The Nuffield Trust today warns that plans for an unprecedented £22 billion in savings and seven day working by 2020 will not be realised unless the health service reconnects with staff and develops their skills to better meet changing patient needs.
The NHS needs to hit very ambitious efficiency targets, at the same time as fundamentally changing the way care is delivered and moving to a seven day service. That can only be done if it has the right staff in the right places. Yet there are not enough staff to fill gaps in key areas, and we are seeing clear signs of stress and disengagement.Nigel Edwards, Chief Executive
In a new briefing, published as MPs prepare to debate the health elements of the Queen’s Speech, the think tank highlights the growing trend of hospitals relying on agency staff, problems recruiting and retaining GPs and a rise in staff sick leave due to stress.
The Nuffield Trust argues that these factors, together with the continued effects of holding down staff pay, suggest that disengagement and burnout could hamper progress at a time of immense pressure on the NHS.
The warning comes shortly after official figures showed NHS spending on agency workers soaring by 31% in just one year, largely accounting for an £800m hole in hospital and community service finances.
Nuffield Trust Chief Executive Nigel Edwards said:
“The NHS needs to hit very ambitious efficiency targets, at the same time as fundamentally changing the way care is delivered and moving to a seven day service. That can only be done if it has the right staff in the right places. Yet there are not enough staff to fill gaps in key areas, and we are seeing clear signs of stress and disengagement.
“Already, the health service has been thrown off course by the massive bill for agency staffing because it can’t get enough permanent nurses to join hospital trusts. Solving these problems doesn’t just mean pledging more doctors and nurses. We need to use those we have more intelligently, so that they’re more ready to deal with the growing number of older people with very complicated health issues.”
The briefing outlines ten priorities for the new Government on health and social care, making the case that:
- The Government’s continued support for the NHS’ Five Year Forward View plan, centred on new organisations combining GPs with specialists, is the right approach. Transforming the care patients receive outside of hospital needs to be a priority and more thought must be given to funding this change.
- The health service faces a funding crisis this year, with immediate action needed to stabilise it. The Government needs to bring in its pledged £8 billion funding increase at a steady pace, rather than holding it back to the end of the parliament.
- The health service still has a top-down culture, which can be too closed and punitive. The focus on the four hour A&E target at the expense of other goals risks distorting hospital priorities and wasting time.
Nigel Edwards continued:
“It’s welcome news that the Government has agreed to a steady plan for funding the NHS. But that plan relies on £22 billion in efficiency savings. That is well above what the health service, or the rest of the British economy, have managed in the recent past. We need more detail about where that sum will be found, and how it can be achieved in the face of rising patient needs, expensive new drugs, and plans for a seven day NHS.”
Notes to editors
- Health and social care priorities for the Government: 2015–2020 lays out ten key steps which the Nuffield Trust believes must be taken to secure and improve health and social care during this Parliament.
- The briefing follows figures from NHS regulators, Monitor and the Trust Development Authority, showing that agency staffing has risen sharply in the 2014/15 financial year.