The NHS: More money but work harder
Picture by John Cameron
The NHS is to receive a budget boost of £22.6 billion.
However, Sir Keir Starmer has warned NHS Staff that they will have to work harder.
Obviously, we will need to do more if we are to treat the 7.6 million people already on waiting lists, consult with more patients and undertake more investigations. However, the NHS is in a critical condition and the call to increase productivity comes when the workforce is experiencing significant challenges.
The NHS cannot be fixed just with money, the staff need to be fixed as well.
According to the Institute for Government, despite increased funding and additional staff, activity has not yet returned to pre-Covid levels. Waiting lists were becoming lengthy well before the pandemic and many of the factors which are negatively affecting staff were already present before the pandemic.
We need to understand the factors which are preventing staff from providing a level of care which they would regard as adequate.
Stress and Burnout
Stress was rife in the NHS before the pandemic. In his evidence to the Covid enquiry last week, BMA Council Chair Prof Phil Banfield said that at the beginning of the pandemic ‘many Doctors felt overwhelmed and undervalued. They suffered the moral injury and trauma of being unable to provide patients with the care they wanted to … the medical profession entered the pandemic burnt out, with many already suffering from exhaustion…’.
The 2023 NHS Annual Staff Survey found that 41.7% of staff had reported feeling unwell due to work-related stress. We have to improve the wellbeing of NHS professionals, for their own sake and for the sake of the service.
Vacancies and Staff absences
Between September 2022 and September 2023, between 15,000 and 23,000 doctors left the NHS in England. Posts remain unfilled; there were over 112,000 staff vacancies in the NHS workforce in March 2023. Current vacancy levels are likely to be even higher. 25% of staff absences in the NHS are due to stress and burnout, and sickness rates are double the national average.
Vacancies and absences increase the pressure felt by other staff, and increasing the workload of already stressed professionals impacts on the quality of care they can provide.
Loss of Career Direction
Work pressures, organisational changes, constantly changing priorities and targets and a feeling of unfulfillment have left many NHS staff feeling uncertain about their careers. This lack of clarity reduces motivation and engagement, and removes the motivation to go ‘above and beyond’ when they are already giving more than they can adequately sustain.
The Case for Coaching
While the government's focus on equipment upgrades and recruitment is important, there is an even stronger argument for investing in healthcare staff.
The NHS needs a National Coaching plan. The Secretary of State should implement Coaching for all staff, but especially frontline staff and senior leaders. Here's why:
Coaching Empowers Staff
Confidential Coaching, by a qualified Coach, provides a skilled listening space which gives staff the tools and strategies to navigate stress, manage their workload, and rediscover their sense of purpose.
Coaching Enhances Leadership
Coaching produces a significant return on investment by building more supportive and efficient leaders. The NHS is chronically undermanaged and desperately needs to improve the performance of its leaders and managers.
Coaching Improves Retention
Staff who have a clear sense of purpose and who understand their career progression are less likely to leave. Coaching addresses high turnover rates by providing staff with a clearer sense of their professional and personal development opportunities.
Coaching Boosts Productivity
Nobody can give their best when they are stressed or approaching burnout. Career stagnation and the feeling that ‘their best is no longer good enough’ reduces personal and professional effectiveness. Coaching addresses these issues, improving performance and leading to better patient outcomes.
What is needed?
The value of coaching is clear, you can see the evidence here.
It is essential that Coaches have appropriate qualifications, and experience in working in Health Care is desirable.
Although in-house Coaching can be effective, staff need the freedom to speak of concerns within the organisation, and confidentiality is therefore essential. Coaching should therefore be provided by coaches external to the employing Trust or Board.
In addition to but not as an alternative to Coaching, the NHS must:
Address Workload Issues to tackle staffing levels, vacancies and cross-cover requirements.
Enhance Career Development by creating pathways for career progression and skill development.
Improve Work-Life Balance by enabling flexible and innovative working working practices. We cannot continue to expect more and more from already stressed staff.
Improve Management by empowering managers with the autonomy and resources needed to make effective decisions.
Investments in equipment and recruitment are essential, but fundamental to the success of the NHS is the investment in its Staff. The potential return on investment from Coaching is vast; it will produce a more resilient, engaged, and effective workforce.
Increased engagement and clarity of purpose will fundamentally benefit healthcare professionals. It will result in better patient care and outcomes, and a more sustainable NHS.
Peter Brunskill
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