NHS faces chronic shortage of staff, warns King's Fund Deepening gaps in service's workforce so serious that bosses are under pressure to alter pay agreements to attract staff.
The NHS is facing such chronic shortages of GPs, nurses and specialists in elderly care in the next few years that patients may not get the care they need, a report warns.
Deepening gaps in the service's workforce are so serious that bosses may have to rip up longstanding national pay agreements in order to attract key staff, risking confrontation with the health unions, according to the King's Fund thinktank.
In an assessment of the NHS's 1.4 million labour force, it concludes that while it will soon have too many hospital doctors, there will also be too few psychiatrists and emergency care doctors.
It comes after the Commons health select committee highlighted the fact that more than 80% of A&E units cannot provide coverage by an on-duty consultant for the 16 hours a day needed to guarantee the best possible care.
These major gaps in NHS personnel will also be mirrored in social care, which by 2025 will have several hundred thousand fewer staff than it needs to properly look after the increasingly elderly population.
"The potential shortages in the formal and informal workforce faced by the health and social care system are breathtaking and will pose challenges to the implementation of new models of care. The scale and urgency of the task is immense", said co-authors Candace Imison, the King's Fund's acting head of policy, and Richard Bohmer.
Shortages of certain personnel are already affecting patient care, Imison said. For example, fewer newly qualified doctors are choosing to become geriatricians because of the pressures involved, and p – but at a time when increasing lifespans mean that more are needed. Psychiatry is also experiencing shortages due to similar pressures on staff, she added.
The NHS workforce will have to undergo radical changes if it is to cope with looming challenges in healthcare, such as the rising demand for healthcare posed by growing numbers of elderly people who may be suffering from several long-term conditions such as diabetes, heart trouble and kidney problems, said Imison, who is also a non-executive director of Kingston hospital in south-west London.
Staff will increasingly have to work outside of hospitals as more care is delivered in or near patients' homes, and staff currently working alone will have to do much more teamworking to benefit patients.
Dr Chaand Nagpaul, chair of the British Medical Association's GPs committee, voiced concern that "policymakers have failed to get a grip on NHS workforce planning. The projected imbalances between different specialities will have serious implications for patient care."
A shortage of doctors deciding to go into general practice will add to the already intense pressure on GPs and could mean that there are not enough GPs available to provide care to patients.
The Royal College of GPs has estimated that by 2021 there could be 16,000 fewer GPs than are needed, while the Royal College of Nursing has forecast a shortfall of 47,500 nurses by 2016 and 100,000 by 2022, as more nurses retire or go abroad to work and fewer would-be nurses start training. NHS statistics showed this week that there are 4,893 fewer nurses in England's NHS now than in May 2010.
Ending long-established UK-wide pay scales in the NHS could help overcome staff shortages, especially in areas where recruitment of staff is difficult, the report suggests. But Dr Peter Carter, the RCN's chief executive, signalled that nurses would oppose it. While they share the thinktank's call for a more flexible workforce "we strongly disagree with any proposals to localise the negotiation of pay, terms and conditions".
Professor Steve Field, the NHS's deputy medical director, said the report showed that NHS workforce planning had been "very poor for years".
He favoured looking again at existing pay structures and a greater use of "incentives" to help encourage teams of staff to provide higher quality care. The Guardian
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