Over 100 health and care organisations, including the Royal College of Physicians, behind the #StrengthInNumbers campaign have signed a letter to the Prime Minister urging him to accept the Lords’ amendment to the Health and Care Bill that will guarantee independent assessments of how many health and social care staff we need now and in future.
Rt. Hon. Boris Johnson MP, Prime Minister
10 Downing Street
London
SW1A 2AA
Dear Prime Minister,
We are writing to ask you and your government to accept the amendment on workforce planning when the Health and Care Bill returns to the House of Commons.
The pandemic has reinforced what we’ve long known: the NHS and social care need more staff. The amendment that was passed on 3 March – with support from cross-party peers, the Health and Social Care Select Committee and 100 health and care organisations – means that the bill now provides a mechanism for attaining clarity about the number of doctors, nurses, allied health professionals and social care staff we need now and into the future. Without it, we will continue to fly blind on NHS and social care staffing.
Lords amendment 29 will give a national, independent view of how many health and social care staff are needed to keep pace with projected demand over the next 5, 10 and 20 years. Our over 100 health and care organisations believe these data are crucial to begin putting the workforce back on a sustainable footing, support more strategic spending decisions and provide long-term cost savings. Recovery of our health and care services will be fatally undermined without a comprehensive workforce strategy that addresses endemic staff shortages by projecting future demand and supply.
There are significant challenges facing our country, including an ageing population, more people reliant on long-term care, and long-standing regional and specialty shortages. A national independent picture of projected staffing supply relative to projected demand will help to ensure the NHS and social care systems are prepared for the future. Staff shortages are a false economy. The current mismatch between supply and demand is leading in part to significant spend on locum and agency staff. In 2019/20, £6.2bn was spent on agency and bank staff in hospitals in England. Strategic increases in substantive staff would reduce reliance on locums and provide cost savings in the long run. These independent assessments are central to enabling the NHS to make the best use of public money.
Regularly published assessments will also enable the health and care system to make best use of new and emerging roles in health and social care, improving efficiency by ensuring staff are working to the top of their band and that their practice is informed by the latest evidence. These assessments will be based on current trajectories of demand given the rise in certain health conditions, demographic changes and the rising use of technology. By understanding the staffing numbers required to meet projected demand, the assessments will also provide robust data to inform decisions on wider policy measures – such as investment in prevention and public health strategies – which reduce avoidable pressure on health and care services.
The non-legislative approach taken so far has not worked. There are chronic vacancies across health and care, and previous NHS and Health Education England workforce frameworks have failed to set out how many staff are needed to keep pace with demand. Without transparency on numbers, progress cannot be made. Staff in post are under huge pressure as they pick up the additional workload created by staffing vacancies. We recognise that there are record numbers of staff working in the health service – but demand is at a record high too, with 6.1 million people currently on NHS waiting lists. Vacancies are rising too and now match pre-pandemic highs, with over 110,000 full-time equivalent vacancies in the NHS. Overstretched staff have significant implications both for safety and quality of care for the public and retention of staff.
Without this amendment, the Health and Care Bill will fail to address the biggest challenge facing the NHS and social care system: staffing shortages. The money from the National Insurance rise this April to help reduce pressure on the NHS and support social care reform will only go so far if there are not enough staff to deliver care to those on waiting lists or accessing social care services. Workforce is the limiting factor in your government’s plans for health and care. We urge you to carefully consider the intention of amendment 29 and ensure it stands part of the final Act.
We look forward to your response to this letter and would welcome the opportunity to meet with you to discuss this further.
Yours sincerely
- Academy of Medical Royal Colleges
- Action Kidney Cancer
- Age UK
- Alzheimer’s Society
- Association for Palliative Medicine of Great Britain and Ireland
- Association of British Clinical Diabetologists
- Association of British Neurologists
- Association of Cancer Physicians
- Asthma and Lung UK
- Bliss
- Blood Cancer UK
- Bowel Cancer UK
- Brain Tumour Charity
- Brain Tumour Research
- brainstrust – the brain cancer people
- Breast Cancer Now
- British and Irish Association of Stroke Physicians
- British Association of Dermatologists
- British Association for Sexual Health and HIV
- British Cardiovascular Society
- British Geriatrics Society
- British Heart Foundation
- British Medical Association (BMA)
- British Nuclear Medicine Society
- British Pharmacological Society
- British Psychological Society
- British Society for Haematology
- British Society for Rheumatology
- British Thoracic Society
- Cancer Awareness for Teens and Twenties
- Cancer Black Care
- Cancer Research UK
- Cancer52
- Centre for Mental Health
- Chartered Society of Physiotherapy
- Children with Cancer UK
- Children’s Cancer and Leukaemia Group
- Clinical Genetics Society
- CLL Support
- Crohn's & Colitis UK
- Diabetes UK
- Faculty of Dental Surgery of the Royal College of Surgeons of England
- Faculty of Physician Associates
- Faculty of Public Health
- Faculty of Sexual and Reproductive Healthcare
- Faculty of Sport and Exercise Medicine
- Grace Kelly Childhood Cancer Trust
- Health Foundation
- Independent Age
- Intensive Care Society
- Jo’s Cervical Cancer Trust
- Kidney Cancer UK
- Macmillan Cancer Support
- Marie Curie
- Medical Schools Council
- Mencap
- Mental Health Foundation
- Mesothelioma UK
- Mind
- Myeloma UK
- National Voices
- Neurological Alliance
- NHS Confederation
- NHS Providers
- Nuffield Trust
- One Cancer Voice
- Ovacome
- Ovarian Cancer Action
- Pancreatic Cancer UK
- Parkinson's UK
- Prostate Cancer UK
- Rethink Mental Illness
- Royal College of Anaesthetists
- Royal College of Emergency Medicine
- Royal College of General Practitioners
- Royal College of Midwives
- Royal College of Nursing
- Royal College of Obstetricians and Gynaecologists
- Royal College of Occupational Therapists
- Royal College of Ophthalmologists
- Royal College of Paediatrics and Child Health
- Royal College of Pathologists
- Royal College of Physicians
- Royal College of Physicians of Edinburgh
- Royal College of Physicians and Surgeons of Glasgow
- Royal College of Psychiatrists
- Royal College of Radiologists
- Royal College of Speech and Language Therapists
- Royal College of Surgeons of Edinburgh
- Royal College of Surgeons of England
- Sarcoma UK
- Society for Acute Medicine
- Society for Endocrinology
- Solving Kids Cancer
- Stroke Association
- Sue Ryder
- Target Ovarian Cancer
- Teenage Cancer Trust
- The King's Fund
- The Richmond Group
- UK Kidney Association
- UNISON
- Young Lives vs Cancer
- Young Minds
CC Chancellor of the Exchequer, Secretary of State for Health and Social Care