient safety should shock ministers into action.

“On pay, the committee was very clear saying it is unacceptable that some NHS nurses are struggling to feed their families, pay their rent, and travel to work.

“Their recommendation that nursing staff should be given a pay rise that takes account of the cost of living crisis should make the government rethink the latest pay deal that follows a decade of real terms pays cuts that will force even more to leave the profession.”

Unison general secretary Christina McAnea added: “The government’s had years to improve the workforce situation but has done little.

“Only last week ministers could have acted to stop the exodus of porters, healthcare assistants and other NHS staff with an above-inflation wage rise. But chose not to.”