Record number of GP closures force 265,000 to find new doctors (The Guardian: 7 April 2017)
A record number of GP practices closed last year, forcing thousands of patients to find a new surgery, in spite of government attempts to stop local doctors shutting their doors.
NHS England data showed nearly a hundred practices closed in 2016, a 114% increase in GP closures compared with figures from 2014. Of the 92 practices that shut, 58 did so completely, while 34 merged with other local surgeries in order to pool resources.
The drop in GP numbers meant 265,000 patients – an increase of 150% from 2014 – had to change their practice last year, often travelling further for care. Brighton was particularly badly affected with 9,000 patients displaced when four practices closed. There have been a total of seven closures in the city over the past two years.
The new data, obtained by the GP website Pulse, has renewed fears that family doctors are not coping with increased demand and need an urgent cash injection to survive. Senior doctors also expressed concern that government funding was not being targeted correctly. ...read more
What Impact does Brexit have on nursing? (The Guardian: 28 February 2017)
The NHS faces a major shortfall in nurses – and the EU referendum result threatens to derail supply further.
The NHS faces a severe nursing shortage. An ageing population has pushed up demand, while an ageing nursing workforce – with one in three nurses set to retire in the next 10 years – is reducing supply. The shortage is particularly acute in mental health, with specialist nurse numbers falling more than 10% in the past five years.
And the Brexit vote may make it even worse. A July 2016 Institute for Employment Studies (IES) report reveals about 4.5% of NHS nurses in 2015 were from EU countries excluding Ireland, a steep rise from the 1% of 2009. In some trusts in London and the east of England, the proportion is as high as 20%.
Nurses who have been here more than five years will be eligible to remain. But what will happen to the others? Helen McKenna, senior policy adviser at the King’s Fund thinktank, believes that the government “urgently needs to clarify its position on the status of nationals who are already here in the UK working in health and social care roles”. While the prime minister has said she would like to guarantee the rights of EU citizens already living here, that is by no means certain. McKenna says: “Her position is likely to be dependent on reciprocal agreements for UK citizens living elsewhere in Europe.”...Read More
Maternity units across England facing the axe under plans to transform NHS care (The Mirror: 16 February 2017)
Eleven maternity and neonatal units across England are reportedly facing either being axed or merged under plans to transform obstetrics care in the NHS .
Proposals to remodel the health service in order to plug a £22 billion hole by 2021 reveals major changes across toe maternity services.
Now hospitals in Lancashire and South Cumbria, West Yorkshire and Harrogate, South Yorkshire and Bassetlaw, Lincolnshire, Leicestershire and Rutland, Birmingham and Solihull, Milton Keynes, Dorset, Coventry and Warwickshire are being marked to shut or to move substantial distances.
A week ago the Royal College of Midwives’ annual report said maternity services across Britain could already reach “crisis point”, as more than a third of midwives are nearing retirement age.
The report said that more student midwives are needed to be trained as a “matter of urgency”...read more
NHS intensive care ‘at its limits’ because of staff shortages (The Guardian : 29 January 2017)
The NHS’s network of intensive care units is “at its limits” because they are overwhelmed by staff shortages and the sheer number of patients needing life-or-death care, senior doctors are warning in an unprecedented intervention.
Intensive care units (ICUs) are becoming so full that patient safety is increasingly at risk because life-saving operations – including heart, abdominal and neurosurgery – are having to be delayed, the leaders of the specialist doctors who staff the units have told the Guardian.
“Intensive care is at its limits in terms of capacity and struggles to maintain adequate staffing levels,” said Dr Carl Waldmann, the dean of the Faculty of Intensive Care Medicine (FICM).
“It is important that bed occupancy rates do not exceed 85% in order to ensure there is capacity for emergencies. The reality is that many units are quickly reaching 100% capacity whenever there is excessive hospital activity,” he added...read more
More than 7,000 nurses could face axe under secret NHS plans (The Telegraph: 16 January 2017)
More than 7,000 nurse posts could be axed from NHS hospitals across the country despite a mounting Accident & Emergency crisis, new plans reveal.
Every area has been ordered to draw up meaures to save £22bn and reorganise health services in order to meet rising demand from an ageing population.
But new documents suggest that the proposals could result in the loss of more than 17,000 staff by 2020 - including 7,300 nurses and midwives.
Last night senior nurses said the implications for safety were “truly frightening” with widespread shortages of staff already in overstretched hospitals.
The forecasts, seen by Health Service Journal, also reveal that the plans rely on a dramatic reversal in trends which have seen casualty units under unprecedented pressure.
Health authorities across England have been ordered to draw up 44 “sustainability and transformation plans” (STPs) to tackle rising pressures on the health service.
The controversial measures will see swingeing bed cuts in many parts of the country, and widespread closures of Accident & Emergency departments....read more
Over a third of GPs in Scotland plan to retire in the next five years (British Medical Association: 13 December 2016)
More than a third of GPs are planning to retire from general practice within the next five years according to the latest figures from the BMA’s survey of GPs in Scotland.
