NHS workforce recruitment challenges in healthcare industry (2024)

NHS recruitment and workforce challenges: Issues and potential solutions

The past two years have shone a huge spotlight on our National Health Service (NHS), reinforcing its enormous value and inspiring increasing interest in healthcare careers.

In 2021, Health Education England (HEE) reported a record rise in the number of applications for nursing degrees, with Professor Mark Radford, chief nurse of HEE, acknowledging: “To see applications rise for the third year running, and by such an extraordinary leap, is really wonderful news.”

There is no question that healthcare roles at any level can provide diverse and intellectually and emotionally rewarding careers, but the effects of the pandemic have taken their toll and the current healthcare recruitment challenges facing the NHS mean there is a need to act now to ensure a steady pipeline of future talent.

What are the key NHS workforce challenges?

1. Workplace pressure

Workplace pressure is one of the biggest NHS workforce challenges, which has been amplified dramatically since the pandemic. A Royal College of Nursing employment survey, published in December 2021, highlights issues of staff morale, sickness absence and the prospect of rising vacancies. In many cases staff feel undervalued, exhausted, and unable to provide the desired level of care to patients.

One of the biggest challenges of the NHS is workplace pressure, which has been amplified dramatically since the pandemic. A Royal College of Nursing employment survey, published in December 2021, highlights issues of staff morale, sickness absence and the prospect of rising vacancies. In many cases staff feel undervalued, exhausted, and unable to provide the desired level of care to patients.

“Nursing is an incredibly rewarding career and offers many exciting roles across health and care,” says Dr Nichola Ashby, head of learning and practice development at the Royal College of Nursing (RCN). But she adds that “They’re leaving the profession because of poor pay, the unrelenting pressure they’re under, the lack of support and not feeling valued”. Hence why nurse recruitment challenges require immediate addressing.

Innovations already being implemented include the Professional Nurse Advocate (PNA) programme which, since March 2021, has delivered training and restorative supervision for nursing staff across England.

Professor Martin Marshall, chair of the Royal College of General Practitioners (RCGP) agrees that change and support are needed. “Being a GP can be a fantastic job and it’s a career I would recommend to any aspiring medic,” he says. “But historic poor workforce planning and a decade of underinvestment in the general practice service has led to the profession working under intense workload and workforce pressures.” He says these pressures existed before the pandemic but that the crisis has exacerbated them – in some cases leading to GPs burning out or leaving the profession earlier than planned.

But he goes on to say “Despite the challenges facing the profession, efforts to boost recruitment into general practice are proving successful and we have more GPs in training than ever before. The fact that so many young medics want to be GPs is excellent.” He suggests “We now need to see equivalent efforts put in place to keep highly trained, experienced GPs in the profession longer, delivering patient care, and this needs to start with robust plans to address the escalating workload in general practice.”

2. Training and funding

Access to relevant training and continuing professional development (CPD) opportunities has never been more vital – as is the necessary funding and time to undertake training.

A report published by the British Medical Association (BMA) in 2021 (Medical staffing in England: a defining moment for doctors and patients), highlights that today’s clinical practice is multi-disciplinary, with patient care demands being more varied and complex than ever. As such, more and varied skills are needed across the board, from nurses and doctors to healthcare assistants.

Suggested measures to help fill the supply gap include more medical school, foundation programme and specialty training places, an expansion of teaching spaces and student clinical placement options, as well as the need for a rapidly expanded workforce of medical educators.

Experts add that there is a need to look at “innovative ways to move to blended approaches and flexible learning to maintain the quality of patient care and experience.”

This goes hand-in-hand with the need for greater funding. Just one issue that has been felt over the past five years is the removal of bursary funding for nursing in England, which created a fundamental barrier to training for many wanting to join the profession. As a result, fewer qualified nurses today are finishing their training. There is a need for “ministers to urgently grip these issues and ensure training and professional development is properly funded,” says the RCN’s Dr Ashby.

3. NHS workforce challenges: The need for adequate pay and prevent early retirement

At a time when challenges and workload in the NHS have never been greater, the need for adequate pay for valued knowledge and skills is vital. Yet pay remains one of the reasons staff are leaving the profession or retiring early. Nursing pay, for example, has fallen significantly in the last decade – by 15% in real terms. “The pay in nursing doesn’t match other graduate professions and those staff are dealt below-inflation pay awards year after year,” says Dr Ashby.

4. Why is the NHS so short staffed?

The driving desire of all those in healthcare roles is to give the best care possible to patients and this means having the necessary staff numbers and skills in the right place at the right time. Without adequately staffed teams in hospitals, social care and community nursing, the quality and experience of patient care can suffer, and staff can experience stress and burn out.

Experts say it’s up to ministers to step up and take responsibility for safe staffing levels, starting with the publication of a fully funded health and care workforce plan.

5. Sustainability recruitment: how to hire for the future

There is no quick fix to the recruitment challenges faced by the NHS. Sustainable long-term solutions need to be put in place to ensure the UK’s health and social care system is effectively staffed. This means ensuring careers in healthcare are attractive and fulfilling, and that staff are adequately supported, funded, paid and valued.

Despite the challenges of Covid, the pandemic has provoked positive opportunities for change. As well as highlighting healthcare roles as vital careers, it has inspired new ways of working, with more flexibility of roles and systems, and greater optimisation of skills. The importance of communication, trust, leadership and staff empowerment have been underlined, with the NHS noting “We must all now build on this momentum to transform the way our teams, organisations and systems work together, and how care is delivered for patients.”

Dr Ashby agrees that now is the time for action. “The pandemic has shone a spotlight on nursing prompting a surge of interest in the profession – it would be a crying shame if that wave of enthusiasm was squandered.”

Other measures to help tackle NHS workforce challenges...

• More flexible working conditions, which are vital to support staff productivity, as well as the work-life balance and health and wellbeing of NHS staff.

• Promoting “retire and return”: a vast pool of expertise lies with former NHS workers. During the pandemic, “retire and return” arrangements with former doctors, medical educators, researchers and specialist occupational health physicians helped plug the supply gap. This will continue to be a valued resource of talent for the NHS.

• Apprenticeships: the NHS highlights the need for more apprenticeships as a route into a variety of healthcare careers, from entry level up to senior scientific, clinical and management roles.