40% of GPs to quit within five years (Pulse: 26 October 2015)

Four out of five GPs in England are planning to cut back or stop practising in the next five years, with half of those intending to quit for good, according to a survey carried out in the West Midlands.

Out of nearly 1,200 GP respondents, four out of five – 82% – said they would be leaving general practice, reducing their clinical hours or taking a career break.

And around two out of five – 42% – said they intended to leave the job completely, while almost a quarter – 23% – said they planned to take a break.

Only 67 (5.6%) respondents said they planned to increase their hours of clinical work.

GPs intending to leave cited the volume and intensity of their workload, too much time spent on unimportant tasks and introduction of a seven-day working week as major contributors to their decision.

The study’s authors, from the University of Warwick Medical School, said their findings reflected ‘the breadth and magnitude of factors contributing to the workforce crisis facing general practice in England’ and suggest the ‘the scale of this crisis may be even greater than previously reported’.

They concluded: ‘New models of professionalism and organisational arrangements may be needed to address the issues described here. Without urgent action, the GP workforce crisis in England seems set to worsen.’

Junior doctors: 7 in 10 to leave NHS if Hunt pushes through new contract (The Guardian: 21 October 2015)

Thousands of junior doctors in England will quit the NHS if Jeremy Hunt presses ahead with his threat to impose an unpopular contract on them, a survey shows.

The poll has prompted warnings that such an exodus would leave the NHS unable to function, given young medics’ key role in delivering care.

In all, 2,949 (71.4%) of the 4,129 junior doctors polled said they would move abroad, become a locum or give up medicine altogether if the contract is forced on them next year as part of the government’s move to a seven-day NHS. Fewer than one in three – 1,180 (28.6%) of respondents – said they would stay in the NHS.

“These figures paint a very worrying picture. They echo the outpouring of anger from junior doctors in recent weeks and show just how let down they feel by the government’s proposals,” said Dr Johann Malawana, chair of the junior doctors committee (JDC) at the British Medical Association, the doctors’ union.

“If even a small proportion of junior doctors choose to vote with their feet, it would be a disaster for the NHS, coming at a time when we need more doctors, not fewer, to meet rising demand on services.”

The 4,129 respondents were asked: “If this new contract proposal goes through for August 2016, would you as a doctor leave the NHS?”. Some 1,733 (42%) said they would leave to work abroad, notably in Australia or New Zealand. Another 731 (17.7%) said they would leave the NHS and change career, and 485 (11.7%) said they would leave to work privately as a locum doctor.“Of the 70% of doctors declaring their intention to leave the NHS if the contract goes ahead, only a small fraction need to follow through to deliver a catastrophic blow to the survival of the NHS as we know it. Patients will find their already understaffed A&E or GP practice stretched beyond the limit,” said Dr Anne Warrington, who co-organised last weekend’s rally and the online survey.


Staff shortages common theme across NHS, warns CQC (Nursing Times: 15 October 2015)

Staffing shortfalls have been identified as a key factor affecting patient safety in hospitals and care homes, according to a report from the Care Quality Commission.

Poor staff numbers and skill mix and a tendency to rely on agency staff were a common factor in services rated “inadequate” by the regulator, it said today in its State of Health Care and Adult Social Care in England 2014-15 report.

The regulator’s annual analysis on service quality, published today, stressed that “quality depends on getting staffing right”. However, the regulator found that safe care at some of the top-rated organisations was also being hampered by staffing issues.

While the CQC found the majority of health and social care services in England were “good” or “outstanding”, it also found big variations in quality with safety still the biggest concern.

More than one in 10 hospitals – 13% – checked so far under the CQC’s new inspection regime were rated “inadequate” for safety. This was true of 10% of adult social care providers and 8% of primary care services.

In its wide-ranging report, the CQC stressed that having the right number and mix of staff was crucial to delivering the best care. Insufficient staffing number and skills mix were among key factors putting safety at risk across all sectors, the regulator said.

Other key issues identified by the CQC as affecting safety included failure to investigate and learn from mistakes, failure to do vital safety checks and staff not being able to raise concerns.


The regulator acknowledged nationwide recruitment difficulties in both the NHS and adult social care and expressed particular concern about staffing levels in mental health wards, with a drop in the number of psychiatric nurses and a surge in the use of bank and agency staff by mental health trusts.

It found even the best services were services struggling to fill vacancies and this was true when it came to NHS hospital trusts.


As well as emphasising the importance of getting staffing and skills mix right, the CQC also highlighted the key role of staff training and development.

Trusts will struggle to achieve agency nurse spending caps (HSJ: 14 October 2015)

Several trusts will struggle to reduce spending on agency nurses in line with the targets set by regulators, HSJ has been told. 

Monitor and the NHS Trust Development Authority last month issued “ceilings” to each provider on the proportion of nursing expenditure they can spend with temporary staffing agencies. The new targets, which vary depending on the amount trusts have previously spent, came into force at the start of this month.

The ceilings vary from 3 to 12 per cent. HSJ asked trusts across the range if they thought they could reduce spending as required. The responses suggest trusts currently spending a higher proportion on agency nurses will find it more difficult to meet their ceilings. Tameside Hospital Foundation Trust spends 6-8 per cent of its nursing expenditure on agency staff and is expected to gradually reduce this to 3 per cent by 2018-19. 

Chief executive Karen James said: “It’s going to be impossible to achieve a significant reduction in our spend [and] we can’t achieve the level we are being asked to this year.

