Falling short: the NHS workforce challenge

Early in 2019, the Health Foundation, in collaboration with The King’s Fund and the Nuffield Trust, published Closing the gap1 – a joint report on the NHS workforce, in the context of the 10-year plan for the NHS. The joint report argued that staffing was “the make-or-break issue for the NHS in England”. It pointed out that shortages are already having a direct impact on patient care and staff experience and, without significant funding and policy action, the staff shortfall was likely to become more pronounced, notably in nursing and primary care. 

The report highlighted nursing and general practice as two critical areas and made a series of recommendations, including using the skills of other staff much more widely in general practice, a ‘radical expansion of nurse training’, and an increase in international recruitment. The report was followed by the publication of another influential report in late 2019, by the Health Foundation, Falling short: the NHS workforce challenge.2 This highlighted the fact that the health service is increasingly having to rely on less-skilled clinical support staff to fill gaps in services when there aren’t enough nurses. 

The Health Foundation’s report revealed that, between March 2018 and March 2019, the NHS saw the biggest annual increase this decade in its overall workforce. However, the authors added that this growth is masking an ongoing shift in the mix of clinical staff employed in the NHS – while numbers of doctors have increased, much-needed growth in the number of registered nurses has been outstripped by increases in clinical support staff, including healthcare assistants and nursing associates. The report states that: