Public must get behind NHS workforce as concerns grow about second COVID-19 wave

Danny Mortimer

The public support for the NHS during the first part of the COVID-19 crisis was “remarkable and humbling” and this support will be needed again as a second wave hits at a time when the health service’s workforce is overstretched, and faces chronic staff shortages, the NHS Confederation has said.

In the latest report of the membership body’s NHS Reset campaign, COVID-19 and the health and care workforce: supporting our greatest asset, the NHS Confederation highlights the vital role the public has played, and calls for this to be “harnessed in collective efforts to improve people’s experience of work and to build the workforce of the future”.

The report also includes a key finding from a new member survey of more than 250 healthcare leaders, which revealed that nine out of ten respondents are concerned about the long-term impact of COVID-19 on the wellbeing of their staff.

The report adds that the greatest risk to supporting staff and delivering the NHS People Plan is workforce shortages, at a time when the most recent vacancy statistics for the NHS in England showed more than 83,000 vacancies at the end of the three months ending 30 June this year, with more than 120,000 vacancies in social care.

The recent promise of £28 million for international nurse recruitment, set out in Chief Nursing Officer for England Ruth May’s letter to regional chief nurses and nursing directors, was welcome, and the contribution of students and returners in the first phase of the crisis must be recognised, but there is still a much bigger problem to be addressed, especially in light of the backlog of elective and diagnostic activity.

It is therefore imperative that every effort is made to address workforce shortages, according to the report, immediately, and over the long term, to make sure the best and brightest staff can be both attracted and retained.

The NHS People Plan for 2020/21 and the NHS People Promise contained a welcome focus on underpinning employment practices that create open and inclusive workplaces, improving staff wellbeing, providing development opportunity and flexibility in working arrangements, but these fail to address fully the long-standing supply and vacancy issues facing health and care organisations, the report adds.

The Government’s upcoming comprehensive spending review must include investment to commit to the increased support for undergraduate study; support the workplace placements of additional healthcare professionals; and continue to lead national attraction and recruitment campaigns for health and social care, it states.

Among the other issues the report highlights, it also describes how discrimination, and especially that experienced by Black and minority ethnic (BME) staff, has been the greatest challenge to staff as a result of the COVID-19 pandemic, with a direct impact on mortality among the workforce and in turn, on staff’s mental wellbeing.

In the face of a disease that killed proportionately more people from BME backgrounds than anyone else, the report says, generations of racist discrimination in the UK were exposed. Now, the report makes clear, the evidence regarding discrimination and racism has led health and care leaders to take action, as they accept that it challenges their privilege, their inaction and the practices, policies and cultures that perpetuate inequality both in society and in NHS organisations.

The report sets out key actions that must be taken across the sector, such as improving diversity in NHS boardrooms, as leadership that better represents the people it serves has been shown to improve outcomes for patients; improving engagement so that the experiences of BME staff are properly understood by health and care leaders; and making sure BME staff feel safe and supported to speak up and raise concerns.

Taking an in-depth look at the first six months of the crisis and the impact on the health and care workforce as a whole, the report also highlights the extreme pressure on staff, with concerns over burnout and resilience.

To improve staff experience and reduce the risk of burnout, action on the ground must include commitment from senior leadership to create the conditions for an open and supportive culture; building line manager confidence, capability and capacity to support individuals and teams; and providing opportunities for staff to have input into job design and delivery.

Meanwhile, there has also been positive action taken across the sector to support staff, the report adds.

For example, Imperial College NHS Foundation Trust developed a comprehensive and stepped approach to supporting workforce wellbeing throughout the pandemic, during recovery and beyond. Focusing on practical support in the initial critical phase, it then pooled expertise to create a multi-modal offer to cover a 12-month period that will continue to support staff through the longer-term recovery phase.

Danny Mortimer, deputy chief executive of the NHS Confederation, said: “We owe a great debt of gratitude to everyone working in health and care over the course of the COVID-19 crisis. They have displayed admirable dedication, sacrifice and fortitude in the face of the greatest challenge the health service has ever faced. Our members are clear that they will need to continue to support their staff, and to take decisive action to address the serious concerns of BME staff.

“NHS staff are working hard to restore normal services, as well as respond to the resurgence of the virus. This resumption of non-COVID services for their patients is really important to them, but there are limiting factors due to the long-standing level of vacancies across the NHS. The scaling back of non-COVID services and treatment, and the support of the public, helped mitigate this pre-existing problem, as did the commitment and flexibility of NHS teams. Action and investment for the longer-term supply of additional staff is, however, vitally important.”

The NHS Confederation is now calling for four key actions from the Government:
  1. Provide funding to run more student placements, especially in mental health, learning disability and smaller professions;
  2. Continue investment made in staff mental health and wellbeing services to supplement local offers;
  3. Run a national recruitment campaign for health and social care;
  4. Ensure that any pay award for NHS staff is properly funded with additional investment and does not require reductions in other NHS budgets.

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