Source · Select Committees · Public Accounts Committee
Recommendation 2
2
Accepted
Provide Committee with update on reducing NHS staff shortfalls and improving retention rates.
Conclusion
NHS England’s improvement plans rely on better staff recruitment and retention to address significant shortfalls in the NHS workforce, but we are not convinced that NHS England’s current approach will achieve its very optimistic assumptions. NHS England has identified a potential shortfall of 260,000 to 360,000 staff by 2036–37, compared with a current shortfall of approximately 150,000 full-time equivalents. It intends to address this through ramping up recruitment, improving retention, and reforming work and training practices. NHS staff are currently experiencing very high levels of physical and mental ill health, particularly in the wake of the COVID-19 pandemic, with the most recent 5% sickness absence rate reported for 2022–23 above the long-term average of 4.2%. NHS England estimates that the rate of staff turnover in the health service was 9% in 2022–23. NHS England hopes to retain 130,000 staff who would otherwise leave the NHS over the next 15 years and stated this will be cost neutral. However, the realism of the assumptions underpinning this aspiration seems highly doubtful, given NHS England has identified multiple dependencies on other factors and unknowns. Recommendation 2: NHS England should write to the Committee within six months to provide an update on progress with reducing staff shortfalls and improving retention rates. This update should include details of action it has taken and an assessment of whether its original assumptions have proved accurate. 6 Access to urgent and emergency care
Government Response Summary
The government agrees with the recommendation, highlighting the positive impact of the Exemplar programme on staff retention and outlining the NHS Long Term Workforce Plan's projections to reduce leaver rates. NHS England will also submit its full cost estimates for the plan as part of the next Spending Review process.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. cost of living impacts and the need to maximise workforce capacity during the extremely challenging winter. The Exemplar programme was launched in April 2022 and is based on the idea that by delivering the interventions aligned to the People Promise together in one place, at the same time, improved outcomes for staff, organisations and patients will be achieved, as well as optimum staff satisfaction and retention. Exemplar organisations’ leaver rates are improving faster than non-Exemplars. All staff leaver rate in Exemplars declined 0.6 percentage points (pp), from 8.9 to 8.3%, compared to 0.3pp in non-Exemplars (9.0 to 8.7%). Nursing leaver rate has declined 0.9pp, from 7.8 to 6.9%, whereas the non-Exemplar group has only decreased by 0.4pp (7.3 to 6.9%). The NHS Long Term Workforce Plan considers the challenges facing the workforce over the next 15 years and sets out actions to address them. The collective impact of the Plan’s proposals is projected to help reduce the overall leaver rate for NHS employed staff from 9.1% in 2022 to between 7.4% and 8.2% by 2037. This is equivalent to retaining 55,000– 128,000 full-time members of staff. billion to fund education and training costs up to 2028-29. NHS England will submit its estimate to the government of the full cost of the NHS from 2025-26 onwards, which will include the financial implications of the NHS Long Term Workforce Plan, as part of the next Spending Review process. The outcome of the Spending Review process and what that expenditure covers will be published by HM Treasury in the usual manner.