Staff shortages holding back NHS progress
pharmafile | October 31, 2003 | News story | |Â Â Â
A chronic shortage of staff in some parts of the NHS is holding back improvements to the service, according to a major new report.
Made up of staff, patients and the public, the NHS Modernisation Board says strong progress has been made across the service, but that shortages of doctors and nurses remain one of several major problems holding back faster progress.
Reviewing achievements made since the NHS Plan was launched three years ago, the boards report highlights many areas of rapid improvement, including waiting times and treatment in cancer and heart disease patients.
"The NHS Plan is on schedule. The resources going in the NHS are paying dividends for patients but there is still a long way to go," it said.
But it also said: "Capacity problems remain. The building blocks are there, and the culture of the NHS is changing. With extra resources about to come on stream we feel confident that fast and effective progress can be made. The patient-centred NHS, once a distant ambition, is now drawing visibly closer."
In particular, the board said cancer services were "under great pressure" because shortages of doctors, nurses, radiographers, biomedical scientists and administrative support staff remained despite efforts to recruit new workers.
Contrary to reports of funds being diverted away from priority areas, the board said there was "growing evidence of the money getting through and making a difference," but said that the equally vital expansion of capacity was a longer-term process.
"We recognise that building new hospitals takes time and recruiting and training new staff cannot happen overnight," it said. "The NHS Modernisation Board, the Department of Health and NHS organisations are working hard to identify ways to plug major gaps in capacity which still exist and develop the NHS in a way that allows it to make more of the investment as it comes on stream."
Progress in primary care was illustrated by the successful growth of the GP-led immunisation programmes for flu and meningitis C, as well as the training of 650 GPs to carry out simple surgery and procedures in their practices. Figures for 2001-2 show 600,000 procedures, which would have otherwise been conducted in hospital, were carried out by primary care staff.
Meanwhile, despite the setting-up of dedicated outreach teams across the country, the board found serious shortcomings in mental health services.
"From a low baseline, progress has been slower in mental health than in other parts of the NHS, it said. In the years ahead we will look for evidence of catch-up."
Returning to the theme of capacity building, the report warned that, as the new commissioners of services, PCTs must put aside suspicions of new ways of providing services.
"The whole health service needs to accept and endorse the plurality of providers that can supplement and complement the capacity of the NHS, including the use of the voluntary sector, private sector and overseas clinicians."
These measures, including the growing row over foundation trusts, have faced scathing criticism from many frontline clinicians, many of whom doubt the measures are cost-effective or good for the long-term future of the NHS.
The report highlighted a number of encouraging trends, including findings that 84% of GP practices were now offering patients an appointment within 48 hours, and that a target of recruiting 20,000 more nurses had been met two years early.
While most of the professional bodies welcomed the report, the NHS Alliance, which represents primary care professionals, said the Modernisation Board had missed an opportunity to demand faster progress.
NHS Alliance Chairman Dr Michael Dixon said: "There are too many meetings, too many directives and too much lip service to modernisation. That's why many doctors and clinicians are feeling discouraged and disenchanted."
He added that talk of "earned autonomy" was a disservice to primary care professionals, who must be engaged more fully in the commissioning of patient services.
"Almost a year after the publication of the Government's policy on Shifting the Balance, we are still waiting for solid evidence that it is really happening."
