NHS suffering worst ever staff and cash crisis, figures show

This article was taken from: https://www.theguardian.com/society/2018/sep/11/nhs-suffering-worst-ever-staff-cash-crisis-figures-show

By Denis Campbell Health policy editor

Number of vacancies at record high in England as underlying deficit of £4.3bn revealed

The NHS’s staffing and financial problems are the worst they have ever been, official health service figures show.

The number of vacancies across the NHS in England has hit a record high while NHS bosses have disclosed for the first time the service’s underlying deficit built up over recent years – £4.3bn.

At the end of June the health service had 107,743 unfilled posts, up 9,268 from the 98,475 total seen just three months earlier, NHS Improvement said in its latest quarterly report on the service’s performance.

The regulator warned that the NHS’s struggles to recruit and retain staff were so difficult that vacancies would become even more common during the rest of 2018-19.

The NHS was short of 41,722 nurses – 11.8% of the entire nursing workforce. That is the highest number yet and a big rise on the 35,794 vacancies seen at the end of March.

Similarly, there were 11,576 vacancies for doctors across all types of NHS services inside and outside of hospitals. That was again a record and a significant increase on the 9,982 posts that were vacant three months before. Across England, 9.3% of posts were vacant.

Experts warned that NHS understaffing was so widespread that it was becoming a “national emergency”.

Siva Anandaciva, the chief analyst at the King’s Fund thinktank, said: “After a punishing summer of heatwaves and ever-increasing demands on services, today’s report shows that the NHS is heading for another tough winter.

‘Widespread and growing nursing shortages now risk becoming a national emergency and are symptomatic of a long-term failure in workforce planning, which has been exacerbated by the impact of Brexit and short-sighted immigration policies.”

Chris Hopson, the chief executive of NHS Providers, which represents NHS trusts, said that, despite their best efforts, hospitals were failing to cope with ever-increasing demand for NHS care.

“Trusts tell us they are most worried about the workforce shortages they face, and it’s a real concern that these figures have shown such a big increase in vacancy levels. It’s worrying that this problem is getting worse rather than better,” he said.

The NHS in London has the highest proportion of vacancies for nurses – 14.8% – with particular shortages in mental health and acute hospitals. But the biggest shortfall of doctors is in the Midlands and east of England, where the vacancy rate is 11.5%.

Vacancies meant the NHS had to spend just over £1.4bn in April, May and June employing personnel from employment agencies (£599m) and staff “banks” (£805m) to plug gaps in rotas. “Trusts have had to turn to using more bank and agency staff to ensure patients get the care they need,” NHS Improvement said.

Overall, 80% of nursing vacancies were filled by bank or agency staff, as were 85% of medical vacancies.

Having to spend such huge sums was the main reason NHS providers of care overspent and ended the first quarter of the year £814m in deficit, the NHS agency said.

Health experts praised the service for publishing for the first time its assessment of the true amount that NHS care providers are in the red.

Jonathan Ashworth, Labour’s shadow health secretary, said eight years of tiny NHS budget increases since 2010 had left “wards overcrowded and treatments cut back as hospital bosses struggle to make ends meet within the budgets provided by the government”.

Tom Sandford, the director of the Royal College of Nursing in England, said: “With winter fast approaching, these shocking figures betray the perilous state of NHS finances in England. An underlying deficit of £4.3bn, driven in part by reliance on expensive agency staff, does not point to a robust or resilient health service.”

In an illustration of the NHS’s ongoing parlous financial situation, the Barking, Havering and Redbridge NHS acute trust in north-east London has had to ask the Department of Health and Social Care if it can borrow about £100m to help it get through 2018-19.