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1 day ago
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NHS trusts are right behind government ambitions to shift more care of patients from hospitals to the community and to do more to prevent ill health in the first place (Editorial, 8 March). But nobody should be under any illusion that this is going to happen overnight. Despite the recent budget boost for the NHS, finances for hospitals, mental health, community and ambulance services are stretched to the limit.
People are the backbone of the NHS, but growing demand and workloads, vacancies and financial pressures have left far too many staff feeling worn out and suffering low morale. This has driven up the rate of people leaving the health service. Worries about staffing cuts as trusts try to balance their books are going to make an already tough situation even harder for overstretched frontline teams.
A healthy nation needs a healthy NHS workforce. To achieve this, the NHS needs to recruit, train and keep the right amount of staff with the right mix of skills in the right places. That – and sustainable social care staffing – is what a plan for the next 10 years and a refreshed long-term strategy for the workforce must address, as trusts continue to work flat out to do all they can to make the most of every pound that goes into the NHS.
Saffron Cordery
Interim chief executive, NHS Providers
I recently retired from psychiatry practice after 42 years in the NHS. I have seen many reorganisations and cuts reframed as “efficiency savings”. In the 1990s, there was a move to reset community psychiatric care to be largely provided by non‑professional staff at lower cost than the elusive and expensive community psychiatric nurses, occupational therapists and social workers. The results of a well‑conducted trial of the new system against the old showed it to be less effective and more expensive, with marginally worse outcomes.
At the time, the enthusiasts were keen to press on but, happily, large amounts of money were not wasted in this way – perhaps because the next round of “efficiency saving” came rolling through.
Dr Geoffrey Searle
Salisbury
As the parent of a newly qualified doctor about to begin foundation year 1 training, I am witnessing first-hand the alarming crisis in medical career progression that threatens the future of our NHS.
Instead of celebrating her medical qualification, my daughter is caught in an anxiety-inducing scramble to build a competitive portfolio for specialty training. The British Medical Association recently highlighted a “significant year-on-year increase in applicants for specialty training places … without a commensurate increase in available positions”. The bottleneck is so severe that many UK-trained doctors face the prospect of unemployment or insecure fixed-term contracts.
The UK has “far fewer doctors than equivalently wealthy countries”, according to the BMA, yet successive governments have failed to plan adequately for workforce needs. Our brightest medical graduates are being forced to compete against increasing numbers of international applicants for too few training positions.
We need immediate expansion of specialty training positions and a comprehensive workforce strategy that values and retains the doctors we’ve already trained. Without urgent action, we risk losing a generation of medical talent at precisely the moment the NHS needs them most.
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