NHS Recruitment Crisis: True Scale of Staff Shortages Revealed

More than two-thirds of NHS trusts are being forced to recruit doctors and nurses from abroad as they struggle to cope with a shortage of qualified staff, according to figures obtained by the BBC following a freedom of information request (FoI).

Over 30,000 Vacancies for Nurses & Doctors

The figures reveal that in December 2015 the NHS in England, Wales and Northern Ireland had more than 23, 443 vacant nursing posts and 6,207 available positions for doctors. That equates to a vacancy rate of 7% for doctors and 10% for nurses compared with an average vacancy rate of 2.7% for the general economy as assessed by the Office for National Statistics.

The figures also revealed a sharp increase in vacant posts since 2013, with the number of vacancies for doctors up by 60% and nursing vacancies up by 50%. The BBC’s FoI request also revealed that 69% of trusts were actively recruiting staff from abroad in the face of the escalating NHS recruitment crisis. Some trusts are even advertising in places as far afield as India and the Philippines in order to try to fill vacancies.

As we previously reported in our article on the weekend effect in NHS patients, staff shortages are also very much in the thinking of people who may need specialist medical treatment – a situation that could translate into increased cases of clinical negligence.

Situation Unlikely to Improve Until 2020

According to Ian Cumming, chief executive of Health Education in England, the situation is not expected to improve until 2020 at the earliest. Speaking on BBC Radio 4’s Today programme, Cumming said: “We certainly do recognise that there is a particular shortage of nurses, but also some other workforces within the NHS at the moment. The demand for nurses has gone up by 24,000 over the last three years.”

Referring to the failings exposed in the Mid Staffordshire hospital scandal, where hundreds of patients died needlessly as a result of substandard care and staff failings at two hospitals in Mid Staffordshire between January 2005 and March 2009, he explained that concerns about patient safety had prompted NHS trusts to try to recruit more qualified nurses.

Cumming said: “We are predicting that we will have supply and demand right for nurses for the NHS by about 2019/2020, but it does leave us with a gap between now and then. We train 20,000 nurses a year and if the demand goes up over and above what we normally have, by 24,000, we simply can’t fill those in one or two years.”

Number of Overseas Staff ‘Increasing’

It has also emerged that 69% of UK health trusts are actively recruiting from abroad for doctors and nurses, and Cumming indicated that said approximately 50% of vacant nursing posts would be filled by qualified nurses on full-term contracts. The rest of the vacancies would be filled by more expensive agency and temporary staff, as well as by recruitment from overseas.

Despite the fact that thousands of nursing vacancies remain unfilled, Cumming refused to be drawn on whether the current shortfall in qualified doctors and nurses amounted to a crisis, referring to the fact that vacancy rates in the north-west and south-west of England are only 3%, compared to the 15% in some parts of London.

Although Cumming admitted that the number of overseas staff in the NHS was increasing, he added: “This isn’t a new phenomenon. Overseas nurses have always made a contribution to our NHS.”

‘Patient Safety will Not be Compromised’

Despite the huge shortfall of qualified doctors and nurses in the health service, Cumming insisted that the NHS recruitment crisis would not compromise patient safety. He said: “There are more nurses employed in NHS hospitals now than there were two years ago. So the quality of care being delivered now is significantly better than it was two years ago. We aren’t where we want to be in terms of substantive staff, but most of these vacancies are being filled by temporary staff, therefore they are delivering care.”

What Could be Causing the Recruitment Crisis?

There are many potential reasons for the large number of vacancies in nursing and doctor posts at hospitals in England, Wales and Northern Ireland. The obvious reason is that more posts now exist, but the number of trainees needed to fill those positions has not increased significantly enough. In the wake of the 2008 financial crash, nursing jobs were cut, although they are now on the way back up. The British Medical Association (BMA) suggests it takes around 15 years between a medical student starting out at university and becoming a consultant, so planning the NHS workforce supply and demand is a complex process with a long lead-in time.

A growing population that is living longer is also contributing to the growing pressures on the NHS right across the UK. Quite often, elderly patients have “complex health needs” consisting of multiple ailments such as arthritis, diabetes and heart problems – all of which puts an additional strain on an already overstretched NHS.

The Royal College of Nursing and the BMA believe that poor workforce planning is one of the main reasons for the problems hospitals are having in finding qualified nursing staff.

Janet Davies, chief executive of the Royal College of Nursing, said: “Nursing posts are often the first target when savings need to be made, leading the NHS to find itself dangerously short and having to spend more on agency staff and recruitment from other countries.”

A spokesman for the BMA – which is currently locked in a dispute with the government in England over a new contract for junior doctors – said: “Poor workforce planning means we aren’t producing enough doctors and sending them to the right areas,”.

In a statement, the Department of Health (DH) said: “Staffing is a priority — that’s why there are already over 29,600 extra clinical staff, including more than 10,600 additional doctors and more than 10,600 additional nurses on our wards since May 2010.”

However, the DH did concede that “much more needs to be done”, and said the government was “changing student nursing, midwifery and allied health professionals funding to create up to 10,000 more training places by the end of this Parliament.”