The NHS is facing a significant and growing problem with staff shortages (Worst NHS staffing crisis in its history is putting patients at serious risk, MPs warn, 25 July). However, a focus on recruitment fails to get to the root cause. As a doctor, I know all too well that treating the symptoms of a problem, without investigating the underlying cause, does not lead to a reliable recovery.
Retention is where we should be focusing. NHS clinicians are burning out at an alarming rate. Inflexible rotas, mounting pressure from record waiting lists and overstretched resources are forcing many talented colleagues out of the door. Until we address these issues, recruitment drives and pay increases will not solve the crisis. Any new recruits will simply follow in the path of their predecessors, and the spiral will continue.
Anas Nader
CEO, Patchwork Health
• The ever growing gap between the available workforce and that which is needed to keep the NHS running means we need to overhaul how many elements of health and social care are delivered. The Covid-19 vaccination programme highlighted the ability to use new mechanisms – it wasn’t only registered healthcare professionals who delivered jabs into arms, but also skilled and experienced people from wider backgrounds.
It’s time to take the lessons from the vaccine rollout and apply them throughout the NHS, starting with areas with a high risk of staff turnover or understaffing where competency at particular tasks can be achieved under careful supervision, akin to resuscitation training, and undertaken readily by a wider group of volunteers, freeing up our highly skilled healthcare professionals to carry out other work that they are trained for.
Amanda Grantham
Healthcare expert, PA Consulting
• The NHS has a staffing crisis because scores of thousands of skilled staff have left prematurely. I took early retirement in 2017, and would return to a job I loved tomorrow if incentivised. The skills are out there, but trust is not. For me, the incentive is political: I would not contemplate returning to NHS work until there is a change of government. Can English voters not see what successive Tory governments have done to the NHS?
Jeremy Seymour
Retired psychiatrist
• Health Education England’s recent announcement of medical doctor degree apprenticeships promises to help solve the NHS recruitment crisis and promote increased diversity in the profession by providing an “alternative route”.
However, the available details are as sparse and vague as they are alarming, with everything from entry requirements to programme structure left open to individual employers (mainly NHS trusts) and partnered medical schools. There is a remarkable overreliance on the yet-to-be-implemented and therefore still unproven medical licensing assessment as an endpoint measure of equivalence. Given that it is such a dramatic departure from a centuries-old model, this is particularly problematic.
Claims that it will be “the same training, at the same high standard as traditional educational routes” are at best unevidenced. Rather than meaningfully addressing the issue of parity of access to university and medical school, this offering could end up undermining the profession, the would-be apprentices and the patients that it purports to serve.
Dr Sharon Holland
Psychiatrist
