New report says NHS and social care staff burnout at ’emergency’ level

NHS and social care staff burnout has reached an “emergency” level and poses a risk to the future of services, MPs have warned.

Burned out

In a highly critical report, the Health and Social Care Committee called for immediate action to support exhausted staff who have worked throughout the coronavirus (Covid-19) pandemic, but pointed to long-standing, unresolved issues even beforehand.

For example, the Royal College of Nursing (RCN) told MPs that, prior to the onset of the pandemic, there were 50,000 nursing vacancies in the UK, while the Royal College of Psychiatrists has said a lack of staff is one of the biggest causes of workforce burnout in mental health services.

In their new report, the MPs said:

The emergency that workforce burnout has become will not be solved without a total overhaul of the way the NHS does workforce planning.

After the pandemic, which revealed so many critical staff shortages, the least we can do for staff is to show there is a long-term solution to those shortages, ultimately the biggest driver of burnout.

A woman cycling past a rainbow graffiti in support of the NHS in Soho, central London (Victoria Jones/PA)
A woman cycling past a rainbow graffiti in support of the NHS in Soho, central London (Victoria Jones/PA)

The MPs said that, while issues such as excessive workloads may not be solved overnight, staff should be given the confidence that a long-term solution is in place. The study said:

The way that the NHS does workforce planning is at best opaque and at worst responsible for the unacceptable pressure on the current workforce which existed even before the pandemic. It is clear that workforce planning has been led by the funding envelope available  to health and social care rather than by demand and the capacity required to service that demand.

The MPs said that without a proper public statement on the staffing needs for the next decade, “the shortages in the health and care workforce will endure, to the detriment of both the service provision and the staff”.

They said they “recommend again” that Health Education England publishes “objective, transparent and independently-audited” annual reports on workforce needs for health and social care that cover the next five to 20 years.

Hunt

Tory MP and former health secretary Jeremy Hunt, who is chairman of the committee, said:

Workforce burnout across the NHS and care systems now presents an extraordinarily dangerous risk to the future functioning of both services. An absence of proper, detailed workforce planning has contributed to this, and was exposed by the pandemic with its many demands on staff.

However, staff shortages existed long before Covid-19.

Staff face unacceptable pressure with chronic excessive workload identified as a key driver of workforce burnout. It will simply not be possible to address the backlog caused by the pandemic unless these issues are addressed.

Achieving a long-term solution demands a complete overhaul of workforce planning.

Those plans should be guided by the need to ensure that the long-term supply of doctors, nurses and other clinicians is not constrained by short-term deficiencies in the number trained.

Failure to address this will lead to not just more burnout but more expenditure on locum doctors and agency nurses.

Hunt co-authored a book which called for the “NHS to be replaced with private insurance”, according to the Independent. OpenDemocracy reported on his time as health secretary, noting that:
Jeremy Hunt took over responsibility for the NHS in 2012. By the time he left the post 6 years later, patient experience and staff morale had both taken a dramatic turn for the worse across many key indicators. Winter crises deepened, with official figures showing 2017, 2018 and 2019 were successively “worst on record”.
On his role as chairman of the health committee, Dennis Campbell wrote:
The former health secretary will in effect be marking his own homework. It is bad news for the NHS, the public and democracy

Sickness in the NHS

During the pandemic, the NHS Staff Survey found 44% of staff reported feeling unwell as a result of work-related stress in the previous 12 months. But even before the crisis, the NHS faced shortages of around “one in 10 or one in 12 staff”, the MPs’ report added.

Meanwhile, in adult social care, MPs heard during their inquiry that the situation is “fragile”.

Skills For Care estimated that 7.3% of roles in adult social care had been vacant during the financial year 2019-20, equivalent to around 112,000 vacancies at any one time.

Professor Martin Marshall, chairman of the Royal College of GPs, said:

This report by the Health and Social Care select committee highlights the intense pressure that colleagues have faced across the health service, much of it as a direct result of inadequate staff numbers and appropriate workforce planning for the future.

We simply don’t have enough GPs or other members of the practice team to meet demand and general practice is only set to get busier as we support our communities’ recovery from the pandemic.

Stress

Dr David Wrigley, the British Medical Association’s (BMA) well-being lead, said:

Health and care staff suffered stress and work-related anxiety before the pandemic but it is now far more serious and we believe the current level of staff burnout and stress presents a worrying risk to the future functioning of the health and care system and safe patient care.

There’s an urgent need to address the severe workforce crisis facing health and care services, and – as called for by the BMA and others – the report also calls for continuous and transparent assessments of workforce shortages and future staffing requirements.

The RCN’s acting general secretary Pat Cullen said:

The unprecedented demand on nursing staff during the pandemic has had a huge impact on their own well-being.

But, as this report shows, the cracks in the systems designed to look after nursing staff appeared years ago.

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