It hasn’t been a good week for the NHS. Public satisfaction with the service has dropped to a record low, maternity services are still putting women and babies at risk, and whistleblowers are being failed by the regulator. The long-awaited workforce plan shows that unless efforts are made to train more homegrown doctors and nurses, the NHS could face a shortage of more than half a million staff by 2036. Hope comes in the form of a new plan to introduce cloud-based telephony into GP practices to make sure more patients are able to make an appointment, but it feels like a small measure in the face of very substantial problems.
Public satisfaction with the NHS has fallen to the lowest level ever recorded by the British Social Attitudes survey, which has been running since 1983.
Fewer than one in three (29%) said they were satisfied with the NHS in 2022, representing a drop of seven percentage points since last year. Respondents cited waiting times and staff shortages as their biggest concerns.
A&E saw the biggest drop in satisfaction, but ratings fell for all services, including general practice, dentistry and general hospital care.
The fall in overall satisfaction was seen across all ages, income groups, sexes and supporters of different political parties.
The NHS has promised to create a system of NHS phonelines to end the problem of people phoning GP practices en masse at 8am to get a same-day appointment.
The plan is designed to improve access to family doctors and help patients secure an appointment. It aims to make sure that more GP practices introduced cloud-based telephony systems so that patients can get through. Practices have been told they must no longer tell patients to call back later, but instead make sure the right help is available, or signposted.
In January a report by the Office for National Statistics found that one in four patients who needed to see a GP had been unable to secure an appointment in the previous month. Nearly one in three said they had had difficulty contacting their practice while more than half who secured an appointment found it “difficult” or “very difficult” to get the slot.
Private health care provider Bupa plans to close, merge or sell a fifth of its dental practices, which could mean nearly half a million patients losing their dentist.
The decision will affect 85 of Bupa’s 450 practices. NHS patients are already facing the biggest rise in dental costs for 17 years.
Bupa is one of the biggest providers of dentistry in the UK, providing NHS dentists as well as those carrying out private work. It said it took the “difficult decision” because of a shortage of dentists willing to deliver NHS care, while practices were struggling to cope with extra running costs caused by inflation and rising energy bills.
The company said 74 of the affected practices are in England, with closures also due in Wales, Scotland and Northern Ireland.
Unsafe maternity services are putting mothers and babies at risk, the NHS ombudsman has warned.
Despite a series of public investigations into unsafe maternity care, such as those into Morecambe Bay, Shrewsbury and Telford and East Kent, maternity services are still providing unsafe care, the ombudsman’s report says.
More tragedies will occur unless the NHS takes decisive action to put an end to repeated and deeply engrained problems which lead to “the same mistakes over and over again”, he said.
The report by Rob Behrens, the NHS ombudsman for England, details the failings experienced by several women while giving birth. “If we do not start tackling these issues differently, there will be more tragedies,” it says.
If the NHS is to avoid a recruitment crisis leaving it short of 571,000 staff, it needs to train and recruit a large number of homegrown health care professionals.
NHS England’s long-awaited workforce plan, seen by the Guardian, says the NHS is already operating with 154,000 fewer full-time staff than it needs, and that number could increase to 571,000 staff by 2036 based on current trends.
Instead of relying on recruiting overseas staff and spending billions of pounds on agency staff, the NHS needs to have a bigger supply of health professionals trained in the UK, the plan says. The UK currently has 7,500 medical school places, for example, but that number should be doubled. Similarly, it argues, the number of trainee GPs in England needs to increase from 4,000 to 6,000 and the annual supply of nurses from 29,865 to 52,722
The follow-up of whistleblowing concerns from health and care staff by the Care Quality Commission (CQC) has been poor and inconsistent, and there is a “widespread lack of competence and confidence” on dealing with race and racism at the organisation, two reviews have found.
A “Listening, learning, responding to concerns” review was published by the CQC earlier this week, alongside a linked independent review into how it had failed Shyam Kumar, a consultant orthopaedic surgeon in the North West, who was also a CQC specialist professional adviser.
Examining how the CQC responded when whistleblowers raised concerns with it, the review found “an unacceptable level of variation in the way we responded… and some concerns had been handled poorly”.
Staff “did not always feel they were able to act on the concerns raised by workers in the way they wanted to”, often because of a lack of resources or being asked to focus on other priorities, the review said.