The greatest workforce crisis in NHS history

We are facing the “greatest workforce crisis in NHS history,” and the government is endangering patients’ lives by lacking any conclusive plan to address the acute staffing shortages in health and social care. 

This is the shocking conclusion of a new report published today from the cross-party Health and Social Care Select Committee. According to its findings, there is a shortage of 105,000 workers in NHS England, making the government’s post-pandemic aim to clear the record waiting lists of 6.6 million by 2024 “unachievable”. At the same time, NHS staff face “unsustainable” workloads in the face of “ever-growing demand”.

Making the situation worse, Sajid Javid, the former Health Secretary, told the committee that England is not on track to deliver its manifesto pledge to increase the number of GPs in England to 6,000 by 2024. There is also a shortage of midwives: between March 2021 and March 2022, over 500 midwives left the health service, exacerbating pre-existing concerns about England’s inadequate maternity care. 

What’s more, the report described conditions in social care as “regrettably worse”. Roughly 95% of care providers are struggling to hire staff while three quarters are finding it difficult to retain existing workers. The committee urged HMRC to be more proactive in enforcing the minimum wage, amid concerns that 17,000 care workers were paid below the legal rate of £9.50 an hour.

In light of these damning findings, the Department of Health and Social Care has insisted that NHS England is developing a long-term plan to recruit and retain more staff: for instance, “a £95m recruitment drive for maternity services” is currently underway. 

Yet the acute need to incentivise more individuals to join the NHS and social care sector comes at a time when the workforce is facing a real-term pay cuts. 

Last week, the government announced that newly-qualified nurses, paramedics and midwives are to receive an annual pay rise of 5.5%. With inflation set to soar above 10%, this amounts to one of the largest ever real cuts in wages. 

The report has cited low wages as a key factor in the workforce crisis. Patricia Marquis, England’s director at the Royal College of Nursing, said: ”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.” 

The report also warned that, without improved pay and better contracts, “social care remains a career of limited attraction, even when it is desperately needed.”

Jeremy Hunt, the former health secretary who chairs the committee, insists that tackling the workforce crisis should be a “top priority” for our next prime minister – a job he was hoping to fill himself. 

What solutions – if any – have the two rival candidates to become Prime Minister proposed so far? 

So far, neither Truss nor Sunak have proposed a real-time pay rise for health or social care staff. Despite health unions warning that below-inflation pay offers could lead to a staff exodus, both have argued that wage settlements above 5% for public sector workers could lock in high inflation for years, leaving staff worse off in the long term. Sunak has said he will make the NHS a priority but has yet to spell out any details.

Truss has also said that April’s National Insurance rise of 1.25% will be scrapped. It’s not hard to see why she’s adopted this policy: it’s popular with much of the public who are facing the highest tax burden in 70 years, amid the soaring cost of living.  Yet this tax – also known as social care levy – was specifically brought in by Boris Johnson to to address the “crisis in social care”.

 If Truss wants to reverse it, she will need to offer up some alternative ideas for how to set about making social care a more attractive sector where people want to work.