Staffing solutions are key to NHS recovery

How to heal the NHS: The top priority for the new prime minister must be putting a plan in place to try to solve the greatest workforce crisis in history, writes Rachel Clarke

Friday 26 August 2022 14:23 EDT
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There are more than 100,000 vacancies in the NHS
There are more than 100,000 vacancies in the NHS (Getty Images)

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Does anything expose a politician’s capacity to talk stone cold hogwash quite like a Conservative leadership campaign? Only this week prime ministerial shoo-in Liz Truss made the following claim to Times Radio: “What people who work in the NHS tell me is the problem is the number of layers in the organisation they have to go through to get things done, the lack of local decision-making. That’s what people are telling me is the problem, rather than a lack of funding.”

In the same breath, she airily announced a plan – although it sounded infinitely more like a whim, less “red meat” than pork scratching – to fix the real-time implosion of the NHS by taking £13bn of NHS funding and move it into social care. Yes, you read that right. Our prime minister-to-be alleges she can address the 6.7 million people on waiting lists, the horrendous ambulance and A&E waiting times – and the worst workforce crisis in NHS history – by effectively slashing 10 per cent of its intended budget.

I can’t even laugh, though it’s obviously risible. Because the truth is, conditions for NHS patients have never been more heartbreaking. Only two days before Truss’s fatuous comments, for example, the horrifying story of 87-year-old David Wakeley emerged.

The great-grandfather from Cornwall suffered seven broken ribs and two fractures of his pelvis after a fall – yet was forced to lie on the ground outside for 15 hours for an ambulance. That isn’t merely inhumane, it’s unforgivable. Yet cases like his are happening everywhere. Patients are dying in their homes before ambulances can reach them, in hospital corridors because we have no beds, in their own excrement because there aren’t enough staff to clean them – in conditions that are simply shameful for a country that calls itself civilised.

And for the real frontline staff who, like me, are forced to bear daily witness to this human suffering (as opposed to the fictitious ones who have Liz Truss on speed dial) the cumulative impact is soul-destroying.

Scarcely a week goes by at work these days in which I don’t come across a doctor or nurse on the wards in tears. There are various euphemisms for what those complicit in an imploding health service are forced to feel – burnout, moral injury and compassion fatigue, for example. But none really capture what it’s like to give everything you have to try to help patients, while seeing them slip through the ever-widening cracks.

Small wonder there are more than 100,000 vacancies in the NHS and a huge shortfall of nurses. The job, for too many, has become unendurable. None of my colleagues believes the NHS has a future if things continue as they are. Instead, we grit our teeth and look impotently on as the most humane thing Britain has ever achieved breaks apart around us – in plain sight, let’s be honest – while Liz Truss and Rishi Sunak pander to their bases with tired old tropes about cutting red tape and charging feckless patients.

Read more from our series on ‘How to heal the NHS’ by clicking here

The government now plans to recruit thousands of foreign workers from countries such as India and the Phillippines to plug those staffing gaps, according to reports, but it’s not nearly enough. We need staff now – before winter. The NHS has no future if endemic understaffing persists. Stealing nurses from Nepal just won’t cut it, quite apart from the ethical bankruptcy of this latest plan.

It galls me to quote Jeremy Hunt approvingly – not least when the NHS’s longest serving health secretary failed throughout his six years in post to produce any semblance of a proper, long-term workforce plan – but at least he talks sense now.

“We now face the greatest workforce crisis in history in the NHS and in social care, with still no idea of the number of additional doctors, nurses and other professionals we actually need,” he said recently, adding that exhausted NHS staff “know there is no silver bullet to solve this problem, but we should at least be giving them comfort that a plan is in place. This must be a top priority for the new prime minister.”

Let me be blunt: shortages of doctors, nurses, carers, paramedics, midwives, physiotherapists and every other type of allied health professional are, collectively, causing avoidable patient deaths in their thousands – and, in the longer term, they are destroying the NHS. I really can’t put it more plainly than that. To help heal the NHS, we need to start by bolstering those who prop it up.

Dr Rachel Clarke is a palliative care doctor and the author of Your Life in My Hands, Dear Life and Breathtaking

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