NHS: Failure to prepare is prepare to fail


BBC today reveals that NHS staff shortage are affecting basic services across the country. Trainee numbers are dwindling and young doctors and nurses are moving abroad in their droves….writes Dr Kailash Chand

NHS HospitalThousands of NHS doctors posts, both in general practice and hospitals lie vacant. In England, many hospitals are having to rely on expensive agency workers to make up the shortfall in staff. That is one of the key factor driving a growing financial crisis within the health service.

The situation is particularly grave in emergency medicine and paediatrics, where there are hundreds of  vacancies, when demand remains high and more staff are needed, they aren’t there. Those that are become overworked, which persuades some of them to leave, adding to the shortage. That’s why we are grossly short of emergency medicine doctors, GPs, midwives, theatre nurses, and more.

The NHS then has to hire agency staff at inflated cost, £2.6bn last year. The number of doctors, both GPs and consultants, who are considering retiring early is staggeringly high and a huge worry for the NHS and patient care. The health service could be left with a shortage of clinicians, with the remaining doctors spread too thinly. Cuts, in the name of “efficiency savings”, have eaten away at the NHS to the point where it is down to its bare bones.

The problems facing GP practices are all around us. There are now 7,962 GP practices in England – one in 20 has disappeared since 2010. The rate of loss of local surgeries has speeded up – 79 closed and 55 opened in 2010 but since then hundred of GP practices have closed and only 13 opened. There has been a five-fold rise in the number of GP surgeries approaching senior NHS managers for advice about shutting their doors or merging with nearby practices. GPs’ ever increasing workloads – not helped by the denigration of the profession by media and politicians – is bringing about a recruitment and retention time-bomb.

Trainee numbers are dwindling and young GPs are moving abroad in their droves. We now have a dangerous situation where there are hundreds of vacancies for GP trainees. Meanwhile, one in three GPs tell the British Medical Association they are considering retiring early and practices report they are struggling to meet demand for appointments.

While workloads are rising, wages have been chipped away at and are now at 2008 levels. Morale is low. This matters because frontline staff are the beating heart of our health service. The NHS needs a motivated and enthusiastic workforce if it is to rise to the challenges facing it yet in many parts of the NHS, especially general practice and emergency medicine, the pressure is becoming too much, sparking a recruitment and retention crisis.

The crisis in recruitment is down to a number of factors. Poor workforce planning means we aren’t producing enough doctors and sending them to the right areas.But also there are signs that pressures on the NHS – rising workload, falling funding, salary freezes – means that some doctors are opting for early retirement while newer medical graduates are moving abroad or less inclined to go to rural areas or challenging specialities.

The Health and Social Care Act 2012, and its focus on competition, privatisation and marketisation, has brought the NHS to its knees. The NHS family has been treated in a stepmotherly fashion by this administration. Junior doctors, consultants and GPs are in dispute with government about their new contracts. If this administration doesn’t look after the genuine concerns of its workforce, the very future of the NHS – is at risk. The NHS has never been in a more dangerous position than it is right now. Rather than political gimmickry, the prime minister needs to focus on addressing the pressures facing the NHS. He needs to abandon the political pipedreams of tomorrow and get real about how we properly resource and rebuild the publicly funded NHS today.

(Dr Kailash Chand OBE is deputy chair of the British Medical Association (BMA) and has worked as a GP since 1983. He is ex-chair of Tameside and Glossop NHS.)