The National Health Service, or NHS, has long been embattled with an understaffing problem, clearly cited in numerous reports from both public and private research agencies. While an ongoing cry for change has been proclaimed loud and clear by the staff and the patients being treated, the NHS and the powers that be continue to struggle to keep up successfully with growing healthcare demand. In mid-May, a report entitled “Reshaping the workforce to deliver the care patients need” was released by the UK health policy research firm, Nuffield Trust. The title of the report prompts both intrigue and optimistic regarding a way forward for NHS, but the contents of the newly published piece leave something to be desired.

The Nuffield Trust report, commissioned by the NHS Employers, an agency tasked with negotiating contracts for NHS staff on behalf of the Government, speaks to the need for a redesign within the health care system. However, the proposed changes from researchers’ perspectives are not all clearly aligned with true patients’ needs, nor the needs of the more than 1.3 million staff members committed to providing that care.

NHS hospital entrance

The Proposed Restructuring

As the population continues to age and additional pressure is placed on the health care system, the need for sweeping change to correct the understaffing issues within NHS becomes more critical than ever before. The recent report offers some insight into how the NHS can begin to correct the concerns and effectively “grow” the workforce without squandering available funding, including the following four steps:

  • Place additional responsibilities on support workforce staff, as this group of NHS workers is both large and relatively flexible
  • Extend the skills of registered healthcare professionals already in the system, including nurses, pharmacists, paramedics and physiotherapists
  • Advance practice roles for nursing staff by offering mentoring and training for those with less experience
  • Add the role of a physician associate which allows non-medical staff to perform certain tasks under the guidance of doctors and surgeons

While the Nuffield Trust report purports that these staffing tweaks pave the way for enhanced patient care, some question the validity of restructuring in this manner. The focus of this redesign is to reduce the outlay of cash required for additional training and adding more total workers within the NHS, since the system has experienced and is projected to continue experiencing deficits that are difficult to overcome. While the proposed steps may address the funding gap within the healthcare system by evading the need to hire additional qualified workers, current staff members of NHS are left with even harsher hours with a greater burden of responsibility simultaneously. The report explicitly states that without carefully implementing this type of redesign strategy within the walls of NHS facilities, the combination of increased patient demand and overworked staff may cost more money rather than save it.

What it Means for Staff and Patients

Doctor and staff burn-out is already a pressing concern within NHS, and the recommendation to add responsibilities to the full plate of staffers only compounds the issue. Despite the pleasant report title, the suggestions laid out by Nuffield are not realistically aligned with solving this underlying issue within NHS. In practice, the staffing changes have the potential to create real patient safety issues by way of medical errors and increased number of claims, leading to increased costs for the organization as a whole. In fact, a recent report released by Health Secretary Jeremy Hunt estimates the cost of medical mistakes could be as high as a devastating £2.5bn each year for the NHS, a substantial portion due to overworked healthcare staff.

A representative from Patient Claim Line, a specialist medical law firm, states that these costs are highly correlated to efficiencies within the NHS system. Claims can take years to investigate, assess and process, leading to an expensive drain on resources and manpower. It is not a far stretch to assume that the proposed changes for the staffing structure of NHS may result in increased doctor and staff exhaustion and ultimately burnout – a cost patients who desperately need quality care simply cannot afford.


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