600 GP practices at risk of closure, says RCGP (Pulse: 19 September 2016)

Around 600 practices are at risk of closure by 2020 due to problems recruiting GPs, the RCGP has claimed.

These practices all have at least 75% of their GPs aged 55 and over, the college says, which will lead to a shortfall of almost 10,000 GPs across the UK within four years.

It comes as the RCGP has launched a new video campaign aimed at foundation doctors, medical students and sixth-form students.

The campaign is designed to show that general practice is ‘exciting and challenging’, and address the myth that ‘the role of a GP is somehow run-of-the-mill, with family doctors simply treating coughs and colds’ more


Seven-day NHS: Labour demands inquiry as leak reveals crisis warning (The Guardian: 23 August 2016)

Labour is demanding an inquiry into revelations that senior civil servants fear the government’s push for a “truly seven-day NHS” may be derailed because it faces staffing and money problems.

Tom Watson, the party’s deputy leader, claimed that leaked Department of Health documents obtained by the Guardian and Channel Four News showed Jeremy Hunt had misled the public by pushing ahead with expanding the NHS in England despite his own mandarins’ concerns.

“Leaked secret papers show that junior doctors’ concerns were right. This warrants an inquiry. Hunt misled the public,” Watson tweeted in response to the disclosures, which have prompted renewed scrutiny of a policy that the Conservatives have pledged to deliver in full by 2020.

Senior Tories have responded to the publication of the department’s own risk assessment of the seven-day plan and other papers by making clear that they share the civil servants’ previously private more


Secret documents reveal official concerns over 'seven-day NHS' plans (The Guardian: 22 August 2016)

The health service has too few staff and too little money to deliver the government’s promised “truly seven-day NHS” on time and patients may not notice any difference even if it happens, leaked Department of Health documents reveal.

Confidential internal DH papers drawn up for Jeremy Hunt and other ministers in late July show that senior civil servants trying to deliver what was a totemic Conservative pledge in last year’s general election have uncovered 13 major “risks” to it.

While Hunt has been insisting that the NHS reorganise around seven-day working, the documents show civil servants listing a string of dangers in implementing the plan – as summarised by a secret “risk register” of the controversial proposal that has prompted a bitter industrial dispute with junior doctors.

The biggest danger, the officials said, is “workforce overload” – a lack of available GPs, hospital consultants and other health professionals “meaning the full service cannot be delivered”, they say in documents that have been obtained by the Guardian and Channel 4 more


Hospital doctors ‘miss signs of illness’ because of chronic staff shortages (The Guardian: 20 August 2016)

“Dangerous” medical understaffing in hospitals is so rife that signs of illness are being missed, blood tests delayed and newly qualified doctors left in charge of up to 100 patients.

Chronic shortages of medics are also leading to those with little experience of some types of illness taking responsibility for wards full of medically needy patients, or with complex issues, whose conditions they know little about and do not feel qualified to give proper care to, including in intensive care and stroke and surgical units.

A survey of UK doctors, the results of which have been given to the Observer, reveals widespread concern that gaps in rotas were risking patients’ safety. Doctors said they were left stressed and in tears at being “pressurised” by managers to work more shifts to help hospitals cope with rising demand and said their relationships with patients were suffering.

One trainee surgeon said shortages meant a colleague in his first year of training was the only doctor in charge of more than 100 surgical patients more


Nurse shortage puts children's mental health plan ‘at risk’ (Nursing Times: 19 August 2016)

A government mental health strategy is at risk because most children and young people’s mental health trusts have nurse recruitment difficulties, suggests an independent report.

Experts evaluated whether children and young people’s mental health care had improved since the publication in March 2015 of the government strategy Future in Mind.

The strategy, backed by £1.4bn over five years, aimed to modernise the way children and young people’s mental health services operated and tackle the current treatment gap.

The vision was to move towards a system focused on prevention and early-intervention, where specialist services were integrated with wider health and care support.

