Staffing challenges plague a large number of healthcare organizations and agencies around the world due to a growing population of older patients. One such organization – the UK’s National Health Service (NHS) – is a strong contender for the most tormented not only in terms of available staff but also in regards to staff morale. Since 2012, the NHS has spoken loudly about its organizational plan to ramp up total personnel numbers in an effort to serve patients with the level of care they want and deserve. But a new report from Nuffield Trust, a UK health policy research firm, tells a different tale.

In late May, a reported commissioned by NHS Employers, the agency responsible for negotiating contracts on behalf of NHS staff in the UK, was made available to the public from Nuffield Trust entitled “Reshaping the workforce to deliver the care patients need.” While promising on its face, the Nuffield Trust report speaks to a restructuring among current staff within NHS rather than adding the necessary bodies the organization proposed less than four years ago. Instead of focusing on recruiting additional staff to help shore up the staffing – and patient care – crisis within NHS, the report lays out a plan to redesign how the more than 1 million current personnel work in the NHS system.

Changes on the Horizon

The Nuffield Trust report provides recommendations on how to achieve a restructuring within the NHS without tapping the already strapped budget of the organization. Researchers concluded that the following four alternatives to hiring additional staff may provide a reasonable solution to understaffing issues:

  • Provide additional training to enhance skillsets for current personnel to include physiotherapists, paramedics, nurses and pharmacists
  • Offer mentoring programs to less experienced nursing staff to push practice roles forward
  • Add responsibilities to the current job roles of the large support staff group of workers
  • Make available physician associate roles, allowing non-medical personnel to ability to perform certain work with the supervision of a doctor or surgeon

There is little question that the recommendations put forth in the report allow the NHS to utilize its current staff to a greater extent, but concerns loom over implementation. Focusing on redesigning the NHS workforce as opposed to adding to it imposes a heavy burden on staff – individuals who are already overworked and overextended due to growing patient demand. Longer hours, additional responsibilities and less support equates to a chaotic scene within NHS agencies for both staff and patients alike.

A Bottom Line Focus

Some commend the report, stating that its clear intent to save the NHS from further cash flow woes is the right choice at the right time for the organization. However, the researchers at Nuffield Trust point to the apprehension over proper implementation, noting that a strategic plan must be set in motion in order to fulfill the recommendations set forth in the report effectively. Without a strategic plan, the NHS stands to lose substantially more capital than it would by adding staff to its roster. Money flows out by way of an increased number of medical claims related to lackluster patient care.

A spokesperson from a specialist medical law firm in the UK, Patient Claim Line, explains that the budget concerns within the NHS can be partially correlated to its faulty claims process. The task of investigating and assessing claims made by patients is cumbersome and can take years to work through, only adding to the drain on funding, resources and time. A recent report from Health Secretary Jeremy Hunt compounds these findings, stating that the estimated legal bill for NHS could soar as high as £2.5bn per year, based on an increased number of patients treated combined with the understaffing crisis NHS is currently experiencing. While the Nuffield Trust report offers some cost-conscious guidance on a way forward for the NHS, the ability of staff to implement while maintaining a high level of patient care remains in question.