I was asked some direct questions this week about the NHS and nursing staff. They went something along the lines of: have we been this short of nurses before and what is morale like among nursing staff.
I was a guest on a local radio station, which was covering long accident and emergency waits, as well as looking more widely at nurse staffing because a trust leader had flagged it as a factor.
Among other things, the presenter asked me about national nurse shortages, nurse education, overseas recruitment, waiting times and delayed discharge. But it was the questions above that really made me think and reflect after I had come off air.
What was morale like and had we been this short of nurses before? It is hard to make such comparisons across time, due to the changing nature of pressures and demands on the health and care sector.
My reply was that it felt like we were in a particularly bad place on both counts and that I couldn’t recall a time when it had been worse. I may be wrong or right on one, both or neither, but this is why I said what I did.
“Sadly, we are hearing increasingly about very long ambulance waits, very long A&E waits, delayed diagnoses and more; all indicators of a system that is struggling”
When I began writing about healthcare in the run-up to the millennium, the papers were full of stories about patients experiencing long waits for treatment and being left in hospital corridors. It was a tough period but then things seemed to get better, as funding increased, and I hoped we would never see those times again.
Towards the end of the end of the next decade, the scandal at Mid Staffordshire NHS Foundation Trust emerged, with the phrase “Mid Staffs” becoming a byword for patient safety failings and an emphasis on finance over staffing levels. Again, I fervently hoped we would not see its like again.
Sadly, we are hearing increasingly about very long ambulance waits, very long A&E waits, delayed diagnoses and more; all indicators of a system that is struggling. Current estimates are that the UK has a nurse shortage of around 60,000, against the backdrop of a lack of nursing staff globally that is fuelling increased international recruitment from mid- and lower-income countries.
Meanwhile, data from the Nursing and Midwifery Council shows that 20,000 left the UK register over the past year and the latest NHS Staff Survey indicates that staff in England increasingly report feeling undervalued, overworked and concerned about staff shortages.
These numbers are large and of grave concern. One also has a habit of driving the other in a downward spiral. Staff shortages have a negative effect on morale which harm retention and contribute to further shortages and so on.
Throw into the mix that staff, who were already under pressure, have also coped with a pandemic, the ongoing impact of that pandemic on services and their own personal health and wellbeing, as well as rising living costs and below inflation pay rises, and you have a workforce that is feeling under extreme strain.
I am worried right now. Things seem bad, really bad. Are they the worst it’s ever been? I don’t know, it’s very hard to say, but it certainly feels that we are heading that way if not already there. The warning signs are clearly there and must not be ignored by those in power.