“We can make a slight inroad in terms of the ceiling but we’ve been clear we’re not going to be able to achieve it and other trusts are saying similar things.”

Regarding the financial challenge facing the NHS, she said: “Everyone’s been working towards the [safe staffing] guidance and this has increased demand for agency nurses. This all could have been predicted.”

She described the staffing guidance as a “very crude tool” and called for regulators to account for the roles played by allied health professionals in making wards safe.


NHS 'backtracking' on ward nurse numbers introduced after Mid Staffs (The Guardian: 13 October 2015)

The NHS has been accused of backtracking on improvements in patient safety made after the Mid Staffs scandal by reducing the number of nurses on wards because of its growing financial crisis.

NHS bosses have told hospitals they no longer have to ensure that one nurse is caring for no more than eight patients at a time, in order to help tackle a £2bn black hole that has left 80% of hospitals facing deficits of up to £100m each.

The letter states: “We would stress that a 1:8 ratio is a guide not a requirement. It should not be unthinkingly adhered to. Achieving the right number and balance of clinical and support staff to deliver quality care based on patient needs in an efficient way that makes the best possible use of available resources is the key issue for provider [hospital] boards.”

The move, set out in a letter to all hospital chiefs, has sparked fears that patient safety will be sacrificed to help hospitals cut costs. It makes clear that financial considerations are deemed to be as important as the safety and quality of care patients receive when deciding how many nurses should be on duty.

Cash-strapped hospitals may be tempted to cut their nurse staffing levels as a result of the new advice, the Royal College of Nursing (RCN) warned. Staffing takes up 70% of the NHS’s budget and its bill for employing temporary staff to plug gaps in rotas, especially expensive agency nurses, has hit £3.3bn in the last two years.

The letter has been signed by NHS England, the Care Quality Commission, the National Institute for Health and Care Excellence (Nice), and the regulator NHS Improvement. It recommends that hospitals can ask health professionals, such as physiotherapists, to help look after patients, and use technology to monitor their condition, to reduce the need for nurses on duty.

Devon and Cornwall agency nurses spend raises concerns (The BBC: 30 September 2015)

Health trusts in Devon and Cornwall spent almost as much on agency nurses in the first half of this year than they did throughout 2014, figures show.

Hospitals and other NHS health trusts spent £23.3m from January to June and £25.3m in 2014.

The figures came from a Freedom of Information request by the Royal College of Nursing.

Trusts, which have been ordered to reduce agency staff spending, blamed a national shortage in full-time nurses.

Jeannett Martin, regional director for Royal College of Nursing (RCN), said: "The RCN has been highlighting the increasing agency spend for several years yet we continue to see costs rise year after year.

"NHS trusts are trying to plug the vacancy gap, to ensure that patients get the care they need, by relying on agencies to supply temporary staff but this is not a sustainable approach."

‘I can’t sacrifice my family for the NHS’: the junior doctors forced out of jobs they love (The Guardian: 29 September 2015)

At what point does a dedicated doctor, with a lifelong commitment to the NHS, decide it is time to quit ? For Dr Singh, 34, a junior doctor in general medicine, the moment will come when he is no longer able to pay his mortgage and childcare bills, a situation he expects to find himself facing sometime next year. Dr Singh has worked in hospitals, with regular A& E shifts, for 10 years since qualifying, loves his job and describes himself as “the kind of doctor you’d want to see to your gran”. But, having done an online calculation assessing how the Department of Health’s new junior doctor contract will affect his household income, he believes he and his paediatrician wife face a 25% cut to their joint take-home pay, making life in London unaffordable. He plans to move into the pharmaceutical industry. Several of Dr Singh’s friends have already left the medical profession to work as bankers and consultants in the City; others are considering emigrating to work as doctors in Australia or New Zealand. Most of them are dispirited by the proposed contract, but are more fed up with the daily stress of their work, annoyed that the long hours and considerable financial and personal sacrifices they make during their training are not appreciated, and they worry about the impact that dwindling morale could have on the NHS and its patients. 

Junior doctors will be balloted to decide whether to strike over a radical new contract imposed on them by the Department of Health, which redefines their normal working week to include Saturday and removes overtime rates for work between 7pm and 10pm every day except Sunday. The government says the changes will come with a rise in basic salary, higher hourly rates for antisocial hours and will be “cost neutral” – but doctors believe this change could reduce salaries in some areas of medicine by up to 30%. Anushka Patchava, 29, a radiologist who qualified in 2011 and has at least two more years as a junior doctor before she graduates to being a consultant, plans to switch careers and is midway through a rigorous interviewing process with two management consultancy firms. She is fed up with the hours and the current pay and is despondent at the prospect of getting a substantial cut to her salary. She earns £31,000, which includes a 40% supplement to her basic salary, to compensate for the antisocial hours she works. Once the new contract is imposed, she thinks she will see this reduced to £27,000 or £28,000 and she expects the hours she works will become even more antisocial. If she gets the management consultancy job, Patchava will quadruple her salary on day one. These are not alarmist stories being spread by campaigners. Even the Conservative MP and doctor Sarah Wollaston, who chairs the Health Select Committee, knows about the brain drain – her daughter has left the NHS for Australia. Now she, her husband and eight of their friends work in a hospital where they have yet to meet an Australian junior doctor in the casualty department. “It is staffed almost entirely by British-trained junior doctors,” Wollaston wrote this week. Other changes include the removal of a supplement paid to those going into general practice, to match those working in hospitals, which doctors believe could see trainee GPs losing a third of their pay. Foiz Ahmed, a junior doctor in emergency plastic surgery (who is grappling with £30,000 debt) argues that the new contracts will strike a pernicious blow to the NHS and patient safety. “This isn’t just about salaries, although of course a 10-30% pay cut is unmanageable for most of us. Let’s ignore the fact that I used to earn more an hour while working for a mobile-phone company as a student ... With the continued denigration of public perception of doctors, there is a sustained attempt to make the NHS fail. A demoralised workforce performs less efficiently, and a less-efficient system can be broken up and sold to private firms.”

