The NHS staffing crisis is a problem that has no easy solution. The NHS has seen one of its most challenging winters- the aftermath of Covid, increased seasonal flu admissions and industrial action have laid bare the need for staffing. Recent press coverage on the staffing shortage has increased, but what is the answer? We believe ethical international recruitment can help solve the crisis– here’s how.
NHS staffing crisis: a growing shortage
Recent press coverage has raised concerns over the increasing use of agency and bank staffing. This is an unsustainable workforce model that cost the NHS over £3 billion in 2022. The report also revealed that one doctor was paid £5,200 for a single shift. Costs for agency and bank staff are increasing, despite the NHS committing to decrease spend on agency staff. In 2016, the BMA found acute NHS trusts spend 25 times as much on locums as on permanent doctors. Locum staff are a significant drain on the NHS, which spent upward of £3 billion on locums in 2022. In addition, relying on bank staff, from a workforce that is already overworked and burned out, is not a sustainable model.
The NHS is stuck between filling vacancies with bank or agency staff or cancelling appointments and operations. Neither option is viable with a waiting list of 7 million appointments, and a budget that is already stretched. It is obvious that a staffing strategy based on the use of agency locums and relying on existing staff to cover bank shifts is neither financially sustainable, or good for workforce morale.
The current situation
Vacancies in the NHS have risen significantly in the past few years. The need for recruitment in the face of rising waiting lists, missed targets and reports of staff burnout is evident. The current number of UK doctors in training is far short of the numbers required for the NHS workforce. The problem is set to get worse with increasing numbers of NHS staff planning to leave the profession. There is a predicted shortfall of 571,000 by 2036 if current trends continue. The long awaited NHS Workforce Plan is expected to announce a doubling of medical school places. However, it will take at least 10 years for medical students beginning training to qualify. While we support the increase in training for UK medical students, we need a sustainable interim solution. Currently, doctors in the NHS are doing the work of 1.3 FTE doctors. It is this overwork that is driving NHS staff to leave the workforce- only when vacancies are filled via recruitment will retention be improved.
As of March 2023, one in six doctors working in the NHS were born and trained overseas. This is likely to increase as demographic changes, an aging population, and increased disease burden, mean that more NHS staff are needed. Recent news reports have raised concern over international recruitment. However, without it, the NHS would be in an increasingly vulnerable position and would not be able to provide the level and standard of care every citizen in the UK expects. It is evident the demand for healthcare is increasing. The early months of 2023 saw increasing waiting times for ambulances, missed targets and reports of staff burnout- the only way to meet this demand is to increase permanent NHS staffing.
How ethical NHS international recruitment can plug the gap
There are not enough UK medical school places to fill these vacancies. We need to look to other solutions, including permanent international recruitment. Though recruiting international doctors on permanent contracts is not a magic bullet, it should form a key part of a sustainable workforce plan. It is also clear that international recruitment is a far more cost-effective solution than the current model of relying on agency and bank staff- with one internationally recruited permanent doctor saving on average £100,000 over 9 years in agency fees- amassing a saving of over £350 million based on the 3,500 doctors Remedium has placed since 2013.
International recruitment has been proven to work at several trusts. Remedium partnered with Manchester University NHS Foundation Trust in 2022 to create a full workforce plan. The plan anticipated an increase in demand in doctors ahead of doctor changeover in August, and successfully recruited for 80 doctors in one trip.
Shifting to a more permanent staffing strategy also significantly improves patient care. Permanent doctors provide continuity of care that locums and bank staff cannot provide. Locum and bank staff may be unfamiliar with hospital processes and layouts, which negatively impacts patient care. International recruitment and the building of a permanent workforce will significantly benefit the NHS and its patients.
What is ethical NHS international recruitment?
While the need for NHS staffing is critical, it is also important to recruit ethically from overseas to ensure that recruitment to the NHS does not impact safe staffing levels in other countries. Remedium is committed to the ethical recruitment of international doctors- and as such, we adhere to the NHS code of practice. We are on a mission to solve the healthcare crisis in a sustainable and ethical way.
Towards a sustainable staffing strategy
While we await the NHS Workforce Plan the need for international recruitment has never been clearer. In order to address NHS workforce shortages in the short and medium term, NHS trusts must recruit international healthcare professionals to plug the gap nationwide. Remedium are already supporting trusts across the UK to develop more strategic workforce planning. We must urgently recruit more to fill the staffing gap and improve working conditions for existing staff.
We care deeply about the future of the NHS, and we know we are supporting our clients in addressing a complex and multifaceted problem- which is why we are dedicated to solving the healthcare staffing crisis. Click here to contact our client service team to find out more about how we are supporting the NHS in moving towards a more sustainable recruitment model.