Staffing is the issue keeping NHS leaders awake at night – and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce.
The number of NHS staff quitting their jobs has reached worrying new heights. According to the latest official data, over 42,400 staff voluntarily resigned from the health service in quarter two of this year – the highest number in any equivalent quarter over the last decade.
Breaking this number down even further is even more alarming and reveals almost 7,200 staff members cited “work life balance” as the reason for resigning – the highest it has ever been. “Work life balance” is also now the second most popular known reason for staff voluntarily leaving the NHS, after “relocation”.
Another concern is the spike in the number of staff leaving in search of better pay and reward elsewhere. According to the data, 2,161 staff quit because of this reason, which is more than double the number in the equivalent quarter 10 years ago, when just over 900 staff resigned because of pay.
Although statistics on why NHS workers leave their jobs are notoriously poor (the reason for over 10,000 staff leaving in quarter two was given as “unknown”) the sharp rise described above should not be overlooked.
The Department of Health and Social Care has, unsurprisingly, focused on the number of new staff who have joined the health service, rather than the concerning number of them leaving. Although there are almost 4,700 more doctors and over 10,500 more nurses working in the NHS compared to October 2021, the inflated numbers – as pointed out by Billy Palmer, senior fellow at the Nuffield Trust – are down to accelerated international recruitment, and in the case of nurses, recruitment of less experienced staff.
This is unsustainable; the NHS cannot continue to rely on overseas staff in the context of global healthcare shortages and experienced doctors, nurses, AHPs, admin, IT staff and beyond are absolutely crucial if the NHS is to operate safely and effectively.
Miriam Deakin, head of policy at NHS Providers, said trust leaders are extremely worried about staff becoming demoralised and a rise in resignations.
She added: “Appropriate support is key – particularly as anxiety, depression and stress are consistently the highest causes of staff absence. This also impacts staff retention, which has a further knock-on effect on staffing levels.”
Corridor care must not be normalised
Some trusts have been very open about the measures they are being forced to resort to just to keep things running this month. University Hospitals of North Midlands Trust chief executive Tracy Bullock warned earlier last year that the trust had been “resisting” placing patients in corridors because of the risks to patient safety and staff wellbeing.
However, in its board last week the trust confirmed corridor care has been officially brought back and risk-assessed, with staff recruited specifically to look after patients in corridors.
The trust has been clear – it does not want to treat patients in this way, but has no choice. There is a risk to patients and to the staff who care for them.
The safety impact has already been seen nationally; a country-wide patient safety alert was issued this week warning patients were coming to harm after receiving care in areas of hospitals without access to the medical gas pipeline.
Helen Hughes, chief executive of charity Patient Safety Learning, said it would be valuable for trusts to have clear guidance and examples of good practice of corridor care that “prioritise patient safety”.
However, she stressed this should be a temporary measure and not be normalised. But many frontline staff would argued this has already happened – they have had to contend with corridor care off and on for the last decade.
Ms Hughes also stressed the negative impact caring for patients in corridors and other areas has on healthcare professionals themselves, “raising the risk of moral injury if they are unable to provide the appropriate level of care”.
Ms Deakin echoed concerns about the “moral injury” among staff and trust leaders who can’t help everyone who needs care, describing it as “distressing”.
Ms Deakin is also clear; the government and unions must come together to negotiate on pay. As things stand, further nursing strikes are expected later this month, which will potentially be followed by junior doctors and consultants.
But this January, it really feels that even short-term quick-fixes can’t come soon enough for staff. Considering the extreme winter pressures, described by many experienced staff this month as the worst they have ever seen, it seems likely the resignations trend is going to continue as the year goes on.