The Education Policy Institute think-tank set up a commission in December, which was chaired by Liberal Democrat MP and former health minister Norman Lamb, to assess the progress of the strategy during its first more


Cuts to health visitors could have ‘irredeemable’ effects on obesity and mental health (National Health Executive: 17 August 2016)

Leaders from major healthcare organisations have come together to call on the government to halt deep cuts to health visitor posts in order to keep other problems, such as childhood obesity and mental ill health, from escalating further.

In a joint letter to the Times – signed by the CEOs of 11 health bodies, such as the Royal College of Nursing (RCN), Unite, the Royal College of GPs, the RCPCH, the NSPCC and the National Children’s Bureau – professionals said cuts to the Health Visitor Implementation Programme is deteriorating public health.

The government’s Health Visitor Implementation Plan invested enough funds to train more than 4,000 health visitors, a job that plays a “vital and unique” role to prevent ill health and promote healthy lifestyles to children.

But five years on, posts are being cut harshly throughout England, with the latest workforce figures showing numbers have been falling since the beginning of the year – including a significant drop of 433 posts just between March and April.

According to the RCN, anecdotal evidence suggests this drop is “just the start of a significant reduction” in the number of these services due to ongoing cuts to local authority public health budgets.

In the letter, the 11 signatories argued the loss of health visitor posts could have “irredeemable consequences” for children and families, while “stunting the progress of several key government priorities”, from obesity and mental health issues in children and adults to promoting social more


Hundreds of adult nurse training places expected to be left unfilled (Nursing Times:5 August 2016)

Universities have recruited “significantly less” numbers of students to adult nurse training places than was planned in recent months, which is expected to leave almost 300 course places empty by the end of the year, the national workforce planning body has said.

In addition, problems with filling district nursing and health visiting courses have also more

Bursaries for student nurses will end in 2017, government confirms (The Guardian: 21 July 2016)

The government has confirmed plans to end bursaries for student nurses and midwives from next year, sparking anger across the health sector.

Replacing bursaries with loans would free up about £800m a year to create additional nursing roles by 2020 and help more students enter the profession, according to the Department of Health.

However, the Royal College of Nursing (RCN) said the changes were unfair and risky, while the Royal College of Midwives (RCM) argued that the move threatened the future of maternity services in England.

Student nurses, midwives and allied health professionals, including occupational therapists, speech and language therapists, podiatrists and radiographers, currently do not pay tuition fees. They receive a mixture of a non-means-tested bursary, a means-tested bursary and a reduced-rate student loan to help with their living costs. The government-funded Health Education England decides how many student places are available each year.

However, in a move first outlined by then chancellor George Osborne in November, bursaries will be replaced by loans in England to cover tuition fees and maintenance costs. The government claims this will allow the cap on student numbers to be lifted, creating up to 10,000 extra training places this parliament.

Health minister Philip Dunne said two-thirds of those who applied for a university nursing course were not currently offered a place and that the changes would give those in training about 25% more financial support while they more 

Jeremy Hunt to impose new contract on junior doctors (The Guardian: 6 July 2016)

Jeremy Hunt has said he will impose a new contract on the 54,000 junior doctors in the NHS in England, after they rejected it in a ballot.

The health secretary said the phased introduction of the contract would go ahead as planned from October in order to move on from the uncertainty created by an impasse between himself and the British Medical Association – “a no man’s land that, if it continues, can only damage the NHS”, he said.

He rejected holding any further talks with the BMA, the doctors’ union, pointing out that three years of talks on new terms and conditions for junior doctors had failed to produce a final agreement.

Junior doctors accused Hunt of deliberately choosing the day of the Chilcot report’s publication to confirm that he was pushing ahead with a contract that is deeply unpopular with doctors. One leading junior doctor, who did not want to be named, said Hunt had selected “a good time to bury imposition”.

Hunt made the announcement in an oral statement in the House of Commons a day after the BMA disclosed that junior doctors had defied its leadership’s advice by rejecting – by 58% to 42% – the version of the contract it had agreed with ministers in May and recommended as the best terms that could be secured.

