‘I had a breakdown and am homeless’: the impact of NHS staff shortages

A Guardian Healthcare Network survey found that almost half of respondents (48%) said patient care had been compromised on their last shift, while only 2% felt there were always enough people to provide safe care. Below, seven healthcare professionals explore how staff shortages in the health service affect them and their jobs.

Student nurse: I have been used to cover for registered staff

I am a student nurse and am often used to make up for a shortfall in support staff. This compromises my education and therefore the safety of my future patients. I was even used as cover for a registered staff member on one occasion, although this was an exceptional circumstance. The main issue, and I hear it from other students too, is being used as a support worker and even asked to sacrifice learning opportunities in order to push beds/wheelchairs, do clerical work, collect and deliver parcels.


Low numbers of nurses​ mean more pressure is put on patients’ families to provide ​basic ​​care

Paramedic: I see families wait hours before an ambulance arrives

Patients frequently wait an unacceptably long time because there are insufficient ambulances to meet demand. I regularly work on a rapid response vehicle and attend incidents where I have to hold the fort because no ambulance is available. This is stressful for me, for the dispatcher who sends me, and for the patient and their family who sometimes have to wait hours before an ambulance arrives.

Consultant: Patients’ families are having to provide basic care

Shifts are left unfilled, meaning other doctors cover more than one person’s role or, worse, act up in a role they are not fully trained to do. Patients are being reviewed by staff with less training. Low numbers of nurses mean more pressure is put on patients’ families to provide basic care – and few nurses are available to accompany doctors on ward rounds, meaning that they are not always aware of changes to patient care. Discharges can be delayed as there are fewer people to complete the paperwork – and beds cannot be freed for the next admission.

Allied health professional: I had a breakdown and resigned. I’m now homeless

I was working in a team of clinic-based and outreach therapists at a hospice. My job consisted of a large caseload at a junior level. Then everyone above me either left or went on long-term sick leave. I was left with no one but HR and the trustees to answer to – all other clinical heads of department were in the same crisis, or worse. I was told by HR to “hold the fort” and attempt to get guidance from my line manager, who was had been off for some time.

As time passed I could tell there were fundamental breaches of Care Quality Commission standards with regards to annual training and staff development. I repeatedly asked for help, but got no reply. Another therapist on the team made a complaint about my managerial incompetence. I was called in for a meeting soon after a member of my family was diagnosed with terminal cancer. I had a breakdown and resigned. I’m now homeless, sleeping on my parents’ sofa.

Psychologist: It’s a matter of when, not if, I leave the NHS

I’ve only worked in the NHS for four years, but already I’m feeling burnt out. Most of my colleagues who have recently trained as psychologists feel the same and it’s a matter of when, not if, we leave. Many of us are planning to cut down to two days a week in the NHS and one or two days a week in private practice. We can earn many multiples of our NHS hourly rate in private practice, but that’s not why we’re thinking of going. We love the NHS, we believe in it, but not at the expense of our mental health.

Nurse: Short staffing is detrimental to patient care, staff morale and retention

Short staffing is detrimental not only to patient care, but also to staff morale and retention. On many occasions I have come away from work frustrated and upset that I have not been able to deliver the standard of care that I would expect for a family member. I have worked many shifts where I have been a nurse to 16 high risk poorly patients.

Patients don’t see that you are doing your best, they just feel let down. Who can blame them? If you have one patient that needs immediate life-saving care and there are not enough staff, what are you to do? You treat them, but you are still accountable. It’s unfair to everyone involved, and unsafe.


We love the NHS, we believe in it – but we will not stay at the expense of our mental health

Consultant: I waste time organising cover when I should be treating patients

Staffing levels aren’t just about direct patient care, though that is the most vital area. There are also multiple knock-on effects. As a consultant I have worked extra shifts as far down as a senior house officer level to cover gaps, and have gone in when off duty because more help was needed.

When there are gaps in medical cover, I waste a lot of time trying to juggle rotas, negotiate cover, review possible locums and induct new locums. This time should be spent on treating patients, training juniors, developing services, and maintaining my own professional development.

Job plans have become complete works of fiction. When departments become increasingly reliant upon consultant locums, then the managerial load of running the place safely falls upon a smaller and smaller group of consultants, who are more likely to burn out. That then makes it even harder on those who are left. Morale was already low. But after the case of Dr Hadiza Bawa-Garba, who was struck off, I have seen what little morale remained drain away from my juniors. They know that if they whistleblow, they will end up like Dr Chris Day.

It seems if they do their best in impossible conditions and something goes wrong, the NHS will hang them out to dry and the courts will throw the book at them. Several juniors have informed me that they are now strongly considering emigrating.

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