NHS call handler says service is 'dangerously short-staffed'. (ITV News: 29 September 2015)

A Derbyshire call-handler who worked for the NHS 111 hotline claims the service is dangerously short staffed. Irsah Tahir from Derby says often there is only one nurse on call to cover an area of over 2 million people. Derbyshire Health United say they offer an effective and well led service which performed within NHS guidelines.

London doctors stage Whitehall protest over government contract plans. (London Evening Standard:28 September 2015)

Scores of doctors marched through central London as the row over government plans to introduce new contracts next year intensified. Protesters said several thousand people helped close off Whitehall near Downing Street in the demonstration against the Department of Health's proposals. Critics say the changes include pay cuts of up to 30% as overtime rates would be scrapped for work between 7am and 10pm on every day except Sunday. Janis Burns, a 34-year-old doctor who works for the Royal Brompton and Harefield NHS Trust, told the Standard she had joined the protest because she fears the plans will lead to patients being harmed. "Removing mandatory safeguards and any financial disincentive that protects junior doctors from working unsafe hours will lead to tired and overworked doctors. When doctors are tired we make mistakes, and mistakes harm patients." The British Medical Association has announced it plans to ballot junior doctors on strike action over the proposals.

GPs to debate resignation from the NHS en masse. (Pulse: 28 September 2015)

GPs will debate whether the profession should resign from the NHS en masse at the Pulse Live conference tomorrow. The debate, taking place in Liverpool, will see delegates voting on the question ‘Is it time for all GPs to resign from their NHS contracts ?’, and will involve chair of the Family Doctor Association Dr Peter Swinyard and Dr Zoe Norris, media lead for GP Survival. The panel will be debating whether it is time for GPs to take the major step in response to health secretary Jeremy Hunt’s ‘new deal’, in which he pushed for GPs to offer seven-day access. It also comes as junior doctors are going to be balloted by the BMA on whether to take industrial action in response to the Government imposing a contract that will see Saturday working reclassified as ‘sociable’ hours. In a preview to the debate, Dr John Cosgrove, an RCGP council member who will also be on the panel, argued that the message about GPs’ workload is not getting through to ministers, as evidenced by the ‘new deal’. He added: ‘Experience tells us the only effective negotiating tool to bring about real change is a credible threat of mass GP resignation. Holding undated letters of resignation enabled the BMA to negotiate the 2004 GP contract, and the time has now come for a similar move. ‘This has the potential to persuade the Government to resource general practice adequately and to support us in defining our remit and that of the NHS.’ Dr Roger Henderson, a GP in Shropshire who will also be on the panel, says that at first glance, resigning en masse ‘may seem like a no brainer’.

Numbers of NHS doctors registering to work overseas could reach unprecedented record. (The Independent: 21 September 2015)

The Government’s decision to impose a new contract on junior doctors may risk an exodus of young medics, after figures revealed an unprecedented spike in NHS doctors registering to work overseas. Doctors seeking to work abroad must apply for Certificates of Current Professional Status (CCPS) from their regulator, the General Medical Council (GMC). In just three days last week, the GMC received 1,644 requests for CCPS documents. Typically, it receives around 20 to 25 a day. The extraordinary spike in demand began on 16 September, the day after the Government confirmed it would seek to impose a new contract on junior doctors, after their union, the British Medical Association (BMA), refused to return to negotiations. Proposed reforms under the new contract would see juniors lose out on pay premiums for working weekday evenings and on Saturdays.Thousands of doctors are thought to have left the UK to work overseas in recent years, with Australia, New Zealand and Canada among the most popular destinations. There are no official figures showing how many leave each year and though not all doctors who request a CCPS eventually leave the country, application rates for the certificates are considered the best indicator of interest in working abroad.The BMA said doctors may take industrial action to resist an imposed contract. A petition supporting strike calls has attracted 52,000 signatures. Devolved governments in Wales and Scotland have confirmed they will not be adopting the proposed new contract.

NHS outsourcing deal loses 1,000 jobs (Financial Times: 26 July 2015)

Capita, the FTSE 100 outsourcer, is planning to cut nearly 1,000 jobs when it takes on a £1bn contract to supply administrative support to the NHS.

Almost 80 per cent of employees in the Primary Care Support Services division will lose their jobs and 28 of 30 offices will be shut when the service is transferred from the public sector in September.

The staff provide back-office services such as payments administration and management of clinical records for NHS primary care providers including GPs, opticians, pharmacists and dentists.

The Capita contract is the latest in a series of outsourcing deals in the NHS, as Britain’s state-funded health service increasingly seeks to use the private sector in pursuit of cost savings. Although the award remains subject to final approval from the Department of Health, sign-off is expected within days.

NHS England said the deal would create “substantial administrative savings to reinvest in frontline health services, and will form the basis of full consultation with the employees involved”.


