Responding to this week’s Q3 performance report from NHS Improvement, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, pointed to the “intolerable” pressure on a system that currently has a “staggering” 100,000 vacancies to fill.  
 
"We have repeatedly pointed to severe underfunding in health and care, and a year-to-date deficit in the English NHS of £1,281m is just the latest evidence of this,” he said. 
 
"Our members are at the end of their tether. It is simply not realistic or reasonable to expect the NHS to go on delivering a comprehensive universal service with inexorably rising demand and demonstrably inadequate funding.”

Healthcare recruiters echo those concerns.
 
Olivia Spruce, chief operating officer at Positive Healthcare, told Recruiter the NHS is “creaking at its foundations”. 

“With more than 100,000 vacancies to fill, this is putting intolerable pressure on the existing workforce, which leads to further exits, the consequence of which is a perpetual cycle of even more vacancies,” she said.

“Funding is clearly an issue, but I would suggest that the root cause of unfilled vacancies is the low morale within the existing workforce. Brexit, the new doctors’ contracts, and unsafe staffing on wards leading to compromised patient care have created despair for staff in the NHS. Staff are leaving the system and the government is not doing enough to attract new talent by improving morale.”

Meanwhile, HCL chief executive Stephen Burke called the data “very concerning”.
 
“HCL has been campaigning on a range of issues impacting the supply of workers to the NHS – notably the immense and unnecessary restrictions being placed on overseas medical staff, who for so long have plugged vital gaps to ensure we receive high-quality services at home,” he said.
 
“New language tests introduced for overseas nurses, tier 2 visa restrictions that rank doctors on the same level as ballet dancers on the shortage occupation list, and misalignment between Home Office and NMC rules on English language retakes are all having a profound impact on the supply of staff to the NHS. This doesn’t even touch on the immense challenge trusts are facing to recruit and retain existing UK staff.
 
“While we are encouraged that the government, GMC (General Medical Council) and NMC (Nursing and Midwifery Council) are starting to listen and act, more needs to be done much faster to relieve this situation,” said Burke.
 
According to Paul McQue, managing director at MPA Recruitment, the agency’s key problems in filling vacancies are due to the drastic shortage of nurses and the delay in key compliance requirements being met in time for upturns in shift requirements for all staff in key NHS areas.  

“There is a steady decline in the number of nurses available to recruit. Every year we attend final-year student nursing recruitment fairs in Northern Ireland, and what we are seeing is an appetite for newly qualified nurses to start their nursing careers abroad. We have witnessed many newly qualified nurses leaving our shores to work in other countries, including Australia and Canada. We now have fewer newly qualified nurses than we’ve ever had, as a result.  Pay and conditions are typical key reasons, so it’s no surprise to us that funding is a key issue in this report,” he said.
 
“We supply more than 1000 staff per day to NHS trusts throughout Northern Ireland. As one of the main recruitment providers on the NHS framework agreement (which already sets national wage levels), we have noticed a shift in nurses seeking opportunities in the private sector as opposed to opportunities available in the NHS, basically because the private sector will pay more. We have also come up against the challenge of trying to compete with agencies that are not a part of the trust framework agreements.

“These agencies are supplying nurses to the NHS at a much higher cost, enabling them to pay the nurse a much higher hourly rate. There will always be a place at critical times for these supply/demand agencies, but there is a fine line between the quality of care for the end user and the spiralling costs of the non-framework suppliers,” said McQue.

“This has meant that agencies on the NHS framework are losing nurses to non-contracted agencies. We find that this has also demoralised the ‘contracted’ agency nurses, as a non-contracted agency nurses can carry out a shift in the NHS, complete the exact same duties, but be paid a considerable amount more. We’ll continue to work with our partners within the trusts here in NI and to control, where possible, the use of non-contracted suppliers for these reasons. 
 
“We continue to recruit nurses from abroad where possible, with mixed results. Brexit has had an effect on our recruitment efforts, with fewer nurses willing to come and work in Northern Ireland because of the uncertainty that surrounds the UK leaving the EU,” he said.
 
“A tougher stance on non-contracted agency usage – where rates are often as much as four to five times higher – needs to be taken. Only then can cost control and pay parity, from an agency perspective, be a key to our industry supporting the NHS on the solution to these findings.”