A report by three leading think tanks says that without radical action, the NHS has no chance of training enough GPs and nurses to solve the current shortage. In the report ‘Closing the Gap’, experts warn that the problem is not confined to GPs and nurses, but affects the whole health sector, including care workers.
The report, undertaken by The Nuffield Trust, Health Foundation and King’s Fund, said that the current shortages will continue to rise to nearly 70,000 nurses and more than 7,000 GPs within the next five years. Without decisive action, many NHS services will struggle to function. Co-author of the report Anita Charlesworth stated: “The workforce is the make-or-break issue for the health service. Unless staffing shortages are substantially reduced, the recent NHS Long Term Plan can only be a wish list.”
The report proposes a combination of international recruitment and student grants to address the staff crisis. To this end, it starts by advising that the governments’ 2016 decision to remove bursaries and introduce tuition fees is reversed. The report claims that this decision was detrimental, suggesting an annual grant of £5,200 in addition to the current means-tested loans system to attract more people into nursing. It also says postgraduate students wishing to re-train as nurses should be exempt from university fees.
Even with these measures, in order to close the gap, the NHS will need to treble the amount of nurses they currently recruit from abroad. This could prove difficult in light of the uncertainty surrounding Brexit, which has not only seen EU nurses leaving the UK, but UK nurses going abroad to work. The Royal College of Physicians (RCP) has calculated that the costs of recruiting EU and non-EU staff could more than triple from the current £150m a year if the freedom of movement ends post-Brexit.
The money would be spent on paying for visas to enable staff to work in the UK, and also the £200-a-year immigration health surcharge. On March 7th the government issued a memo announcing NHS exemption from the controversial £30,000 Tier 2 visa salary threshold. This applies to all nurses, paramedics and medical radiographers. However, it does not apply to support workers such as care staff, who play a vital role in supporting the NHS.
The report also made recommendations on how to reduce the shortfall in the number of GPs, which it warns could triple from 2,500 to 7,000 by 2023-24.
A new model of general practice was proposed, with multidisciplinary teams that incorporate the skills of other health professionals, such as physiotherapists, pharmacists and mental health professionals. According to independent research, 42% of GPs plan to retire in the next five years. Although the government launched a refresher scheme in 2016 to attract GPs out of retirement, so far the results have been modest.
Industry experts say that a fundamental change in attitude is needed from the government in order to tackle the problem. They argue that poor planning strategies have failed to build teams for long-term retention, which has resulted in vital skills being lost from the healthcare sector. In order to redress this, the report sets out how the NHS can become a better employer. This includes continuous investment in staff, with £250m per year set aside for skills development. Other initiatives include a plan to close gender and ethnic pay gaps, while flexible working, improved pay and student loan write-offs could be used to encourage staff into shortage areas.
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