Massive leaked NHS privatisation plan could shut 29 centres and make 800 staff redundant (Mirror: 24 July 2015)

A massive NHS privatisation plan worth up to £1bn is threatening to shut 29 centres across England, leaked documents reveal today.

Outraged union reps at Unison fear the plans, handed to the Liverpool Echo , will put the jobs of 800 hard-working admin staff at risk.

The workers are based at 32 Primary Care Support centres, which keep medical records up to date and send out letters to millions of patients.

NHS England is planning to hand responsibility for the centres to private company Capita in September.

Now proposals sent to staff suggest Capita is proposing to shut down 29 centres, leaving just three in Leeds, Preston and Essex.

NHS bosses insist the plans will free up cash for frontline staff as part of the Tories' vow to protect the NHS.


Why Jeremy Hunt is wrong: NHS medical staff respond to ultimatum (The Guardian: 16 July 2015)

Health secretary Jeremy Hunt has given NHS consultants an ultimatum: agree to work weekends within six weeks, or a seven-day contract and cuts to overtime pay will be imposed from April 2017, he said in a speech at the King’s Fund in London.

The British Medical Association (BMA) called Hunt’s plans a “wholesale attack on doctors” and said that the government was attempting to distract from its lack of investment in emergency care.

The head of the BMA, Dr Mark Porter, told the BBC that doctors supported an improved, seven-day NHS service, but other factors were to blame, including a lack of resources.


David Cameron unhappy about loss of NHS nurses (Oxford Mail: 30 June 2015)

Prime Minister David Cameron has said it was “extremely disappointing” Chipping Norton Hospital was to lose NHS nurses from its intermediate care ward.

The Witney MP made the comment after it was revealed nurses at the 14-bed unit at the London Road hospital, currently managed by Oxford Health NHS Foundation Trust, will come under the control of the Orders of St John Care Trust.

OSJCT runs the Henry Cornish care home, which is next door, as well as a number of other care homes across the south of England.

Campaigners have fought to keep the unit under NHS control, fearing a reduction in the quality of care.

Oxfordshire County Council, which commissions the service, has been consulting on the changes and believes it can cut the cost of each individual bed from £1,777 to £823 per week.

Mr Cameron said: “It is extremely disappointing to hear that, following a consultation, Oxfordshire County Council is returning to the original proposal that intermediate care beds are staffed by the Orders of St John Care Trust.”


GP surgery faces closure over NHS funding as doctors quit Limehouse practice (The Docklands and East London Advertiser: 9 June 2015)

The Limehouse Practice in Gill Street could be closed down after two GPs quit—leaving the surgery unable to cope with falling incomes and rising workloads.

The remaining six GPs are now insecure and are also on the verge of leaving, after the NHS switched the way it funds practices in deprived areas.

The practice is “unlikely to find replacements” with the national shortage of GPs and could close within months, it warned.

“This will be a tragic waste if we’re forced to close,” one of the GP partners, Dr Naureen Bhatti, told the East London Advertiser.

Doctors are now just another group of ‘key workers’ being forced out of the East End because we can’t afford to live here any longer.”

Closure of the Limehouse Practice would strain other surgeries, with 10,000 patients struggling to find a new GP, doctors warn.

Embattled GPs across East London have been running a ‘Save Our Surgeries’ campaign since the latest round of cuts began to hit practices.

Stepney’s Jubilee Street Practice managed to get an 11th hour reprieve—but with only two years of funding and half the budget already spent keeping it open. It also fears for its future.


Thousands of patients forced to hunt for a new GP as staffing shortages accelerate practice closures (01 June 2015: Independent) 

Thousands of patients have had to find a new GP because their local practice has closed, as staffing shortages and workload pressures take their toll on surgeries, new figures show.

In England, Scotland and Wales, 61 practices have closed since April 2013 which has forced more than 160,000 people to register somewhere new, figures obtained via Freedom of Information (FOI) requests show. Closures are being forced by problems both in recruiting new GPs and in retaining the existing workforce. The figures, obtained by the GPs’ magazine Pulse, were described as “the tip of an iceberg” by one senior GP.


How nursing agencies making billions are bleeding the NHS dry (31 May 2015: Telegraph)

The extraordinary boom in agencies supplying doctors and nurses to the NHS amid a rapidly deepening deficit in the health service is revealed today.

An investigation by The Telegraph shows how total revenue at 10 of Britain’s biggest medical recruiters rose by almost 40 per cent over three years, with the companies posting overall takings of £7.7 billion since 2009.

The businessmen running the agencies are earning up to £950,000 a year and living expensive lifestyles in properties worth millions of pounds, prompting warnings last night that the NHS needed “to get a grip”.

The chairman of one firm, which supplies both the NHS and the private sector, lives in a £9.5 million house in central London and drives an Aston Martin DB9 sports car.


'War of words' likely over seven-day GP opening (21 May 2015: BBC)

Complaints about the rising workload and lack of funding for primary care in England have been made loud and clear for some time now.

David Cameron's restated drive to make the NHS a fully seven-day-a-week service has added to their sense of grievance.

For the British Medical Association (BMA) to criticise the government over its handling of primary care is hardly new.

The BMA has already made clear its opposition to moving towards seven-day-a-week surgery opening before current shortfalls in staffing and resources are addressed.

But the tone of the speech by Dr Chaand Nagpaul, chair of the BMA's GP committee, represents an escalation of the rhetoric and a further souring of its relationship with Whitehall.

