Recommendation 8

We have repeatedly highlighted the longstanding funding and workforce challenges facing the health and social care sectors. In 2018 we examined the adult social care workforce in England and reported that levels of unmet social care need were high and rising, while staff turnover was as high as 27.8% and spending on care by local authorities had fallen by 5.3% in real terms between 2010–11 and 2016–17.15 In February 2020, the NAO reported that the NHS was carrying about 40,000 nursing vacancies and 9,000 vacancies for medical staff, while patient waiting times were continuing to slip and the number of patients on waiting lists for non-urgent treatment was rising. The percentage of patients admitted, transferred or discharged within four hours of arrival in Accident & Emergency had decreased from 91.9% in 2015–16 to 88.1% in 2018–19 and the number of patients on waiting lists for non-urgent treatment had increased from 3.85 million in March 2018 to 4.23 million in March 2019.16 The level of open vacancies persisted during the pandemic. The British Medical Association noted that, based on NHS data, in December 2020 there were 88,801 full-time equivalent vacancies across secondary care settings in the NHS in England.17