In 2021 alone, one in nine medics (11%) left active service, with thousands more expected to quit in the coming months. As NHS waiting lists hit a record high of 6.4 million patients, a shrinking workforce will only lead to further backlogs and greater fears for patient safety. Without immediate and radical action, additional training and recruitment alone are unlikely to compensate for staff losses to ensure a functional healthcare system. To put it bluntly, addressing the retention of medical staff is critical for the health of the NHS.

Chaotic scheduling practices and a poor work-life balance are widely acknowledged to be a cornerstone of the medical profession and no longer are staff putting up with it - staff are voting with thier feet, citing lack of flexibility and poor work-life balance asthe primary driver to dissatisfaction and ultimately departure. Medics are expected to sacrifice their personal life to accommodate unpredictable and inflexible rotas. With much of the workforce already working well beyond their contractual hours, time off is often left to the staff to sort themselves through swapping with colleagues - a process that is time consuming and rarely feasible. 

The crippling burden placed upon healthcare professionals is only worsened by the systems designed to manage their workload. Currently, the NHS’ systems to schedule shift patterns and source additional capacity are completely outdated and inadequate. With many Trusts stuck on paper-based approaches, in-house spreadsheets, and non-cloud-based rostering systems, rotas often lack transparency and are not accessible or visible to the staff themselves. Inevitably, this added administration leaves staff frustrated and exhausted. Perhaps even more alarmingly, it also holds the capacity to seriously undermine the quality of care that stretched medics are able to provide. Recent research conducted by UCL and King’s College London found that NHS intensive care staff suffered the same levels of PTSD during the pandemic as British military veterans deployed to Afghanistan in a combat role. 69% of those surveyed stated that this intense stress impaired their ability to carry out daily tasks.

Burned out, undercompensated and lacking in recognition, it is unsurprising that many staff resort to leaving the workforce entirely. The impact of this Great Resignation only amplifies the pressures faced by the workforce: with increasingly limited staff numbers, those who remain, stretch themselves further and exacerbate their risk of burnout. To address immediate staff shortages, Trusts often resort to recruitment agencies. Whilst short-term cover offers a temporary solution, it carries with it an eye watering price tag: £4bn per year. In practical terms, this sum is equivalent to approximately 3,424,658 ambulance trips, 6,250,000 non-specialist A&E treatments, or 25,490,696 GP appointments. Even worse, agency interventions often prove to be ineffective, with professionals matched to departments that they are unfamiliar with.

So how can we remedy this staffing crisis? 

Policy needs to prioritise staff satisfaction, retention and better deployment . From the get go, there are quick-win measures that can be put in place – paying staff on time for additional shifts they take, upgrading technology infrastructure to enable flexible working like most other industries, paying staff what they deserve. Beyond basics, instituting tools to support standardised and regular recognition and reward as well as real-time measures of satisfaction. Just by implementing these changes, we’d start to see the current levels of workforce dissatisfaction start to alleviate. 

To ensure we’re getting the best out of those already in the system, rostering and deployment needs to be fixed. Schedules need to be built around the clinician availability and preferences, no longer will staff agree to be placed into shifts like resources without any sense of control over when and where they work..

In addition clinicians must be enabled to work across organisational boundaries. With clinicians working more flexibly, additional capacity can be freed up into the system which may otherwise be blocked. This will reduce the agency bill as currently the only way staff can work across organisational boundaries is via the agency model. By doing this, you would also start to see satisfaction rates improve too – with many needing to plan work around family life, you’re likely to see 77% of the women NHS workforce happier. 

The quickest way to implement these changes is through technology and tooling and the good news is that many of the systems we require are already available. With adoption and roll out of the most up to date technology, the NHS can become more self-sufficient and regain control of staffing issues and expenditure on expensive agency fees.