The NHS Scotland Staffing Shortage
Nicola Biggerstaff - 5 May 2022
The NHS Scotland Staffing Shortage: where do we go from here?
When I set out to meet each one of the members of our healthcare working group for the first time, intent on finding the common thread which brought them all together, little did I know just how much of a shock I was in for. Concerns and grievances were aplenty; waiting times, bureaucracies and hierarchies across departments were having a detrimental effect in the quality of care available to patients. However, one issue raised has caused particular concern, one which has haunted me from the moment it was raised: that of slashed numbers of nursing and clinical staff across the board, ultimately putting the lives of patients in danger.
I sat in the café in Glasgow next to two of our members last week. They started enthusiastically enough, as all our members have with me, with the (not completely unfounded) thinking that, as a comparative youngster, I may not fully appreciate the extent of the issues at play in our health service. It’s true: I’ve spent more time in hospitals as a visitor to friends and relatives than as a patient (thankfully), having not spent so much as an overnight in one since hitting my head as a toddler falling onto the side of an open door, how could I possibly have any grasp of the situation without the guidance of our group with their collective decades of experience?
They discussed many a familiar issue with me: unnecessary amounts of paperwork and staff structures, the intrusive nature of management who can only think in statistics, and the overall detrimental effect this has on staff morale. They then relayed to me the concern which has stuck with me for days since, the one which compels me to sit at my desk on a Saturday night to write this, with a stark warning: if staffing levels are not resolved, and the process of hiring nurses not overhauled, people will suffer.
Just last week, The Herald said that there were 6,674 nursing and midwifery vacancies in Scotland by the end of 2021, with a rise of 1,000 vacancies within the last quarter. To make up for these vacancies, hospitals are turning to both bank nurses, like the two I met with, who can use an app to view available shifts on wards across all the hospitals in their area and build their own schedule, or use the services of private nursing agencies who, in exchange for an extortionate payment from the public purse, will deploy nurses wherever needed, ultimately for better pay and conditions than those they’re working alongside for the day, doing the same work, saving the same lives.
Back in the café, one of our members lifts her phone from the table. ‘I just want to show you something.’ As a bank nurse herself, she paints a bleak picture for me as she logs into the app. She shows me the available shifts for two days’ time, a Sunday before a bank holiday, when hourly paid rates are highest, and would therefore be more popular with those looking for a little extra cash. I look with an increasing sense of dread at the vast availability of shifts at the different wards of different hospitals. At least twenty are scrolled by, ‘See? We’re still looking at dayshifts here. Look at all those shifts going at QEU.’
Thirty, forty, fifty. I lost count.
‘And this is just in Glasgow.’
Much like my flailing body through that doorframe twenty-something years ago, my heart drops to the floor. I think back to all the people I went to school with who were full of bright-eyed enthusiasm at the thought of going off to study nursing, some of whom were close friends. Is this really what they’re going through right now? I think back to my grandparents. Were all those loving and caring hospital staff charged with caring for them during their numerous admissions, and in their final days, all experiencing the same level of inconceivable pressure? Judging from our conversation that day, I’ll have to assume yes to both of these questions. So where do we go from here?
Our nurse offers me her solution, having observed herself when and where things went downhill. Training should be more easily accessible, with cuts to nursing courses reinvested in more localised training to divert need away from the private nursing agencies into which the NHS are haemorrhaging money to cover these staff shortages. Why should money which would be perfectly suited to bringing in more nurses under direct NHS employment be put straight into the pockets of those only there to profit from the cracks in the system? Would this money not be better served either invested in more traditional, localised nursing training, or at a minimum, used to expand further and higher education opportunities, making it easier for people of all backgrounds to apply to study nursing?
Our nurses reminisce to me of years gone by, a time in which around a dozen nurses in every ward was the standard in the earlier years of their careers. They tell me about the real-time impact of staffing cuts under New Labour and in the wake of devolution. Last month The Scotsman reported on the Institute for Fiscal Studies report that NHS Scotland spending post-devolution has slowed dramatically to just 3% higher than spending in England, compared to 22% at the start of devolution. This has had an impact not on management structures, or the salaries of the highest earners in the NHS, but on the frontline services, and the quality of care available to patients, the consequences of which do not bear thinking about if we let this continue on its current trajectory.
Here at Common Weal, we are working hard to set up our healthcare working group. Having already met with the majority of those interested, there are many common themes in terms of systemic issues in our NHS. We are always on the lookout for those with knowledge and experience of public sector healthcare in Scotland and its problems to help us further advocate for healthcare improvement and provide solutions.
For more information, or if you would be interested in participating, get in touch at nicola@common.scot.