NHS England’s workforce planning is “not fit for purpose”, according to a report that found a high turnover of staff was hurting the health service financially and reducing continuity of care.
The Health Foundation found the number of nurses and GPs had fallen at a time when the NHS was struggling to cope with growing demand, although a rise in managers and consultants contributed to an overall increase in the NHS workforce by 2% in the year to April.
In Rising Pressure: the NHS workforce challenge, the charity says that almost a third of staff are leaving some trust each year. This left management fighting and spending huge amounts of money “just to stand still”, it adds.
Anita Charlesworth, the foundation’s director of research and economics, said: “There is a growing gap between rhetoric about the government’s ambitions to grow the NHS workforce and the reality of falling numbers of nurses and GPs.
“This year has been characterised by a series of one-off announcements and initiatives, beset by unrealistic timescales and no overall strategy.
“The challenges and risks ahead for the NHS are well known, and must be met by collective action led by the government to put in place a coherent strategy to provide a sustainable workforce for the NHS.”
The charity found that the number of nurses declined by 0.2% in the year to April, while the number of GPs fell by 0.7% from December to the end of June.
The report casts doubt on the government’s ability to meet a number of targets, including increasing the number of GPs by 5,000 and creating 21,000 new mental health posts by 2020.
The fall in the number of nurses was found to be most notable in community nursing and mental health. The Health Foundation also found 1,220 fewer students from England had started undergraduate nursing degrees this year, which it blamed partly on the switch from bursaries to loans for training.
Just 38 GPs were recruited from overseas in the first six months of this year, despite the government aiming to recruit 2,000 to 3,000 foreign family doctors over the next three years, the foundation found.
Danny Mortimer, the chief executive of NHS Employers, said more needed to be done to improve staff retention and that uncertainty over the future of EU staff post-Brexit had made the uncertainty worse.
A Department of Health spokeswoman said: “Patients can be assured that the NHS has the staff it needs to provide the best possible care — over 12,700 more doctors, 10,600 more nurses on our wards and over 5,600 fewer managers and senior managers since May 2010.
“We have a clear plan to ensure the NHS remains a rewarding and attractive place to work, including more flexible working for nurses and greater safeguards for junior doctors, alongside an historic 25% increase in undergraduate medical school and nurse training places.”
The NHS pay cap has been highlighed as contributing factor in staff leaving the health service. In a separate report, also published on Monday, the Institute of Public Policy says lifting the cap would be about half the headline cost of £1.8bn a year by 2019-20.
The thinktank’s analysis identified the real cost as £950m, after taking into account money immediately returned to the Treasury through higher tax receipts and lower welfare payments plus the impact of additional GDP generated.
It found that a “catch-up” scenario of increasing NHS pay in line with private sector earnings plus 1% would have a headline cost of £3.9bn by 2019-20, but a net cost to the Treasury of £2.1bn. The analysis was welcomed by NHS Providers and the Royal College of Nursing, which both urged the chancellor to act on it in his budget next month.
A Treasury spokesman said: “We have already confirmed that the across-the-board 1% public sector pay policy will no longer apply. The independent pay review process is now underway for NHS staff and will report in spring 2018.”