I think you would be hard-pressed to find someone who doesn’t agree that the NHS is still, at least conceptually, a venerable institution. “Among British citizens, the NHS ranks highest with 54% of the public saying this is what makes them most proud to be British, higher than our history (32%), our culture (26%) or our system of democracy (25%).”
Whether or not it is still a desirable place to work, however, is a different question.
The NHS is now struggling to attract international clinicians to the service – international clinicians that we are wholly dependent on to keep the service running. And who can blame them? Constant strikes, well-known bad working conditions, poor pay, and more litter the news. The NHS is being attacked from all angles, and the most vocal of the population are full of nothing but criticism of the service.
If we are to continue sustaining the system that is still successfully delivering high-quality care to thousands of people per day, we need to remind people – and specifically, potential employees – about what makes the NHS great, whilst not skirting around its issues that need attention. Although it may be difficult to believe at the moment, there are several undeniable reasons that the NHS is still esteemed as one of the world’s best healthcare systems.
Quality of healthcare in the NHS
This should maybe be caveated with ‘when you can get it’, with patients currently facing record waiting times for elective care. However, the UK has lower rates of unmet medical needs compared to other countries with similar healthcare systems, including the majority of European countries. This data suggests that the NHS is continuing to provide good access to care and, very importantly, protecting patients from high-out of pocket costs. Over the past decade, the UK has experienced the fastest reduction in deaths amenable to healthcare compared to its peer nations – a positive sign. This indicates that the healthcare that is provided is not only of good standard, but is continuing to improve over time. Treatment of certain illnesses is becoming more efficient. Furthermore, the NHS’ ‘reoffender’ rate is low: health-care associated complications, such as deep vein thrombosis after joint surgery, or infections related to treatment, are seen less in the NHS than in other comparable healthcare systems.
Research and Innovation
The NHS is a world leader in healthcare innovation, and has been for its 76 years of operation. These range from small, local initiatives – like the use of courier bikes in Oxford which decreased the time required to deliver chemotherapy treatments in the area – to larger, world-changing research – like the stunningly progressive 100,000 Genomes Project spearheaded by NHS England. This is part of a wider initiative, whereby the NHS is the first national healthcare system to offer whole genome sequencing as part of routine care, leading to enhanced genomic medicine. Not only does this result in personalised patient care and precision for patients in the UK, but contributes to healthcare research and development across the globe.
These are just two examples in a long list of pioneering healthcare developments brought about by the NHS and its capabilities. This is why many international clinicians, despite knowing they can receive higher salaries elsewhere, come to work for the NHS – because of the opportunities it presents to be a part of scientific progression.
Training and Development for clinicians working in the NHS
Multidisciplinary teams, countless university and research partnerships, and access to a wide range of patients with different conditions, as well as integrated care systems, make the NHS one of the best places to train as a doctor, with unrivalled opportunities for career progression.
The NHS is committed to fostering the professional growth of its staff, providing a robust framework for Continuous Professional Development (CPD) that is essential for revalidation by professional bodies such as FPH, UKPHR, and GMC. Employees benefit from a structured Personal Development Review system, ensuring access to a broad spectrum of training courses tailored to enhance skills across various disciplines.
The NHS actively supports its workforce in adapting to new technologies and methodologies. This is evident from the significant investments in learning opportunities such as apprenticeships and professional qualifications, which are crucial as advancements in science and technology continue to evolve the healthcare landscape. Furthermore, the NHS Leadership Academy plays a pivotal role in nurturing leadership qualities among staff, aiming to reflect the diversity of the patient population it serves and addressing underrepresentation at senior levels.
In addition to fostering career growth through education and training, the NHS provides practical support to its employees. This includes paid sick leave, regular supervision, and career progression support, alongside financial assistance for those pursuing professional qualifications. This comprehensive support not only aids in personal and professional development, but also enhances job satisfaction and retention within the NHS.
Equity of access
Despite having fewer resources than a number of other countries, the NHS still leads the world in terms of equity of access. Its commitment to universal healthcare is the basis it was founded on, and is apparent through a number of its initiatives – for example, the ICS framework. The introduction of ICSs promotes collaboration across regions, attempting to reach underserved areas and provide integrated care. The ICS system broadens the NHS’ reach and reinforces the institution’s core principle of providing healthcare based on need rather than ability to pay.
In response to the critical workforce shortages projected in the NHS Long Term Workforce Plan, a comprehensive strategy has been outlined to bridge the gap. By 2036/37, the plan aims to address a potential shortfall of 260,000-360,000 staff through increased investment in domestic education and training, enhancements in recruitment practices, and improvements in workplace culture and retention. These measures are designed to sustain the workforce necessary to uphold the NHS’s universal healthcare mandate.
Moreover, the plan includes significant financial commitments, with over £2.4 billion allocated to expand training places by 27% by 2028/29, ensuring that the future NHS workforce is well-equipped to meet the evolving health needs of the population. This investment reflects a proactive approach to maintaining the NHS’s status as a leading provider of comprehensive and accessible healthcare services, true to its founding principles.
Care
It may sound trite, but having worked NHS-adjacent for just over a year now, I can honestly say that everyone I’ve spoken to who works in the service exudes a genuine passion for patient care and a true desire to deliver high-quality service. Whether a brand new junior doctor, a consultant, a medical director, or part of HR, the pleasure at the work these individuals do is palpable when you speak to them.
A few months ago, I spoke to a consultant psychiatrist who had worked at the same Trust for 19 years, and they were still as happy and challenged as they were on their first day. I’ve spoken to school nurses whose work in educating children is making the future healthier and ensuring children grow up with crucial knowledge about their own bodies and hygiene. During our recent international project with Southern Health and Social Care Trust, we were asked to support the Trust in pairing clinicians up with other new recruits who were joining from similar regions in India, after they picked up on the different languages spoken across India – a dedication to candidate care and support that had previously been unheard of.
This level of care and effort into making the international recruit’s transition to a new country easier is heartwarming to see. These professionals are willing to go above and beyond and work tirelessly to optimise their processes, improve their service, and make their workplaces inclusive and welcoming.
This is in no way meant to diminish or belittle the struggles currently faced by doctors and nurses within the NHS; the ongoing industrial action we have seen since 2022 is in many ways justified.
The fundamentals upon which the NHS was founded are still near and dear to many and should be upheld as ideals and values we should strive for in our healthcare system. The long and short of it is: don’t give up on the service. There are a number of practical reasons not to work for the NHS, but there are an equal number of equally practically reasons to work for it as well. Equitable healthcare that is free at point of access for an entire nation is a tall order, but it is one worth fighting for.
Remedium has supported over 100 NHS Trusts to recruit skilled and experienced clinicians, on a permanent contract basis. Find out more about our services here. For more insights, read our White Paper, ‘Towards a Sustainable and Robust NHS Workforce’, here.
