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4 March 2022

We are “sleepwalking” into a crisis of care for older people, says Royal College of Physicians

The NHS is “drastically short of staff” across all services, according to the membership body.

By Zoë Grünewald

Drastic staff shortages coupled with an ageing population may result in a serious crisis of care, the Royal College of Physicians (RCP) has warned, following its analysis of population data and a census of physician numbers.

According to the RCP, the NHS is “drastically short of staff” across all services, and the dwindling number of geriatricians is just one example “of where a lack of planning leads”.

Back in January the chief executive of NHS Employers, Danny Mortimer, stated that even prior to the pandemic the NHS had a shortage of “nearly 100,000 staff” and that staff shortages and an “exhausted workforce” present a great challenge to the “recovery of our NHS and the return of safe, high-quality health services for all”.

The RCP says workforce shortages vary across the country, with the East Midlands fairing the worst (one geriatrician per 12,561 over-65s) and central and north-east London the best (one geriatrician per 3,254 over-65s). The RCP also warns that with current trends, the situation will only likely get worse.

“By 2040 there will be over 17 million people in the UK aged 65 and above, meaning 24 per cent of the population may potentially require geriatric care. In addition, many of the doctors providing geriatric care now will soon be requiring that care themselves. With 48 per cent of consultant geriatricians in England set to retire within the next ten years, we could be on the threshold of a dramatic drop off if we don’t act now to retain as many of them as possible.”

In response to the stark figures, Andrew Goddard, president of the RCP, said: “I have dedicated my career to working in the NHS – a service that I am fiercely proud of – and yet it scares me to wonder what might happen should I need care as I get older. There simply aren’t enough doctors to go round, not least within geriatrics.”

The RCP has also warned that the NHS is flying blind on future staffing, with no public data currently available to shed light on just how many staff will need to be trained to meet the future demand for care.

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Goddard said: “The workforce crisis we’re facing is largely down to an astonishing lack of planning. All successful organisations rely on long-term workforce planning to meet demand and it’s absurd that we don’t do this for the NHS and social care system.”

Earlier this year, Julia Cumberlege, a member of the House of Lords, tabled an amendment to the Health and Social Care Bill that places a duty on the Secretary of State for Health and Social Care to “publish a report describing the system in place for assessing and meeting workforce needs”. The amendment, backed by 100 medical organisations including the RCP, as well as NHS England chief executive Simon Stevens, is due to be debated in the House of Lords this week.

According to a briefing on the proposed amendment by NHS Providers, the legislating of such a reporting system was necessary in order to meet future demand. “Regular, independent public workforce projection data will not solve the workforce crisis,” it stated. “But having a collective national picture of the health and care staff numbers needed now and in future to meet demand will provide the strongest foundations to take long-term strategic… decisions about funding, regional and specialty shortages, [and] skill mix and underpin a long-term workforce strategy. We hope peers will consider supporting this amendment.”

The bill is currently at the report stage in the House of Lords having already passed through the House of Commons. It will be debated in the chamber later this afternoon, Thursday 3 March.

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