Expert advice

People can see there are nurse shortages – and they expect the government to act

Politicians need to listen to what the public is telling them about the NHS

Politicians need to listen to what the public is telling them about the NHS

Picture: iStock

Just before the general election last December, IPSOS MORI pollsters asked a sample of the UK population which aspects of health and care people wanted the new government to prioritise.

The response was loud and clear, with three in five respondents (61%) believing that increasing the number of NHS staff should be the number one priority for the government.

Although nursing shortages dominate the NHS staffing discourse, there are difficulties across the workforce. A Health Foundation review, published just before the IPSOS MORI poll, set out the scale of the overall problem.

Ageing demographic means demand for care is outstripping supply

One of the key points is that population growth and ageing mean demand for care is outstripping the supply of people able to provide that care. The overall number of full-time-equivalent (FTE) staff working in the NHS in England actually increased in 2018/19 by about 2.8%, but this growth was insufficient to meet the longer term and increasing growth in demand.

Beneath this headline, nurse staffing supply is lagging; at the start of the last decade there were 3.0 nurses per doctor in the NHS, a figure which has now fallen to 2.6. There has also been a major change in the mix of nurses and clinical support staff, such as healthcare assistants. 

Dilution of the skill mix in the nursing workforce

In 2009/10 there were equal numbers of nurses and support staff in the NHS, with one clinical support staff member for every FTE nurse. By 2018/19, the number of support staff per FTE nurse had risen 10% to 1.1 FTE per nurse.

There are deeply embedded skills shortages in key areas of the NHS, including nursing. The public know this through personal experience and voiced it to the pollsters.

Now it is up to the politicians to heed the voice of the public.

James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh

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