Around 37,000 doctors in training and final- and penultimate-year medical students – 68% of those eligible to vote – took part in the BMA’s more


Unions attack ‘ill-informed’ bursary reform plans (Nursing Times: 1 July 2016)

Government plans to replace bursaries for student nurses and midwives with a system of loans are “ill-informed” and represent an “unprecedented gamble”, the royal colleges have warned.

Both the Royal College of Nursing and the Royal College of Midwifery have submitted their responses to controversial plans to scrap the nursing bursary and tuition fees payment and replace them with a system of loans.

Under current government proposals, the new system would come into operation from September 2017.

The government has claimed that removing the bursary will free up universities to run as many course places as they can fill, potentially leading to 10,000 additional nursing, midwifery and allied health training places by 2020.

But unions have argued that the plans will saddle future students with large debts and deter many from choosing a career in nursing or more


Brexit 'will make NHS staff shortages worse' (BBC News: 30 June 2016)

The vote to leave the EU risks making staffing shortages in the NHS worse, health leaders are warning. The NHS Confederation said doctors and nurses from Europe may be put off accepting jobs after the referendum.

If that happened the NHS could face some major problems, it said. The organisation, which represents health managers, said there were currently 130,000 EU health and care workers in the UK, including 10% of doctors and 5% of nurses.

Elisabetta Zanon, the director of the NHS Confederation's European office, said: "There is a real risk the uncertainty and the falling value of the pound will make people think again.

"If that happens, we could see shortages in some key areas get worse."

A report earlier this year from the House of Commons Public Accounts Committee warned the front line in England may be as many as 50,000 staff short - out of a workforce of slightly more than 800,000 clinical staff.

Ms Zanon also said Brexit could have an impact on medical research and the free healthcare Britons received when abroad. But she said the workforce issue was the most pressing, as the impact could be felt straightaway.

And there were signs this had already started happening, with reports that an EU recruitment drive in West Yorkshire had already run into more


The other NHS crisis: the overworked nurses who are leaving in despair (The Guardian: 25 June 2016)

At what point is a qualified nurse – who entered the NHS expecting long hours and low pay – pushed so far that they can no longer carry on? For Stacey, a 27-year-old nurse from Liverpool, it was when she had become so broken that she felt she had lost every one of the “five Cs” that are instilled in nurses during their training: commitment, conscience, competence, compassion, and confidence.

Stacey worked in A&E for five years. When she started, there were 20 nurses on the emergency ward; by the time she left last month, there were 11. Meanwhile, there has been a dramatic increase in patients going to A&E: a rise of 400,000 in a decade. Stacey, like many other nurses across the country, felt she had reached breaking point.

“With A&E, you never know what is coming through the door,” she says. “It has to be very organised. We had three wards – majors, minors and observation – and each is supposed to have at least two nurses. But when I left, we were so stretched that there was often only one. There’s a reason you need at least two.”

She thinks back to her most stressful nights, on the observation ward, which admits patients suffering from problems such as overdoses or brain injuries, who are then observed over 24 hours.

“It was impossible to keep my eye on everyone, and there were times when someone would rapidly deteriorate and I would be too busy with other patients,” she says. On really busy nights, the observation ward became a “dumping ground” for patients with complex medical problems who could not get a bed anywhere else. “It was really tough. There were cases where patients were just put there, and I hadn’t been trained to deal with their more


GP vacancy rates at highest recorded with one in eight positions unfilled (Pulse: 1 June 2016)

Around 12% of all GP posts in the UK are vacant, the highest proportion recorded, a Pulse survey has revealed. The Pulse survey of 690 GPs has found that 11.7% of posts are currently vacant, up from 9.1% last year and 6.4% in 2014.

It also reveals that almost half of practices have had to recruit a partner within the past 12 months, taking longer than six months on average. GP leaders told Pulse this is a major reason why practices are closing, while other GPs said they have had to recruit advanced nurse practitioners (ANPs) as they are unable to recruit.