He refers to a "catastrophic timebomb ready to explode" in the shape of doctors leaving general practice. He says that without a turnaround in recruitment "we won't have a comprehensive general practice service in parts of the UK".


Concern over practicality of 'seven-day NHS' plan (21 May 2015: SourceWire)

Commenting on the Government’s outline plans for a seven-day NHS, Nick Simpson, CEO of the nursing recruitment agency MSI said;

“As an organisation which is on the front line of recruitment into the NHS, we understand the direct correlation between timely access to healthcare professionals and patient safety. On this basis, we welcome proposals to extend the availability to access to GPs. However, it is perhaps needless to say, that an increase in availability of front line services will exacerbate existing GP and Nurse Practitioner shortages.”

“It’s no secret that the NHS is already struggling to recruit enough GPs and other health professionals. Indeed, the Royal College of General Practitioners (RCGP) has estimated a fourfold increase in unfilled posts since 2010. According to analysis by health think-tank The King’s Fund, this shortage can be attributed to fewer GP training posts being filled, coupled with more family doctors choosing to take early retirement.” 


NHS staffing pressures risk 'stifling' cancer research (19 May 2015: Nursing Times) 

The daily pressure facing nurses and other clinicians is having a serious impact on the ability of the NHS to support world leading research into cancer, a leading charity has warned.

Escalating pressures to deliver routine NHS services are squeezing out time for hospital staff to do vital research, according to a report from the University of Birmingham.

It also highlighted how financial pressures are affecting research infrastructure and the capacity of host organisations to fund additional research costs.


Staffing problems weaken NHS reform plans (29 April 2015: Financial Times)

NHS staff shortages threaten to undermine proposed reforms to the way the health service cares for patients, according to a report from an independent think-tank.

Last October, Simon Stevens, head of England’s NHS, and other health leaders set out a plan to increase co-operation between different parts of the health service.

It involved closer links between primary and specialist care, physical and mental healthcare, and health and social care.

Yet the King’s Fund says that gaps in the workforce, combined with an increasing reliance on temporary staff, could put these reforms at risk.


Paramedics take 40,000 days off sick with stress as strain on NHS takes toll (25 April 2015: The Guardian)

Growing numbers of paramedics are going off sick with stress as the demand for 999 services increases.

Freedom of information requests submitted to NHS regional ambulance services show that both the number of paramedics on stress-related leave and the amount of time taken have increased dramatically in the last three years. Paramedics in England took a total of 41,243 days off in 2014 as a result of stress-related illnesses – up 28% since 2012.

The surge in stress leave has coincided with the NHS facing growing pressures after budgets were frozen in real terms.

Gerry Egan, a paramedic and executive director of the College of Paramedics, said: “It is clear that there are very real concerns among our membership in regards to mental ill health and many are worried that they will not reach retirement age of 68 years as a result of physical or psychological injury.”


Hospital staff absences for mental health reasons double (24 March 2015: BBC News)

Staff absences for mental health problems have doubled at hospital trusts across England in the past four years.

Figures obtained by the BBC revealed 41,112 staff were off sick with anxiety, stress and depression in 2014 - up from 20,207 in 2010.

NHS England said it needed to do more to support staff.

The Royal College of Nursing said the figures reflected the "relentless pressure" staff were under.

The NHS employs 1.25 million people across all of its services throughout the country.


Emma Mamo, from mental health charity Mind, said there had been funding cuts of about 8% to NHS services with 3,000 nursing posts lost.

"These figures could suggest sickness absence relating to mental health problems is on the rise among hospital staff.

"The impact of these cuts, through increased workloads and changes to services, is bound to have an impact on staff morale and wellbeing.


Nurses at breaking point as number off work with stress soars (17 January 2015: Guardian)

The number of nurses taking time off due to stress has soared as the NHS has struggled to cope with rising demand for care. Responses to freedom of information requests submitted to NHS organisations by the Observer show that both the number of nurses on stress-related leave and the amount of time taken off are up significantly in the past three years in London, Scotland and Wales.

The figures have prompted claims by health unions that the NHS’s 400,000 nurses are being stretched to breaking point as a result of having to work more demanding and longer shifts at a time when understaffing and the increasing complexity of illnesses add to pressures.

In London, almost 1,500 nurses at 31 NHS trusts took time off because of stress during 2014, up 27% on the 1,179 who did so in 2012. That meant that one in every 29 nurses were off ill with stress. The 1,497 nurses took an average of 38 days off for stress.

Some may have had anxiety or depression rather than stress, as the NHS includes those conditions in its definition of stress-related leave. The number of nurses’ working days lost to stress at the 28 acute trusts and three mental health trusts rose from 38,654 in 2012 to 57,156 last year – a rise of 48%.


Hospitals recruit nearly 6,000 nurses from oversees to tackle staff shortages (Health Service Journal: 17 December 2014)

A shortage of registered nurses to fill an increasing number of posts has driven nearly three-quarters of hospital trusts to recruit overseas, an HSJ investigation has revealed.

Analysis of data from all 140 English acute hospital trusts shows that 103 recruited a total of 5,778 nurses from overseas in the 12 months to September 2014.

The numbers illustrate the scale of the shortage of UK based nurses and mean that overseas recruits constituted a substantial proportion of the total hired by hospitals.

HSJ’s figures indicate overseas recruitment increased dramatically compared with the same period in 2012-13. In that year, of 105 trusts that provided information, only 40 reported recruiting a total of 1,360 nurses from outside the UK.


