Valuing our NHS staff is important now more than ever

I am putting it out there – I love the NHS. I know millions of people across the country do as well.  Having a service that provides free medical treatment – usually of high quality – when we need it, is something that the UK can be truly proud of. However, my love for the NHS also means that I worry about it. The NHS Five Year Forward View boldly says that the NHS value of providing high quality care for all has not changed, however adaptations need to be made to meet the challenges that society is now experiencing: people living longer (and with more complex health issues) and advances (and opportunities) that science and technology provide. Alongside this, there is great pressure for the NHS – service users have higher expectations of the care they should be provided, yet a recent report indicated that the NHS has to deliver efficiency savings of 2-3% a year, effectively setting a 10-15% real term cost reduction by 2021. To put that in simple terms – the NHS has to find £22 billion of efficiency savings.

This challenge that faces the NHS of managing the dual objectives of efficiency savings and continued quality improvements within our changing society becomes incumbent on NHS staff – and this highlights to me just how important NHS staff are, and how the NHS needs to look after them. There are numerous studies now showing how having a good work environment (e.g. managerial support, employee voice, etc.) and adequate staff to patient ratios have implications for patient satisfaction and patient outcomes…but are we getting this right.

Headlines this week suggest that we are not.  The NHS is facing unprecedented staff shortages levels, and there are quite rightly concerns with regards to the impact that this will have on the provision of patient care. But, I am also concerned about the implications this will have for current NHS staff, their increased work intensification and how long their ‘good will’ will continue in this era of increased pressures. Add to this the impact that Brexit could have on the healthcare workforce, with statistics this week showing that new work registrants from the EU have dropped by 96%, surely our focus has to be on maintaining the wellbeing and engagement of current staff to improve retention and reduce both sickness absence and turnover?

The hugely influential Boorman review looking at the health and wellbeing of NHS staff identified that successful businesses and organisations have recognised that good health is key to good business and the health and wellbeing of the workforce directly contributes to an organisation’s success. The review found that despite NHS staff reporting relatively high levels of health and wellbeing, sickness absence was high (an average of 10.7 days compared unfavourably with other government departments, and the public sector as a whole). Staff also reported high levels of presenteeism, and one of the main factors for this was fear of the patient care quality provided by temporary staff. With regards to turnover, an article this week discussing the sustainability of the NHS workforce highlighted a number of reasons why staff leave the NHS. Pay was not the most common (“unknown” rather frustratingly was – is this staff too scared to say?), and issues regarding work-life balance, morale and working relationships were low. This is in addition to the surprising finding in the NHS Staff Survey that employee engagement is showing small but consistent increases despite all the negativity around resource cuts, work intensification, and what I would say are intolerable levels of bullying and harassment. This to me shows the resilience of our NHS staff to engage with the values of the NHS to do the best they can for their patients despite everything happening around them. But how much longer can this last?

If the staff shortage levels continue increase how do we efficiently (both in terms of financial resources and patient care) ensure the sustainability of the NHS Workforce? We know that the NHS cannot be continuously supported by bank and agency staff (primarily for financial reasons, and the often anecdotal evidence regarding their impact on patient safety), so retention is critical. One way would be to see how well the recommendations of the Boorman Review were implemented into Trusts. Is it time to resurrect this review, see how far Trusts understood and took on board the recommendations, and review the health and wellbeing of the NHS workforce again?

I would like to thank our NHS staff for the work they do, and show how valued by the public it really is. I hope that people in the Department of Health and the NHS do the same.