NHS England’s General Practice Forward View acknowledged the difficulties in recruitment, and committed more than £200m on a number of schemes, including recruitment of pharmacists, retention of GPs and training nurses, clerical staff and practice managers.

It comes as official figures have revealed there was a 2% drop in GP numbers last year, while a Pulse investigation has cast doubt on the Government’s pledge to recruit 5,000 extra GPs by 2020. Pulse’s survey on vacancy rates is the most robust study on the issue, and has frequently been cited by official bodies.

This year’s survey has revealed the situation is worse than ever, with more than one in nine posts vacant, despite many practices appointing non-GPs to fill the more


Patients ‘at risk’ as the anaesthetists shortage is predicted to increase (The Observer: 12 June 2016)

The NHS faces a critical shortage of anaesthetists that could force operations to be delayed and even threaten patient safety, doctors’ leaders have warned.

New research shows that by 2033 every hospital trust will have 10-20 fewer consultant anaesthetists than they will need to meet rising patient demand. It estimates that, while the NHS has agreed that its total of anaesthetists should expand to 11,800 by that date, on current trends it is likely to reach only 8,000 – a shortfall of 3,800, or about 33%.

Anaesthetists play a vital role in preparing patients for surgery and monitoring them, are key members of the medical teams in maternity units and intensive care, and deliver pain relief and resuscitation. They become involved in the treatment of two-thirds of hospital inpatients.

Like many other areas of medical care, anaesthesia already has too few practitioners. Rota gaps – where there are too few doctors to cover every shift in hospital units – are increasingly common.

The Royal College of Anaesthetists (RCoA), which carried out the research, warned that patients and the smooth running of hospitals would be hit if the existing shortfallin numbers was allowed to increase. Dr Liam Brennan, the college’s president, said: “Anaesthetists possess a unique and non-transferable skill set that is essential to maintaining core hospital services, so the potential impact of a reduced anaesthetic workforce would have serious implications for patient safety across the whole NHS. We already have fewer than we need and the shortages are worrying.”

The college’s latest census of the UK’s anaesthesia workforce, the first since 2010, also found that 74% of hospitals already rely on locum anaesthetists hired from medical employment agencies to ensure their rotas are full. The cost of that is part of the NHS’s huge annual bill – £3.7bn a year in England alone – for temporary more


Majority of nurses 'would not have trained without bursary' (Nursing Times: 4 June 2016)

Two thirds of nurses would not have studied to join the profession if they had been unable to receive a bursary for their tuition fees and living costs and had to take out a full loan instead, a survey has suggested.

The Royal College of Nursing, which carried out the survey of 17,000 of its members, warned the findings indicated government plans to scrap bursaries in England next year would put off thousands of potential nurses.

Around 80% of nurses taking part in the survey said they believed the changes would have a negative impact on patient care.

In addition, almost 90% said they either “disagreed” or “strongly disagreed” with the plans, which will apply to all new nursing, midwifery and allied health professionals from August 2017.

The survey also revealed 80% of nurse educators did not agree with the more


Staff shortages cited as factor in delayed discharge (Nursing Times: 26 May 2016)

Workforce capacity issues in health and social care organisations are making it difficult to discharge older patients from hospital effectively, a report has warned.

Across the health and social care system, providers and commissioners said that staff recruitment and retention were a significant cause of delays, according to the National Audit Office report.

It warned that vacancy rates for nursing and home care staff were up to 14-15% in some regions, and fewer than half of hospitals felt they had sufficient staff trained in the care of older patients.

Efforts to speed up discharge was also being inhibited by health and social care organisations not sharing patient information effectively, despite a statutory duty to do so.

While hospitals were financially incentivised to reduce discharge delays, there was nothing similar to encourage community providers and councils to speed up receipt of patients, added the report titled Discharging older patients from more

Economists claim there will be a 6% drop in student numbers after bursary scrapped (Nursing Times: 25 May 2016)

Economists have estimated that demand for healthcare courses will drop by at least 6% following the removal of bursaries next year, leading to thousands fewer nurses being trained in 2017.

