New RCP policy paper on how to grow and retrain the healthcare workforce

The Royal College of Physicians (RCP) has published a new policy paper that makes several recommendations on how to grow, train and retain a healthcare workforce to ensure the long-term sustainability of the NHS.

The paper sets out a range of short- to medium-term solutions the government must implement now to keep the NHS running and says unless the government acts immediately long waiting times in the NHS will become normalised.

With staffing shortages being the biggest barrier to bringing down waiting lists and delivering healthcare sustainably in the long-term, the RCP says a long-term plan for increasing staffing numbers, including expanding medical school places, is sorely needed to restore timely access to care and put the NHS workforce back on a sustainable footing.

But it adds that given the amount of time that it takes to train new doctors, the NHS cannot just wait for new medical students to qualify and begin practising. Therefore, it has made a number of other suggestions and action to:

ensure that health and care staff from overseas who wish to come to the UK and work in the NHS have the opportunities and support to do so
help staff to access flexible, affordable childcare
embrace flexibility, including in training – the RCP has developed a toolkit on working flexibly, which includes tips for those at different stages of their career and advice on discussing flexible working with employers
encourage and facilitate retire and return, including by using portfolio job plans that maximise the benefits of returners’ professional experience.

45% of consultant physicians say that they work excessive hours

Staff shortages have put huge additional pressure on staff as they try to pick up additional workload created by vacancies. According to the RCP census, 45% of consultant physicians say that they work excessive hours or have an excessive workload ‘almost always’ or ‘most of the time’.

The RCP is calling on the secretary of state for health and social care to commit to publish the long-term workforce strategy commissioned by the Department of Health and Social Care in January by the end of the year as planned.

Dr Sarah Clarke, president of the Royal College of Physicians, said: “The Royal College of Physicians has long argued for a significant expansion of the medical and wider healthcare workforce. Staffing shortages are the biggest barrier to meeting demand for care now and in the future.

“Workforce shortages are not a new problem and a failure to act has allowed them to worsen. Long waiting times will become normalised if this doesn’t change. We need a multi-year investment to expand the NHS and social care workforce, with planning to ensure future demand can be met. This should begin with publication of the NHS workforce plan by the end of 2022, along with immediate measures to ensure that the NHS can deliver high-quality care to all those who need it.”

The government must listen and act on this paper

The policy paper was welcomed by the NHS Confederation and British Medical Association (BMA) who said these findings and recommendations serve to once again highlight the huge and negative impact staff shortages are having on the NHS, which, unless addressed head on means waiting lists will spiral further, staff will continue to feel exhausted and demoralised and patient care will unfortunately be compromised.

Matthew Taylor chief executive of the NHS Confederation said: “With one of the most challenging winters for decades just around the corner, NHS leaders are calling on the government to urgently publish a fully costed workforce plan to tackle the NHS staffing crisis which now tops 132,000 vacancies at the last count, as well as the 165,000 vacancies in the social care workforce.”

The BMA added that the College is right to highlight the need for multi-year investment and the publication of the NHS workforce plan – which must contain fully-modelled workforce assessments so that they can properly review government plans.

It also supported the assertion that chronic pay erosion and punitive pension taxation arrangements need to be urgently addressed because punitive pension tax rules continue to force senior doctors to reduce their hours or take early retirement, constraining clinical activity. The number of doctors taking early retirement has more than tripled over the last 13 years, for example, and the average retirement age has already fallen to 59.

Professor Philip Banfield, BMA council chair, added: “The government must listen and act on what this paper, and the BMA, is proposing. However, it can’t keep falling to doctors to find solutions to the workforce crisis in the NHS – the government must sit up and take responsibility, not only for why we have a workforce crisis, but also for fixing it. The health service is the people who work in it, and without them, we face a reality where there isn’t an NHS left to save.”