The findings are the second set of results from the BMA’s survey of the profession in Scotland
Key findings from the survey about the current state of the GP workforce include:
One third of respondents (35%) are planning to retire from general practice in the next five years. One in five (20%) said they are planning to move to part time. Six per cent are planning to move abroad and six percent are planning to quit medicine altogether.
Over two thirds of GPs (70%) state that while manageable, they experience a significant amount of work related stress. However, 15% feel their stress is significant and unmanageable.
Asked to rank what factors were having a negative impact on their commitment to being a GP, 55% of respondents said that workload had the most negative impact, 21% said that unresourced work being moved into general practice was the biggest negative and 13% said that insufficient time with patients was the biggest negative...read more
RCM warns against permanently altering midwife roles to plug staff gaps (National Health Executive: 12 December 2016)
The Royal College of Midwives (RCM) has issued guidance urging NHS organisations to ensure that midwife roles are protected as they struggle to ensure safe staffing levels.
The RCM argued that an additional 3,500 midwives are needed as the NHS faces persistent staffing shortages at a time of rising demand due to a historically high birth rate, increasingly complex pregnancies and expectations that midwives will deliver more support and advice.
In ‘Getting the Midwifery Workforce Right’, a new report it published today, the RCM agreed that midwives may need to take on changed roles and new skills in order to cope with a changing role.
However, it added: “Whilst the RCM accepts that NHS organisations wish to maximise the flexibility of their workforce, it is not acceptable to permanently alter midwifery roles to compensate for staffing shortages or changes in doctors’ roles (for example, by routinely requiring midwives to assist in caesarean sections).
“We do not believe that this kind of response solves the fundamental problem of medical shortages, but merely moves the problem onto another profession.”...read more
Workload damages patient care, say GPs (British Medical Association: 9 December 2016)
GPs in Scotland have sent a clear message that their workload is unsustainable and is affecting patient care.
A BMA survey has shown that more than nine out of 10 GPs believe their workload negatively affects the quality of patient care.
GPs also believe that they should have more time to spend with patients, with just 7 per cent saying consultation times are adequate.
The Scottish Government said action was already under way to address GPs’ concerns, including additional investment in primary care, and an agreement with the BMA on the future direction of general practice.
The 900 GPs in Scotland who responded to the survey were asked to rank the measures they thought should be top priority to help them deliver general practice.
Almost half (44 per cent) said increased funding for general practice was the top priority, while 36 per cent said the most important thing was to increase numbers of GPs. Almost one in five (18 per cent) said longer consultations should be the top priority.
More than half (53 per cent) believe there should be longer consultations for certain groups of patients, including those with long-term conditions, while four in 10 say that all patients need more time with their GPs ...read more
Overwhelmed’ social worker who deflected from struggles sanctioned (Community Care: 9 December 2016)
Conduct panel issues three-year caution after social worker whose team was “fire fighting” fails to prioritise high-risk cases
An experienced social worker who was “overwhelmed” by her workload has been cautioned by the HCPC after she failed to admit she was struggling.
A conduct committee found the social worker, who was a team manager in children’s services at the time, moved a disabled child into a foster placement without a placement planning meeting having taken place and failed to ensure visits were carried out to service users in two high-risk cases that needed urgent action. These matters constituted misconduct, the panel found.The social worker put the failings down to the pressures and staff shortages in her team which had left her social workers “fire-fighting”....read more
Nearly a third of GP partners in England have been unable to fill staff vacancies during the past 12 months, a BMA survey has found.
Children’s trust grappling with staff shortages ahead of launch (Community Care: 2 December 2016)
Sunderland council is 79 permanent staff short ahead of the trust's launch in shadow form next year
Sunderland council is stepping up efforts to address staff shortages as its currently 79 permanent staff short of what is needed to run a new trust model launching next year.
The latest council report on plans for the trust, published in October, revealed the council estimates 235 permanent staff are required to deliver the new model but services only had 156 employees. Another 114 staff are currently in agency posts.
The trust will formally take over the running of the council’s children’s services next year, following a negative Ofsted report published last year.Meeting the recruitment targets was “crucial” to the trust’s organisational performance and cutting agency spending but the council faced high competition from neighbouring authorities, the report said ...read more
Risk of doctor training being ‘eroded’ by high workloads (National Health Executive: 2 December 2016)
Doctors in training are increasingly complaining of excessive workloads and workplace exhaustion, leading to warnings from the General Medical Council (GMC) that medical training is being “eroded”.
The GMC annual survey of medical education and training found that 43% of doctors in training described their workload as ‘heavy’ or ‘very heavy’, a 2.3% increase compared to 2012.
Furthermore, 44.5% said they were unsatisfied with their workload, although this represented a 1.5% drop from the rate in 2014. Nearly a quarter of doctors in training also complained of feeling sleep deprived on a daily or weekly basis, a 3.4% decrease from 2012.
Emergency medicine, acute internal and general internal medicine, respiratory medicine, and gastroenterology were among the specialties with the highest workloads...read more
Staff shortages now outweigh funding fears among NHS leaders (The Nursing Times: 29 November 2016)
South coast community trust warned over staffing levels (The Nursing Times: 23 November 2016)
The trust, which provides a range of community services including community nursing, specialist nurses, health visiting and school nursing, was rated “requires improvement” overall, following visits by the Care Quality Commission in June and July this year.
