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Where is the NHS workforce plan?

The time for promises and postponements has passed.

By Sarah Clarke

Physicians across the country are renewing their call on the government to publish its long-awaited NHS workforce plan. We have record-breaking waiting lists, patient care targets missed and unprecedented demand for services. This week the Royal College of Physicians’ latest research highlights the scale of understaffing and how the quality of patient care is at risk.

Nearly one in five of the doctors we asked, as part of a census by the Royal College and our sister colleges in Glasgow and Edinburgh, said they almost never feel in control of their workload and more than two in five report having an excessive workload almost always or most of the time. This is unsurprising given that more than half (58 per cent) report consultant vacancies in their departments and 69 per cent say there are daily or weekly gaps in trainee rotas. The loss of control erodes morale and puts doctors’ mental and physical well-being at risk; the findings highlight that 19 per cent of consultant physicians are at risk of burnout.

With junior doctors protesting about their pay and conditions, the figures released on 22 June reflect the daily struggles faced by the UK’s senior doctors as they try to provide the best care to their patients against a backdrop of persistent vacancies and growing demand. Healthcare professionals are stretched to their limits and finding it increasingly challenging to provide the high-quality care that they have been trained to provide and that patients deserve. This crisis is not limited to a single specialty or region; it permeates our entire healthcare system.

Colleagues can’t give exceptional care if their own well-being is compromised. A worrying seven out of ten consultant physicians say the gaps in rotas are having an impact on patient care, as services struggle to meet the demands of our growing and ageing population. Access to outpatient care, the length of hospital stays and out-of-hours inpatient care are most impacted by rota gaps.

[See also: Rishi Sunak pledge tracker: Is the PM now regretting his promises?]

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I have seen the impact of these gaps in my own specialism, cardiology. The latest NHS figures revealed there were more than 132,000 people waiting six weeks or more in April for an echocardiogram – an ultrasound scan which helps to diagnose a number of heart conditions, some needing urgent attention. I am aware of patients that have delayed seeking emergency treatment because they are concerned hospitals are too busy, or that have left emergency departments before being seen because the waits to be seen or get tests are so long. These are tests and diagnoses that may save their life.

Patients deserve timely and effective treatment from a fully staffed and adequately supported healthcare system and we cannot subject the urgently needed next generation of doctors to such pressure at work. It is time to address the staggering number of vacancies – 112,000 full time equivalent vacancies across the NHS – and take steps to prioritise the health and well-being of our own medical workforce to improve retention. The government must come good on its promises and publish the long-delayed long-term workforce plan in full.

We need a clear plan that sets out independently verified medical staff projections for the next five, ten and 15 years, and is underpinned by robust funding plans. The plan must consider the increasing demands placed on our healthcare system, as well as the need to attract and retain talented medical professionals, including expanding the number of medical school places.

The publication of the plan is vital but only the first step in putting the NHS workforce back on a sustainable footing. It is imperative that the government commits to regularly reviewing and refreshing the plan and collaborates closely with organisations such as the Royal College of Physicians, which represents over 40,000 members. A comprehensive workforce plan will focus us on where we need to increase recruitment, better support our doctors and the wider workforce and allocate resources strategically.

The time for promises and postponements has passed. As the country approaches the NHS’s 75th birthday, we will look back on its tremendous successes in providing care for all, free at the point of delivery. Our dedicated health and care workforce is central to that. The anniversary is a golden opportunity for the government to set out those long-awaited plans for how we sustain the NHS for years to come. The well-being of our medical workforce is at a critical juncture and the consequences of inaction are too grave to ignore. We must seize this opportunity to increase the medical workforce and act urgently to retain the doctors we have now. The health of our nation depends on it.

This article was originally published on 22 June.

[See also: The family doctor knows best]

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