A workforce crisis in the NHS

Abstract

Dissatisfied, burnt out, alienated. Is there a better way to describe how NHS staff feel? When you consider how much the public values health professionals, we have arrived at a desperate place. These problems pre-date Brexit. For example, in 2014, the National Audit Office estimated 50,000 vacancies across all clinical staff. Since then, the situation has declined and Brexit has not helped. As the workforce contracts, demands on staff expand. NHS organisations want more from fewer staff. This calculus is not only unsustainable, it is potentially catastrophic.

The undercurrents of job dissatisfaction, burnout and alienation are crushing the workforce. Trainee doctors are not progressing to specialty training in sufficient numbers. Primary care is understaffed. Senior professionals seek early retirement, even without the added impetus of a pension crisis. More nurses are leaving the profession than joining, with community services particularly vulnerable.

These are not mere hunches. Steve Iliffe and Jill Manthorpe have carefully sifted the evidence, and where there is despair, they bring hope and a model.¹ Their model tells us that the three undercurrents are reversible but that the solutions lie in work environments and processes rather than by focusing on individual vulnerability to stress. In an era obsessed with Brexit and ‘Love Island’, the screams from the front line of the NHS are loud but met with deafening indifference.

Elsewhere, this month, we bring you five strategies to ensure patient safety investigations improve patient safety,² the public health weaknesses revealed by recent cases of Listeria,³ and Winston Churchill's long sunset.⁴ Our aim, as ever with JRSM, is to add to your job satisfaction without contributing to burn out or alienating you. We would welcome your insight and ideas to help solve the workforce crisis of the NHS.

References

Iliffe S and Manthorpe J. Job dissatisfaction, ‘burnout’ and alienation of labour: undercurrents in England’s NHS. J R Soc Med 2019; 112: 370–377.

Macrae C. Investigating for improvement? Five strategies to ensure national patient safety investigations improve patient safety. J R Soc Med 2019; 112: 365–369.

Ashton J. Hospital and community deaths from listeria and streptococcus reveal weaknesses in public health. J R Soc Med 2019; 112: 401–403.

Vale JA and Scadding JW. Sir Winston Churchill: fracture of fifth thoracic vertebra and a stroke following a fall on 15 November 1960. J R Soc Med 2019; 112: 378–393.