CQC inspectors said they had identified many good areas of care. However, they found staff vacancies were affecting quality and “many services were experiencing difficulties in coping with demand”.
At the time of the inspection, there were significant vacancies in community nursing teams, especially in Portsmouth where rates of medication errors and pressure ulcers were getting worse.
In 2015, the trust reported 151 serious incidents with the majority – 57.6% – in community nursing and linked to pressure ulcers...read more
Danger of Scotland's maternity wards revealed (The Express: 22 November 2016)
MORE than 25,000 serious incidents have been recorded in Scotland's maternity hospitals in the past five years, new figures have revealed.
The most serious so-called "adverse events" - defined as incidents which cause harm or have the potential to cause harm - included the deaths of 26 newborns and 79 stillbirths.
Three mothers have also died in such circumstances since 2011, according to the figures revealed under Freedom of Information laws.
The details, accessed by the BBC, showed staff shortages, medicines administered in error and treatment delays were among the incidents logged...read more
NHS draws up plans to swap high grade nurses with less qualified staff (The Telegraph: 17 November 2016)
The NHS is drawing up plans to replace nurses with cheaper staff, despite Government insistence that new roles will be used to boost staffing numbers, new plans show.
Health service managers in charge of services in Buckinghamshire, Oxfordshire and Berkshire West intend to save more than £30 million by using more “generic support workers” and healthcare assistants while cutting back on highly qualified nurses.
The four-year plan – one of 44 being drawn up around the country – follows BMJ research earlier this week which linked increased reliance on nursing assistants to a sharp rise in death risks.
The study raised questions about Government plans to introduce 2,000 nursing associate roles across England. ...Read More.
More than five million patients could be left looking for new GP’s after ten per cent of practices in England claimed they were at risk of closing within the next year.
Closures are already at record highs with underfunding and staffing problems given as the main reasons why.
A total of 201 practices have closed in the past year and another 750 may follow suit in the coming months, according to GP Online magazineBMA GP committee deputy chair, Dr Richard Vautrey, said that although resources were available they are not being spent on where they are needed....read more
Number of NHS mental health nurses has fallen by 15% under Tories (The Guardian: 1 November 2016)
The number of mental health nurses working in the NHS has dropped by almost a sixth since the Conservatives came to power in 2010, figures show.
The revelation has sparked fresh doubt that government pledges to improve mental health services are being matched by progress at the NHS frontline.
Philip Dunne, the health minister, has admitted in a written parliamentary answer that while there were 45,384 mental health nurses working in England in 2010, there were just 38,774 in July this year. That fall of 6,610 nurses represents the loss of about 1,000 such specialists a year, or almost 15% of the entire workforce providing that sort of vital care to patients over the last six and a half years.
“This is a very worrying downward trend that shows no sign of turning around, despite all the government’s pronouncements and pledges about equality for mental health care compared to physical health care,” said Labour MP Luciana Berger, the ex-shadow health minister who obtained the answer.
The loss of so many posts meant that patients are at risk of receiving lesser-quality care than before and their recovery is being jeopardised by having less contact time with nurses, who were likely to be busier than ever, Berger warned.
The Royal College of Nursing claimed the figures proved that patients were being let down and ministerial pledges of recent years were not being delivered....read more
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’....read 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 worries....read 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 News.....read 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 overnight....read 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 year....read 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.....read 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 continued....read 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....read 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”....read 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 midwifery....read more
Brexit 'will make NHS staff shortages worse' (BBC News: 30 June 2016)
The other NHS crisis: the overworked nurses who are leaving in despair (The Guardian: 25 June 2016)
More school nurses needed to tackle childhood mental health crisis (Royal College of Nursing: 19 June 2016)
GP vacancy rates at highest recorded with one in eight positions unfilled (Pulse: 1 June 2016)
Staff shortages cited as factor in delayed discharge (Nursing Times: 26 May 2016)
Economists claim there will be a 6% drop in student numbers after bursary scrapped (Nursing Times: 25 May 2016)
Why has the NHS deficit ballooned? One word: understaffing (The Guardian: 20 May 2016)
'Almost half' of junior doctors 'will quit the NHS' if contract is imposed (Pulse: 17 May 2016)
90% of GP trainees to shun full-time clinical work (Pulse: 5 May 2016)
GPs still in favour of mass resignation despite support package (Pulse: 29 April 2016)
NHS looks to India for GPs in attempt to make up shortfall (The Guardian: 7 April 2016)
Staff shortages spark CQC warning for mental health trust (The Nursing Times: 23 March 2016)
Junior doctors to withdraw emergency care in escalation of action (Pulse: 23 March 2016)
Hospital shuts beds after CQC raises staffing ratio concerns (HSJ: 21 March 2016)
Alarm raised over trust's 'risky' proposal to run A&E without specialist consultants (HSJ: 21 March 2016)
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)