They also predicted that universities would lose at least £57m next year, largely due to smaller student intakes, under the new arrangements that will see nursing, midwifery and allied health professional students in England having to take out loans to fund their tuition fees and living costs.

Meanwhile, the report – titled The Impact of the 2015 Comprehensive Spending Review on Higher Education Fees and Funding Arrangements in Subjects Allied to Medicine – estimated the government would fail to make the vast majority of savings it expects from the move because a large proportion of student loans would have to be written off.

According to the analysis, carried out by consultants London Economics for Unison and the National Union of Students, the cost to healthcare students to study at university would increase by 71% under the government more


Why has the NHS deficit ballooned? One word: understaffing (The Guardian: 20 May 2016)

Why are NHS finances in such a mess? The biggest reason is staffing – or, to be more precise, understaffing. The NHS in England is struggling with a serious and growing lack of personnel, especially nurses and some specialist doctors. This is forcing hospital trusts to spend unprecedented amounts of money on locums, especially those supplied by employment agencies, many of which charge what have been described by the NHS England chief executive, Simon Stevens, and the health secretary, Jeremy Hunt, as “rip-off” rates.

The mark-ups these agencies charge takes money away from frontline care. Barts health trust in London – the largest in the NHS – spent about £80m on agency staff in 2015-16, roughly £30m of which was profit for the agencies.

The sharp increase in the bill for agency staff mirrors almost exactly the dramatic decline in the health service’s finances. These personnel cost the NHS £2.5bn in 2013-14, rising to £3.3bn in 2014-15. The bill for 2015-16 was expected to hit £4bn, but new caps on trusts’ agency staff spending, introduced by Hunt last year, brought that down to £3.7bn – a saving of £300m, but still astronomical. There has also been a crackdown on the use of management consultants.

Most trusts have hired extra staff, and increasingly rely on agency workers to fill rotas and wards to standards recommended by Robert Francis’s official report into the Mid Staffordshire hospital scandal,which identified a lack of nurses as a key reason for inadequate care at the trust.

However, Francis’s report was published amid the longest period of austerity in the 67-year history of the NHS, with its 1% annual real-terms budget increases far below the 4% year-on-year rise it had been used more


'Almost half' of junior doctors 'will quit the NHS' if contract is imposed (Pulse: 17 May 2016)

Almost half of junior doctors plan to quit the NHS if health secretary Jeremy Hunt’s threatened contract imposition goes ahead, a survey has found.

The survey, launched by a GP trainee and attracting thousands of responses, was designed to gauge the opinions from doctors and medical students about the junior doctor contract row.

The GPC also reacted to findings, branding them ‘very worrying’ and with ’potentially serious ramifications’.

Out of 4,500 replies via in April, 46% of eligible respondents said they would leave the NHS this summer if the contract goes ahead, with 28% saying they would work abroad in countries like Australia and New Zealand; 15% pledging to leave medicine and change career and 3% vowing to leave to work in private more


Plan to train NHS nurses to cover for doctors sparks alarm (The Guardian: 17 May 2016)

A plan to train nurses to stand in for doctors as a way to tackle the hospital staffing crisis has caused alarm among doctors and patient groups.

A report by the Nuffield Trust, commissioned by NHS Employers, recommends giving extra training to nurses and other support staff to give them “advance practice roles” or “physician associate” status.

It says this will provide a relatively quick solution to the current shortage of doctors and help ease the workload of more qualified medics.

Junior doctors have said the idea is dangerous while the Patients Association said it should be regarded as a quick fix to plug the NHS’s workforce gap.

The report claims that retraining staff “could provide a cost-effective and rapid solution to mitigating some of the pressures on more senior staff”.

The report envisages a new tier of medical staff between doctors and nurses. “Physician associate represent a new cadre of staff with the potential to address a number of workforce challenges,” it says.

The Patients Association said such proposals should not be seen as a cheaper alternative to hiring highly qualified staff.

