President’s column - Vacancies crisis a mortal threat

HCSA President Dr Claudia Paoloni argues that the information gap on medical vacancies must end

When is a vacancy not a vacancy? Unfortunately, there’s no witty punchline here.

The truth is we do not know the real scale of rota gaps in our hospitals and community teams.

The 10 per cent published rate, and much worse in certain specialties, is undoubtedly the tip of the iceberg: a point confirmed by HCSA members.

Vacancies are being hidden from view both because of the way in which they are measured – through job adverts – and through the systematic exploitation by many Trusts and the NHS nationally of staff goodwill.

We know that for HCSA members and their colleagues, shortages of medical and support staff represent the biggest barrier to delivering patient care.

A number of factors are now threatening to bring this house of cards tumbling down. The pensions system crisis is driving hospital Consultants to drop PAs or additional shifts. Even putting the pensions situation to one side, years of pay restraint at a national level and HR policies which undermine the profession’s morale and wellbeing mean there is little left in the goodwill pot, and increasing numbers wish to go less than full time, cut back their PAs to a core 10, or simply leave.

We are seeing an NHS running on empty, and a government and in particular a Treasury seemingly in denial about the scale of the crisis which its decade-long assault on pay, pensions and NHS funding has created.

It’s all well and good putting money into the system to implement a “long-term plan”, but without the staff or goodwill to enact it on the ground, it will fail.

What is also going unnoticed is that the newly qualified doctors coming through the ranks have a very different working agenda and style. Acknowledging a longer working life, their focus is achieving a work-life balance that includes families, recreational time and work practices that preserve their own health. Full-time working with unrealistic demands and expectations will be for the birds. The new doctors coming through will not accept the current situation. They will push back or, if that fails, leave.

The next few months will be vital for the future of the medical workforce. With a Treasury spending review due in the autumn, medical trade unions and employers are raising the alarm and calling for action on future recruitment and retention. It is up to all of us to educate the government and wider public on this mortal threat to the NHS Long-Term plan, and the impact that vacancies are already having on patient care.