NHS staffing crisis ‘cannot be cured just by hiring GPs’
THE NHS staffing crisis is so critical it cannot be fixed by training more doctors and nurses alone, according to a major report.
With falling numbers of GPs, the health service must consider recruiting 9,000 more physiotherapists and pharmacists to help in general practice, it said.
They could look after patients with ailments such as back pain and take care of repeat prescriptions, freeing up GPs to treat those most in need.
The report by the King’s Fund, Nuffield Trust and Health Foundation think-tanks warned patients are facing longer delays for treatment as the NHS struggles to recruit and retain sufficient staff.
Shortages of GPs in England will almost triple to 7,000 and double in nursing to 70,000 within five years unless action is taken, it said.
Richard Murray, of the King’s Fund, said: ‘ Without radical action to expand the NHS workforce, there is a very real risk that some of the extra funding pledged by the Government will go unspent, waiting lists will continue to grow and important improvements to services like mental health and general practice will fail.’
While nurse recruitment is failing to keep pace with rising demand, GP numbers are falling. Despite the Government vowing to create 5,000 additional GP posts by 2020, recent figures suggest a further shortfall of 1,300 full-time family doctors has developed.
Many choose to go abroad for better lifestyles, while high numbers are retiring early to avoid hefty taxes that kick in when their pension pot exceeds £1million.
The report noted 62 per cent of GPs now take early retirement, up from 33 per cent in 2011/12. Consequently, the service must look to other professionals to carry out some of the work, it suggests.
Mr Murray said: ‘We can’t GP our way out of the problem. There’s no way that by training more GPs or by trying to do something on retention that that on its own will create enough GPs.’
To plug the workforce gap, 6,000 more physiotherapists and 3,000 more pharmacists are needed in GP surgeries, he added.
He noted that around 20 per cent of patients who see GPs are there for issues such as back pain, and ‘this is exactly what physiotherapists are trained for’. Mr Murray said: ‘First-contact physiotherapy has been piloted across England and has been successful. You can’t [use it] with all of them – many patients may have things that still need a GP – but there’s a significant workload there [for physiotherapists].’
For pharmacists, he added, ‘there’s a lot of work that GPs do that is repeat prescribing, repeat
‘Patients’ safety put at risk’
dispensing, medications reviews’. Using a wider range of staff could relieve pressure on GPs, making it easier for patients to book appointments, he suggested.
The report warned of ‘dire’ nursing shortages that could escalate to 100,000 positions within a decade. While nursing numbers have increased, the number per head of the population has declined. In the past six years, the number of nurses leaving has grown by 25 per cent and one in nine staff left the NHS in 2017/18.
Anita Charlesworth, of the Health Foundation, said: ‘Although this is a really dire situation, it is not inevitable. The Government could do something to radically transform the situation.’
The report called for a £5,200-ayear grant for trainee nurses and tuition funding for all postgraduate nursing degrees. It also said an extra 5,000 nurses a year must be recruited from abroad, and barriers to international health staff coming to the UK removed.
The think-tanks said their proposals must be backed by a £900million increase in the annual budget for training and developing NHS workers by 2023/24.
Professor Helen Stokes-Lampard, of the Royal College of GPs, said: ‘We must not give up on our aims and endeavours to build the GP workforce.
‘We are extremely grateful to the hard work, skill and dedication of members of the wider practice team – they are pivotal in supporting us. But they are not GPs and must never be seen as direct substitutes or used to fill the gaps long term where numbers of GPs are insufficient.’
Rachel Power, of the Patients Association, said: ‘The NHS’s deepening workforce crisis is putting patients’ wellbeing and safety at risk.
‘This report identifies the massive scale of the challenge and the decisive action required.’
Dido Harding, of NHS Improvement, said: ‘Our staff are our biggest asset. It is vital we do more to retain, recruit and develop them across both health and social care.
‘I welcome this report, which will help inform the development of our workforce implementation plan.’