Junior doctors, who are involved in a dispute with the government over a new contract, said the plans would put patients’ lives at more


Seven-day NHS plans fail to address staffing needs, say MPs (The Guardian: 11 May 2016)

There has been “no coherent attempt” to assess how many staff will be needed to ensure that a seven-day NHS can function, parliament’s spending watchdog has found. 

A report by the public accounts committee says the Department of Health (DH) has not yet worked out if the current supply of staff can adequately meet demand in the health service in England.

“National bodies need to get a better grip on the supply of clinical staff in order to address current and future workforce pressures,” it concludes.

The report will be seized upon by critics of the health secretary, Jeremy Hunt, whose long-running dispute with junior doctors is based on claims that there needs to be more staff working on weekends to ensure patient safety.

MPs add that the DH has failed to assess the staffing implications of the Tories’ pledge for a seven-day more


Hunt: staff shortage due to excessive 'optimism' (BMA: 10 May 2016)

Health secretary Jeremy Hunt has admitted successive governments — including his own — have failed to train enough staff to satisfy the needs of the NHS.

Speaking during health questions in Commons, Mr Hunt blamed the rocketing NHS agency bill, which drained the service of £3bn last year, on an ‘optimistic’ view of how few staff could safely manage a ward.

Mr Hunt (pictured) claimed to be taking action to decrease the vast costs — suggesting the agency cap implemented by the Government last year, which gives hospitals a defined limit on spending with agencies, would save £1bn a year.

Answering a question put to the house, which asked what the Government’s plans were to reduce agency spending, the health secretary said: ‘We’ve taken tough measures to control unsustainable spending on agency staff. Agency spending is now falling.’

Mr Hunt was pushed to respond further by Southport Liberal Democrat MP John Pugh, who said: ‘I don’t share his [Mr Hunt’s] optimism.

‘The real problem is the shortage of permanent staff.’ more


Trust blames 'bad behaviour' of neighbouring providers for staff shortage (HSJ: 4 May 2016)

A financially stricken foundation trust has blamed “bad behaviour” of neighbouring trusts breaking agency spending caps for its staff shortages.

Doncaster and Bassetlaw FT has been forced to suspend inpatient admissions and transfer patients to other hospitals.

In a board briefing last week, chief executive Mike Pinkerton warned the lack of locum agency staff to fill rotas “now poses an escalating continuity of services risk” to the trust. He has complained directly to local trusts and NHS Improvement over the issue.

Papers show staffing became a particular problem in the trust’s Doncaster and Worksop emergency departments following the agency caps being brought down again in February, with staff leaving to “surrounding trusts as a result of them breaking cap rates” more


90% of GP trainees to shun full-time clinical work (Pulse: 5 May 2016)

Only one in ten GP trainees expect to be doing full-time clinical work in five years’ time, a major report from the King’s Fund think-tank has revealed.

The report – Understanding pressures in general practice – also claims that the crisis in general practice has been ‘invisible’ for policy-makers due to failure by the DH and NHS England to collect data.

Its analysis of 30 million patient contacts from 177 practices found that the number of consultations since 2010/11 had grown by 15%, echoing a recent study published in the Lancet.

GP leaders said that the lack of data on general practice had led ‘many to turn a blind eye to the ever-worsening crisis’ in the profession.

The report comes two weeks after NHS England released its ‘General Practice Forward View’, which committed to devoting more than 10% of the NHS budget into general practice.

The King’s Fund welcomed NHS England’s proposed measures, but warned that general practice was in a crisis.

It pointed to an increase in demand and a reduction in funding, as well as a recruitment crisis.

And it warned that the recruitment crisis could get worse, as a survey of 318 trainees revealed they were shunning a full-time career in general practice – and not only because of family more


GPs still in favour of mass resignation despite support package (Pulse: 29 April 2016)

Almost half of GPs are still willing to submit undated resignations, despite the multibillion-pound ‘Forward View’ announced by NHS England last week.

