The fact there is a crisis in our health service workforce is evident in the strikes we’re seeing and the issues around access and waiting times.
The top challenges are pay; a lack of available trained staff; and a lack of desire to continue to work in the NHS.
These issues are adding to some of the absolute deal breakers for NHS staff – moral distress and injury, not feeling valued and stress/burnout.
Moral distress or moral injury are not simply new buzz words. Good nurses and doctors leave the profession because the reason they went into it, to care for people and uphold the Hippocratic Oath, is under threat. The workforce shortages mean they do not feel able to provide healthcare to the standard they want to and compromising values in this way becomes untenable. The lack of available staff to do the work is evident.
But, as is often questioned, where is the clapping now? Covid highlighted starkly the inequities in our society, but it also showed us what mattered, and who mattered. It is no wonder nurses and junior doctors are striking – they are the same healthcare workers who risked their lives just under three years ago. They need to feel just as valued and as important now, as they were when the streets fell quiet, and the daily death toll soared.
There is a glimmer of light in the energy and wave of optimism that comes with a change of guard in the NHS. The ICB chief executives I’ve interviewed, a quarter so far, are all fully cognisant of the challenges but equally determined not to let this stand.
Our report May the Workforce be with you: What primary care wants highlights what each profession wants from their new ICB leaders.
This includes better commissioning to make full use of optometry services and to encourage dentists to take on complex work to tackle health inequalities; equity across employers for practice nurses; clear career progression; investment in estates and IT; flexible working; and support when the system is under stress.
Working across a system gives ICBs a unique view that enables them to plan things in a coordinated way, bringing disparate services together as part of the integrated care system to provide a more holistic service across health and care.
ICBs are not waiting for the government’s workforce plan – although they would welcome both it and the funds to match it. They are being proactive now, by assessing the labour pool across their systems and then figuring out how they can retain existing staff and create career progression within and outside of the NHS. ICBs are also working with training colleges to set about creating a workforce for the future.
Both they and NHS England must articulate why having a career in the NHS is worthwhile in the face of some absolutely terrible PR. If current NHS workers felt valued and happy in their work they would then be advocates for a career in healthcare.
And the NHS must present itself as a place for ambitious people, offering clear career options and opportunities for progression, including for school leavers and those on work experience schemes. Flexible working patterns that fit with people’s lives must also be adopted.
People are proud of the NHS – now the NHS must be able to show it’s proud of its workforce.
I remain hopeful that the darkest hour is just before the dawn.