Declining recruitment and increasing waiting times

by Joe Richardson

Recent news has seen reports of slower-than-average recruitment of NHS nurses and Trusts failing to meet national A&E waiting time targets, leaving the potential risk of failings in patient care.

According to the NHS Digital vacancy statistics, between January and March 2017 there were an estimated 86,035 full time vacancies advertised by the NHS; some advertised vacancies potentially take into account more than one open position, so the true figures could be even greater. This number is up nearly 10,000 from the year prior and raises a serious concern in relation to the retention and recruitment of staff, with the highest percentage increase seen in the ‘Nursing and Midwifery Registered Staff Group”, which accounted for 38% of full-time vacancies. Caroline Ashton, an in-house midwife here at Fletchers, recently wrote about the maternity ward crisis and how the latest figures revealed maternity wards in England had been forced to close nearly 400 times in 2016.

It would appear one of the reasons for the recent decrease in figures is due to poor funding from the Government, with PM Theresa May being accused of overseeing ‘an unprecedented workforce crisis in the NHS’. With some NHS staff reportedly working over 50 hours of overtime per month to help keep departments running in the midst of staffing issues and  the lack of pay rises (since the 1% cap for public sector workers was brought in in 2013), the recent vacancies aren’t drawing in the applicants.

NHS Providers, which represents hospital Trusts in England, fear an NHS winter crisis is looming and worries that patients’ lives will be at risk due to long waiting periods, a lack of available beds and limited staff. As we approach winter the demand for the NHS services is predicted to increase dramatically, and NHS staff will be exceptionally stretched; recently, a North Midlands trust asked people to stay away from A&E unless faced with a genuine emergency, to help reduce the pressures on the units.

Despite Trusts doing as much as they can with posts remaining unfilled, they could be left to fill gaps with expensive agency staff or look at stopping services altogether, a course of action which many view as unsustainable in the long term.

Consequently, overstretched A&E departments and nursing staff can result in patients being left at risk. January of this year was reported as the worst month for A&E departments, with over 80,000 patients waiting four or more hours to be treated.  Of the 1.4 million A&E visits in January, only 82% were dealt with within the Government’s stated target of fours to be seen or admitted.

It is becoming clear that A&E departments aren’t the only ones with increasing wait times, with a recent Freedom of Information request from the Royal College of Surgeons showing that five times as many patients in Wales are waiting more than a year for surgery compared to in 2013. Figures show 3,600 patients waited more than 12 month for surgery, whereas in 2013 it was just under 700.

Using agency staff or over-reliance on already overstretched staff to cover extra shifts and make up the staff shortages isn’t in the best interest of either patients or staff. It could see this winter be even more difficult to deal with than normal, with unsustainable workloads. The combined increase in demand from patients and lack of core nursing recruitment could see the NHS reach a crisis point where patient care sees a significant decline and errors start to occur on an unprecedented scale.