A Pulse survey of 524 English GPs found that 45% would still support mass resignation from the NHS due to the current state of general practice, while a further one in four are undecided.

This is only a small decrease on the 49% who said that they would be willing to resign their contracts in December 2015.

The Special LMC Conference in January voted for the GPC to canvass support for submitting undated resignation letters if the Government fails to implement a ‘rescue package’ for general practice within six months.

Last week, Pulse exclusively revealed that the GPC was still considering the threat of mass resignation following the announcement of the General Practice Forward View, which committed £2.4bn extra funding a year by 2020 plus a £500m support package.

Today’s poll reveals that GP support for the so-called ‘nuclear option’ is maintained, with the percentage of GPs ruling mass resignation out decreasing from 35% in December to 29% more


NHS looks to India for GPs in attempt to make up shortfall (The Guardian: 7 April 2016)

The NHS is looking at recruiting GPs from India in an attempt to tackle the serious shortage of family doctors.

Health Education England, the NHS’s training and recruitment agency, has signed a memorandum of understanding with the Apollo Hospitals chain in India about lending clinical staff between them.

GP leaders said the initiative amounted to “an admission of failure” by ministers to develop enough homegrown staff and that it cast doubt on their pledge to increase the number of GPs by 5,000 by 2020.

It also led to warnings that bringing in doctors who had not been trained in the UK could pose a threat to patient safety.

HEE, which is currently recruiting GPs, provided few details about the link-up.

Dr Ramesh Mehta, the president of the British Association of Physicians of Indian Origin, told the doctors’ magazine Pulse, which revealed the move, that his contacts in India had told him HEE is keen to hire “as many GPs as possible” more


Staff shortages spark CQC warning for mental health trust (The Nursing Times: 23 March 2016)

North Staffordshire Combined Healthcare NHS Trust has been given an official warning about community mental health services for young people, after inspectors found there were not enough staff to provide quality care.

The trust’s child and adolescent mental health services (CAMHS) community provision was rated “inadequate” by the Care Quality Commission following an inspection of all core services in September last year.

Inspectors found staffing levels in community CAMHS were “not safe” because of staffing shortages in various disciplines, including nursing, with “excessively long” waits for treatment.

“There were not enough consultant psychiatrists, nurses, psychologists, or therapists,” said the CQC report. “We found staff on maternity or long-term sick leave were not replaced by temporary staff.”

Inspectors also found risk assessments of young clients were not always completed or safety plans put in more


Junior doctors to withdraw emergency care in escalation of action (Pulse: 23 March 2016)

Junior doctors will fully withdraw their labour, including emergency care, in an escalation of their industrial action, the BMA has announced – the first instance of this ever happening in the NHS.

A statement from the BMA said that the 48-hour industrial action planned for 26 April will now change to full withdrawal of labour between 8am and 5pm on 26 and 27 April. This will follow earlier action – a 48-hour walkout on 6 April – which will continue as planned.

The chair of the BMA’s junior doctor committee Dr Johann Malawana said the Government had left them with ‘no choice’.

The committee had planned earlier this year to withdraw all emergency cover, but did not go through with the action as talks with the Government were more


Hospital shuts beds after CQC raises staffing ratio concerns (HSJ: 21 March 2016)

Southend University Hospital Foundation Trust has been forced into significant bed closures after inspectors raised concerns about staff ratios and its stroke services, HSJ has learned.

The Care Quality Commission’s final report on the trust is not due until next month, but concerns raised by inspectors in preliminary feedback in January were set out in a report from the trust’s February board meeting.

The report said the CQC had raised “concerns over the trust’s ability to maintain registered nursing staffing levels to the ratio as indicated in [the National Institute for Health and Care Excellence] guidance”.

The report added: “While all of the issues noted by the CQC are important the CCG and partners have agreed that the priority areas for immediate action are bed capacity, staff to patient ratios and maintaining safe effective stroke services.”

