Future issues
Both David Cameron and health secretary, Jeremy Hunt spoke about plans for delivering this vision, with a commitment to boosting NHS funding by £8bn and the promise to recruit 5,000 new GPs.
However, the ‘seven day’ plans have attracted criticism from the Royal College of Nursing (RCN) which has threatened industrial action if pay and conditions of nurses are affected.
Doctors’ representatives and The British Medical Association are both calling on the government to explain how it will deliver additional care at a time when there are ‘chronic’ doctor shortages.
The seven-day vision was first announced two years ago by NHS England as a way of tackling higher death rates in hospitals at weekends. Research suggests that death rates are 16% higher for patients with emergency conditions admitted on Sundays compared with those admitted on Wednesdays. Heightening the need for the NHS to be more accessible, afterall you can’t predict when you will fall ill.
This proposal came from medical director Sir Bruce Keogh who said hospitals in England will have to ensure doctors and key diagnostic tests are available seven days a week.
One of the clear impacts of this plan will not only be the need to recruit more doctors but to increase the number of qualified medical staff at all levels to man wards 24 hours a day. As the NHS is currently facing a major shortage of skilled professional workers, agency doctors and nurses will play a bigger role.
The Royal College of Nurses said at the end of 2014 there were fewer nurses then, than in 2010, if midwives, health visitors and school nurses were not included. They claim that the source of these problems were the cuts in nursing training places that took place in 2010 which are now beginning to impact as it takes three years to train a nurse.
The medical profession needs to retain talent
A recent investigation by the BBC highlighted a national shortage of GPs, with doctors leaving the profession and junior doctors avoiding what they see as an “unglamorous career”. The BBC reported that the number of unfilled GP posts has quadrupled in the past three years.
The impact of the long-term shortage of newly trained GPs and nurses already means a severely under-staffed NHS. Add to this our ageing population and the NHS is rapidly approaching breaking point.
We would argue that some of the £8bn NHS investment should be used to fund more training places for nurses and to plan a recruitment campaign that will encourage people to become nurses. There are some early signs this is happening as earlier this year several NHS trusts chose International Nurses Day (12th May) to announce a recruitment drive.
Also in 2014 the Conservatives announced their new nursing apprenticeships to boost nursing numbers. All of these are positive steps, but still it takes time for the results to show and for the NHS to have more fully qualified nurses on hospital wards.
Morale boosting could be the key
There are also other obstacles to overcome than money to recruit. Last year a report by the King’s Fund found that staff morale was the biggest worry for NHS managers. The future of the NHS needs also to focus on the well-being of staff, the health system’s most important asset.
Lack of money, investment in recruitment and low morale have all contributed to the rise in the number of agency workers the NHS is using, which is likely to continue rising with the new seven-day plans.
A House of Commons Committee of Public Accounts report says that the NHS spent £2.6bn in 2013-14 on agency staff, compared with £2.1bn in 2012-13. Recent reports suggested that the NHS in London is spending £32 million each month, or £384 million a year, on temporary nursing staff.
However, whilst this sounds like a high sum, it needs to be put in context. The NHS’s total budget for England alone in 2015 is around £100 billion. The figures also don’t give the full story.
Agency staff currently play a vital role in keeping the NHS staffed at safe levels. In NHS trusts across the UK they are working seamlessly alongside permanent teams, giving hospitals the flexibility to cope with fluctuating staff numbers and avoid potentially dangerous under-staffing.
A shift towards the temporary
Specialist recruitment agencies offer the NHS fully trained, vetted agency nurses that work to the highest standards of care as well as doctors with the skills and experience to ensure that hospitals are always able to offer the best quality care to patients.
Agency staff can be cost effective, because they are only hired when needed and don’t carry the same longer-term costs, as directly employed staff, such as pensions, sick pay and holiday pay.
They help hospitals manage staff sickness, vacancies, annual leave and unexpected busy periods. Furthermore, most agency staff, especially nurses have had many more years of experience than the average for nursing staff.
Just as businesses have become used to using temporary staff when needed, so the modern NHS will need to continue recruiting top class agency workers to bolster teams and provide a fully integrated and seamless service to patients.