Daily Junction.mobi portalHowever, training takes time: it takes 5 years to train a nurse, 5-10 years to train a doctor, and 13 years to train a consultant. This means the impact of increased training places will not be felt until the late 2020s or 2030s.
Retention is the more immediate priority. The Health Foundation estimates that reducing turnover by 1 percentage point (from 11.2% to 10.2%) would save the NHS £200 million per year in recruitment costs and reduce vacancies by 15,000.
1. Competitive pay: NHS pay must be competitive with the private sector, other public services, and international opportunities. The current pay settlements are a start but do not fully address real-terms cuts.
2. Safe staffing levels: Mandatory safe staffing ratios (e.g., one nurse per 8 patients on general wards) would reduce workload and improve safety. The RCN has campaigned for this for years, but it has not been implemented due to cost.
3. Reduce bureaucracy: Simplifying administrative tasks, improving IT systems, and reducing paperwork would free up clinical time. GPs spend 30-40% of time on admin; reducing this to 20% would be equivalent to recruiting 2,000 additional GPs.
4. Flexible working: Offering part-time, flexible, and remote working options (where appropriate) would improve retention, particularly for staff with caring responsibilities.
5. Career development: Clear career pathways, training opportunities, and support for progression would improve job satisfaction and retention.
6. Wellbeing support: Accessible mental health support, occupational health, and peer support programmes are essential given high burnout rates.
7. Address abuse: Zero-tolerance policies for abuse of staff, with enforcement and support for affected staff.
NHS England has 112,000 full-time equivalent vacancies as of September 2024, an 8.2% vacancy rate, with nursing vacancies at 44,000 despite record international recruitment. GP numbers have fallen by 1,800 FTE since 2019 while patient demand has increased 15%, leaving practices struggling to offer timely appointments. 42% of NHS staff report feeling burnt out, with staff sickness absence at a record 5.1%. Real-terms pay for nurses has fallen 6% since 2010, contributing to recruitment and retention difficulties.
The crisis is driven by unsustainable workloads, real-terms pay cuts, inadequate staffing levels, and lack of support for staff wellbeing. International recruitment has increased but cannot compensate for poor retention—the NHS is losing experienced staff faster than it can recruit. The government has committed to recruiting 10,000 additional nurses and 8,000 GPs by 2029, but training takes years and retention improvements are the more immediate priority. Filling all vacancies would cost approximately £4.5 billion per year, but without addressing pay, workload, and working conditions, vacancies will continue to grow. The workforce crisis is the single biggest constraint on NHS capacity and will determine whether the health service can meet rising demand in the coming decade.