The report also revealed the trust’s lead commissioner, Southend Clinical Commissioning Group, called an “emergency health care system meeting” just days after inspectors more


Alarm raised over trust's 'risky' proposal to run A&E without specialist consultants (HSJ: 21 March 2016)

Health leaders in Yorkshire are considering options for running an emergency department without dedicated consultants.

Scarborough Hospital, which is run by York Teaching Hospital Foundation Trust, has long struggled to recruit emergency medical consultants, commonly known as A&E consultants, and is exploring options to make its services sustainable.

Senior clinicians believe a new model can be devised whereby patients could initially be seen by “advanced clinical practitioners”, who have typically trained as nurses or paramedics, but then passed on to the specialty consultant in the relevant department more quickly.

The Royal College of Emergency Medicine has raised concern over the proposal, describing it as a “highly risky strategy” more


Health minister admits Government risks not delivering on GP recruitment goal (Pulse: 21 March 2016)

700 community staff to be transferred twice in months (HSJ: 18 March 2016)

Hospital staffing crisis as 40% of consultant posts remain vacant (The Guardian: 15 March 2016

Warning overseas recruitment is only a 'stop gap' for nurse shortages (Nursing Times: 10 March 2016)

Health trusts reveal thousands of doctor and nursing positions lie vacant (The Independent: 29 February 2016

Junior doctors defy health secretary with three 48-hour strikes (The Guardian: 23 February 2016

NHS Bosses Plan to sell Temp Agency (The Morningstar Online: 23 February 2016)

NHS staff survey: more staff working extra hours (HSJ: 23 February 2016)

We're not surprised half our psychologist colleagues are depressed (The Guardian: 18 February 2016)

Implement junior doctor contract or lose funding, hospital bosses warned (Pulse: 17 February 2016)

The number of doctors applying to work abroad surged by 1,000 per cent on the day Jeremy Hunt imposed new contract (The Independent: 17 February 2016

Liverpool NHS jobs face the axe because of community health funding cuts (Liverpool Echo: 17 February 2016)

Seven-day NHS may not cut death rates, say Hunt's own officials (The Guardian: 16 February 2016)

Revealed: GP training targets in doubt as applications tumble 5% (Pulse: 10 February 2016)

Higher number of HCAs linked with increased mortality, says study (HSJ: 9 February 2016)

Hospital death rates rise if fewer nurses are on wards, says new research (The Independent: 9 February 2016)

Junior doctors' strike to go ahead next week after talks fail (Pulse: 1 February 2016)

Mass GP resignations 'likely' as union urges LMCs to back crisis conference vote (GP Online: 27 January 2016)

More than a quarter of trusts asked to breach agency cap (HSJ: 26 January 2016)

NICE experts called for minimum staff ratios in leaked guidance (HSJ: 20 Janaury 2016

A&E departments may be too short-staffed 'almost half the time', says report (Independent: 20 January 2016)

Industrial action: junior doctors provide emergency-only care (BMA: 12 January 2016)

All NHS staff support the junior doctors’ strike action (The Guardian: 12 January 2016)

London nurse shortage 'critical' as vacancies rise to 10,000 (Nursing Times: 7 January 2016)

GPs under 50 leaving profession due to fear of burnout, NHS study finds (Pulse: 7 January 2016)

Junior doctors and Government to hold fresh conciliation talks (Pulse: 6 January 2016)

New wave of practice closures could mean 25,000 patients lose their GP (Pulse: 6 January 2016)

Directors to review NICE chief's decision not to release staffing guidance (Nursing Times: 5 January 2016)

Junior doctors in England to strike next week after talks break down (The Guardian: 4 January 2016)

Higher ratio of nurses per hospital bed linked to fewer patient deaths (Nursing Times: 18 December 2015)

Half of GPs willing to resign NHS contracts (Pulse: 10 December 2015)

Number of ambulance staff quitting almost DOUBLES leaving NHS facing crisis (The Mirror: 10 December 2015)

Almost half of junior doctors left NHS after foundation training (The Guardian 5 December 2015)

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%.



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

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