Service hit by staff 'exodus' after CCG transfers contract to Circle (Health Service Journal: 16 December 2014)

One of the biggest teaching trusts in England has been forced to axe its once renowned acute dermatology service following an “exodus” of medical consultants following the transfer of their contract to private provider Circle.

Nottingham University Hospitals Trust has confirmed it will cease to provide acute adult dermatology services – including emergency services – from February next year, due to a lack of staff.

The workforce crisis comes after Nottinghamshire commissioners awarded Circle a contract that made it the main provider of dermatology services delivered across the trust and Circle’s Nottingham NHS Treatment Centre.

The trust’s own bid for the contract was unsuccessful and the services were passed to Circle last year, despite warnings from the trust’s 11 dermatology consultants that senior staff would leave rather than be transferred out of the NHS.


Labour warns of skills gap after exodus of senior nurses from NHS (7 December 2014: The Independent)

The NHS in England has lost more than a thousand matrons and 3,400 other senior nurses over the past four years, new figures have shown, leading to warnings that hospitals may be lacking “vital experience and knowledge” needed to cope with unprecedented levels of demand.

Despite continued calls to put matrons and nursing leaders at the heart of NHS care, figures obtained by the Labour Party reveal the number of senior nursing posts has dropped since 2010.

Official data from August also shows that more than 1,028 “modern matrons” overseeing care in wards and 216 community matrons co-ordinating care across different services have been lost since May 2010.

The combination of an ageing workforce and cuts to staffing are thought to be behind the falling figures. Nurses have also warned that an ongoing pay freeze and ever-increasing job stress were driving them out of the profession, and discouraging experienced professionals from coming back.

The total number of full-time equivalent nursing staff working in the NHS has been on an upward trend in recent months. But the recruitment drive has been expensive, and some hospitals have cut senior posts or not replaced retiring senior nurses to help balance the books.


NHS staff stage four-hour strike (24 November 2014: BBC News)

NHS workers, including nurses, midwives and ambulance staff, have staged a four-hour strike in England as part of a pay dispute.

They were protesting about the decision not to implement a 1% rise for all staff recommended by a pay review body.

Members of nine unions walked out at 07:00 GMT in England and at 08:00 GMT in Northern Ireland.

A Department of Health spokesman said it could not afford the rise without risking frontline jobs.


Dave Prentis, general secretary of Unison, told the BBC: "Really it is to get over a message to the public about what is happening and to get the message to the government about the importance of our members providing our health services.

"An independent pay review body that looks at public service workers recommended a 1% increase in line with the government's own pay policy.


Number of GPs seeking to leave UK and work abroad doubles under coalition (23 November 2014: The Guardian)

The number of GPs applying to leave the NHS annually to practise abroad has doubled under the coalition, raising fresh concerns over its handling of the health service.

The exodus risks exacerbating the current backlogs in GP practices and the pressures on A&E departments, according to the Royal College of GPs, which has warned that 600 practices may close in the next year due to poor recruitment and retention of staff. The most recent patient survey reports that one in four patients now wait a week or more to see their local doctor.

New figures show that 529 GPs were issued in 2013 with a certificate of good standing, which allows them to practise abroad. That compares with 266 in 2009, according to figures provided by the General Medical Council.

A spokesman for the Department of Health said that medicine was a mobile profession and that doctors often wanted to spend time travelling and gaining experience overseas before returning to the NHS.

But last night the shadow health secretary Andy Burnham said that the increase in the number of GPs being issued with the certificates was a clear indicator of plummeting morale within the health service, as it struggled to deal with a burgeoning population amid tightening budgets.


NHS spending on agency nurses soars past £5.5bn (1 November 2014: The Guardian)

NHS spending on agency nurses and staff has spiralled to more than £5.5bn over the past four years and is continuing to rise amid a debilitating recruitment crisis in the health service. Budgets for temporary staff this financial year have already been blown apart, it can be revealed, with spending in some parts of the NHS running at twice the planned figure.

Reliance on agencies – at a cost of up to £1,800 per day per nurse – comes as the number of nurse training places in England has been cut. In the last year of the Labour government, 20,829 nurse training positions were filled in England. That fell to 17,741 in 2011-12 and to 17,219 in 2012-13, rising to 18,009 in 2013-14.

According to the latest figures, there were 7,000 fewer qualified nurses in August 2013 compared with May 2010, excluding health visitors, school nurses and midwives. Ministers were accused on Saturday of “truly incompetent planning” by the Royal College of Nurses.

Many of the agency nurses filling the gaps are from abroad, which means their home countries are robbed of medical expertise. Last year 6,228 foreign nurses registered with the Nursing and Midwifery Council, 22% of the total number of new nurses qualified to work. This compares with 4,305 the previous year.


NHS drafts in extra A&E doctors to 'bolster units' (21 October 2014, BBC News)

The NHS is recruiting about 260 extra doctors in an effort to ease pressure on accident and emergency units in England, Health Secretary Jeremy Hunt has said.

Junior and overseas doctors would help bolster A&E units over this winter, the Department of Health said. An aging population was putting pressure on services, it said.

Experts said that the extra doctors would help, but that more experienced doctors were also needed.

Overseas doctors have been recruited on short-term contracts to help plug a gap in the number of experienced doctors in A&E and will start working from November.

There are about 240 A&E units in England, with about 160 of those being large A&E departments.


Unison's NHS workers in Wales vote to strike over pay (20 October 2014, BBC News)

Thousands of NHS staff in Wales have voted to take strike action in a row over pay.

