The RCP has warned that long waiting times in the NHS will become normalised unless the government acts immediately, as well as setting out credible long-term workforce solutions.
In a new policy paper, the RCP reiterates the case for long-term workforce planning and sets out a range of short- to medium-term solutions the government must implement now to keep the NHS running.
Staffing shortages are the biggest barrier to bringing down waiting lists and delivering healthcare sustainably in the long-term. A long-term plan for increasing staffing numbers, including expanding medical school places, is sorely needed to restore timely access to care and put the NHS workforce back on a sustainable footing. But given the urgency of the situation, the RCP has set out a range of short- and medium-term solutions that will make a difference now, from affordable childcare and flexible working to overseas recruitment and a new ‘retire and return’ deal for consultants.
The RCP’s recommendations are supported by findings from its latest census, conducted with the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Physicians of Edinburgh. This found that in 2021 over half (52%) of advertised consultant physician posts went unfilled – the largest number of vacancies on record.
The RCP’s paper makes several recommendations on how to grow, train and retain a healthcare workforce to ensure the long-term sustainability of the NHS, from improving basic staff welfare to changing training programmes.
The targeted focus by hospital teams and clinicians to reduce waiting times for those who have been waiting the longest for treatment has shown some success: in July, there were 1,521,711 patients waiting for diagnostic tests - fewer than the same figures for May and June. But this is in no small part down to dedicated and committed healthcare staff working above and beyond normal hours.
Staff shortages put huge additional pressure on staff as they try to pick up additional workload created by vacancies. According to the RCP census, 45% of consultant physicians say that they work excessive hours or have an excessive workload ‘almost always’ or ‘most of the time’.
The RCP is calling on the secretary of state for health and social care to commit to publish the long-term workforce strategy commissioned by the Department of Health and Social Care in January by the end of the year as planned.
Dr Sarah Clarke, president of the Royal College of Physicians, said: “The Royal College of Physicians has long argued for a significant expansion of the medical and wider healthcare workforce. Staffing shortages are the biggest barrier to meeting demand for care now and in the future.
“Workforce shortages are not a new problem and a failure to act has allowed them to worsen. Long waiting times will become normalised if this doesn’t change. We need a multi-year investment to expand the NHS and social care workforce, with planning to ensure future demand can be met. This should begin with publication of the NHS workforce plan by the end of 2022, along with immediate measures to ensure that the NHS can deliver high-quality care to all those who need it.”
Mr Mike McKirdy, president of the Royal College of Physicians and Surgeons of Glasgow, said: “We are acutely aware of unfilled posts and vacancies in our health service. Doctors and other healthcare staff are forced to compensate for staff shortages by taking on excessive workloads. For too many, this is leading to burnout and has an impact on patient care.
“We simply don’t have enough doctors to meet the current and future demands on our health service. Current workforce planning is inadequate and does not ensure a sustainable medical workforce in the UK.
“We welcome the progress being made in this area at UK Government level with a workforce strategy later in the year. We require a similar approach to workforce planning in the devolved nations in order to see the changes we need to protect the future of our profession.”
Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: “The latest physicians census, by our Colleges, highlights the need to have an effective recruitment and retention strategy in place for doctors across each of the four nations of the UK. This is vital to ensure that the NHS can continue to deliver safe, quality care for people.
“While increasing the number of medical school places and placements is welcome and vital, governments across the UK should also look to increase international recruitment as a means to boost the number of doctors working in our NHS, and to ensure safe staffing levels.
“This should be a temporary solution however, while the NHS workforce strategy is implemented and we must also remember that medical students and postgraduate doctors in training need structured education, supported training and mentorship.
“That, in turn, requires a strong foundation of more experienced doctors capable of taking these roles on – and we must ensure that we are doing everything possible to retain them in our NHS.”