Unison says the Welsh government offer of a payment of £160 to all staff is not enough.

The Welsh government said it is disappointed with the ballot result as pay discussions were ongoing.

Unison said its members in Wales voted by almost 4-1 in favour of strikes and by 9-1 for other forms of industrial action. More than 5,700 took part in the ballot.

Last week, thousands of health workers, including nurses, midwives and ambulance staff, took part in a strike in England and Northern Ireland in a dispute over pay.

Unison regional secretary in Wales Margaret Thomas said: "Our members working in the Welsh NHS have sent a clear message that they are worth more than a miserly £160.


NHS staff shortages pose risk to patients, warns watchdog (17 October 2014, The Guardian)

Some A&E departments and maternity units are so short of doctors and nurses that they pose a danger to patients, the NHS care watchdog has warned.

Despite the Mid Staffordshire scandal, too much care in too many hospitals is still too poor, inspectors say in a report that identifies lapses in safety, patients having to wait on trolleys in corridors and chronic bed shortages as major problems.

Inspectors found examples of children being treated on adult wards, too few staff caring for patients overnight, patients waiting to have their call bells answered, lengthening waits for treatment, and low staffing levels leading to more elderly people falling.

In its annual report assessing NHS and social care services, the Care Quality Commission (CQC) said on Friday that while much care is excellent, “the variation in the quality and safety of care in England is too wide and is unacceptable”.


Health service chief visits NHS Grampian after staffing concerns (16 October 2014, BBC News)

The head of NHS Scotland is to meet consultants from NHS Grampian later, after its chairman resigned following reports of a staffing crisis.

Paul Gray will also meet the remaining health board members as part of a two-day visit.

Bill Howatson, who had chaired the board for almost three years, stepped down on Tuesday.

He said there were "significant challenges" best tackled under new leadership.

Last month A&E consultants warned NHS Grampian for a second time that staffing shortages at Aberdeen Royal Infirmary could be putting patient safety at risk.


NHS strike: Unison leader says more workers to vote on strike action (13 October 2014, BBC News)

Patricia McKeown, regional secretary of Unison, said thousands more workers are expected to vote on strike action.

"Our people are facing a stark fifth year of pay freeze and that is having a very adverse impact, particularly on the lowest paid of health workers," she told a lunchtime rally at Stormont.

More than 4,000 NHS staff in Northern Ireland went on strike on Monday.

Members of the unions, Unite and GMB, walked out from 11:00 BST until 14:30 BST.

"We have seen an enormous rise in the number of our members having to turn to the benefit system in order to make ends meet, we have seen an extraordinary rise in the number of members who have been using the Unison internal welfare system to help them out of serious financial difficulties," Ms McKeown said.

"At the same time, they have not stopped delivering 365 days a year, delivering health care and social care to people right across Northern Ireland in the face of all sorts of cutbacks; they are under big stress and big pressure.

"We are here with a very clear message to our politicians today; we need a response very quickly otherwise Unison, which is the biggest union in the health service in Northern Ireland, will ballot for strike action


More paramedics quitting NHS jobs (9 October 2014, BBC News)

Increasing numbers of paramedics are leaving NHS ambulance services, according to figures obtained by the BBC.

Senior staff say remaining paramedic crews are under greater pressure than ever before to meet demand.

At least 1,015 paramedics left their job in 2013-14, compared with 593 in the same period two years earlier.

The Department of Health says it is spending an extra £28m on the ambulance service in England this year. London Ambulance Service saw 223 paramedics leave in 2013-14, four times the number in 2011-12, and the largest increase in the country.

An internal document, produced by London Ambulance Service and seen by BBC Radio 4's The Report programme, suggests morale among paramedics is low. It says three-quarters of paramedics surveyed had considered leaving the service in the past 12 months.

Anonymous paramedics quoted in the report point to rising workloads as one of their greatest grievances.


NHS ambulance workers vote to strike (1 October 2014: City A.M.)

Members of the GMB union of NHS workers have voted overwhelmingly in favour of taking strike action on 13 October.

Of the ambulance staff who voted, 78 per cent cast their ballot in favour of a walk-out, which will take place between 7:00am and 11:00am. Furthermore, 91 per cent voted for action short of a strike.

The ballot was held in reaction to the government's pay policies. NHS staff have been promised a one per cent rise.


NHS workers plan four-hour strike (BBC News: 24 September 2014)

Health workers in England are to stage a four-hour strike on 13 October, the Unison union has announced.

The strike - which is part of a row over pay - will begin at 7am, and will involve some nurses, healthcare assistants, and porters.

The result of the strike ballot was announced last week, with more than two-thirds of Unison members saying they were prepared to take action.

The Department of Health said the NHS couldn't afford the union's demands.

The government has given NHS staff a 1% pay rise, but not for those who get automatic progression-in-the-job increases.

Those increases are given to about half of staff and are worth 3% a year on average.


NHS staff vote in favour for strike action (BBC News: 18  September 2014)

 NHS workers in England have voted in favour of striking over pay.

Two-thirds of Unison members, which include nurses, healthcare assistants and porters, said they were prepared to take action.

Three other unions - the Royal College of Midwives, GMB and Unite - have also balloted their members. The results are expected in the coming weeks.

Ministers have given NHS staff a 1% increase, but not for those who get automatic progression-in-the-job rises.

These are designed to reward professional development and are given to about half of staff and are worth 3% a year on average.

But the decision by ministers went against the recommendation of the independent pay review board, which had called for an across-the-board rise.


NHS ‘leaving jobs vacant to try to save cash’ (The Scotsman: 27 August 2014)

A SHARP rise in front-line staff vacancies in Scotland’s NHS is piling pressure on overstretched health workers and leading to patient care shortages, doctors leaders and the UK’s biggest nursing union have warned.

The number of unfilled consultancy positions surged from 4.7 per cent to 6.9 per cent during the last year, official Scottish health service figures show. That is equivalent to one in 15 senior doctors.

Ministers were warned the NHS would come under growing strain and the British Medical Association (BMA) described the rise in vacancies as “extremely worrying”.

Nursing and midwifery vacancies also increased from 2.9 per cent to 3.1 per cent during the same year-long period.

The Royal College of Nursing (RCN) Scotland warned a failure to fill the posts was leading to “less time to care for patients”. However, the Scottish Government said the vacancies were due to an increase in recruitment to the NHS, with overall staff numbers reaching a “record high”.


Doncaster care workers to stage 21-day strike (BBC News: 18 August 2014)

Care workers in Doncaster have announced plans for a three-week strike as part of their long-running pay dispute with Care UK.

About 70 workers are set to take part in the action due to begin on 25 August, according to Unison.

The union is calling for wages to rise from £7 to the national living wage of £7.65 an hour. Members have staged a series of strikes since February.

Care UK called the latest action "unnecessary and irresponsible".

The company bids for health and social care contracts from the NHS, and in Doncaster provides assisted living for people with learning disabilities in their homes.


Unison to ballot NHS Wales members on pay (BBC News: 1 August 2014)

Thousands of Unison members who work for NHS Wales are to be balloted for industrial action, including strikes.

The vote in October is in response to the £160 one-off payment in lieu of a rise, it said.

Unison is the first union in Wales to take action following last month's pay offer.

The Welsh government said it was trying to be as fair as possible against a backdrop of drastic budget cuts.

Unison represents 35,000 workers in Wales from the lowest paid laundry workers to chief executives.

Dawn Bowden, Unison's head of health, said: "We understand the very difficult financial situation that Welsh government finds itself in as a result of UK funding cuts, however, we do not believe it is right that our members have to pay the price for this.

"While Unison has welcomed the minister's announcement on the introduction of the Living Wage into NHS Wales, we do no not accept that a £160 non-consolidated one-off payment is the best that could be done for the rest of our members."


Doncaster Care UK workers begin 14-day strike (BBC News: 29 July 2014)

Care workers demanding the living wage in Doncaster have begun a 14-day strike.

Care UK cares for 140 people with learning disabilities in about 40 properties in Doncaster.

Unison members said the company should increase workers' wages from £7 to the national living wage of £7.65 an hour.

Chris Hindle of Care UK said the pay demands were "simply unrealistic" and "at odds with what is happening in the NHS."

The national company bids for health and social care contracts from the NHS.

In Doncaster, it provides assisted living for people with learning disabilities in their homes.

When the strike ends members will have taken 48 days of industrial action since disputes began last September.

Jim Bell of Unison said about 120 of 150 Care UK Unison members had gone on strike in Doncaster. Four years of pay freezes had made it "impossible to meet the basic costs of living," Mr Bell said.


NHS staff balloted on strike action over pay (BBC News: 22 July 2014)

Midwives, nurses and ambulance workers are among more than 400,000 NHS workers in England being balloted on industrial action, including strikes, over pay.

Unison, the Royal College of Midwives, GMB and Unite made the announcements in a coordinated response to the pay deal put forward by the government in March.

It is the first time in their history that midwives have been balloted.

Ministers have given NHS staff 1%, but it does not apply to those who get automatic progression-in-the-job rises.

These are designed to reward professional development and are given about half of staff and are worth 3% a year on average.

But the decision by ministers went against the recommendation of the independent pay review board, which had called for an across-the-board rise.

In Scotland, the recommendation was agreed to in full. Northern Ireland is yet to make a decision, while Wales is doing the same as England but has given extra money to the lowest paid.


Hospitals get guidelines on safe nurse numbers (BBC News: 15 July 2014)

Hospitals in England are being given strict guidelines on safe staffing levels for nurses - but they stop short of giving absolute minimums.

The National Institute for Health and Care Excellence said having more than eight patients to one nurse on a ward in the day should act as a trigger for checking if care was being compromised.


Key Facts

Since the Coalition came to power in 2010 the NHS has lost as many as 6000 nursing posts.

Paramedics stress-related sick days increase by 28% between 2012 and 2014

Hospital staff absences for mental health reasons double

Key Trends:

Between May 2010 and July 2012: the total NHS workforce decreased by 2%.

Within this change:

The number of doctors rose by 7.5%, qualified midwives by 5%, and qualified scientific, therapeutic and technical staff by 2%.

The number of qualified nurses decreased by 2%.

Largest decrease in NHS infrastructure support at 9%

A decrease in support to doctors and nursing staff by 2.5%.

As of 2014 the number of doctors applying for certificates to work abroad has increased by a fifth since 2008 to around 3,000 a year.


Health and Social Care Information Centre Workforce Statistics
"The latest statistics show that the cuts to NHS staff show no sign of slowing down" Peter Carter, chief executive and general secretary of the Royal College of Nursing

Share your examples about the impact of NHS changes - in a community d/base


Our use of cookies / millipedia :: ethical digital