WORK FORCE I S SUE S
factor. Rather than being an optional extra or a logistical challenge, flexible working should be seen as a means by which the NHS and social care can keep more staff in health and care careers for longer. Prerana Issar, NHS chief people officer, told the Committee of MPs that staff in the NHS wanted flexibility “whether that is working from home, when possible, or having a shift system that is not three 12- hour shifts ‘back-to-back’” and that the NHS was looking into “e-rostering and flexibility apps” to support Trusts to that end.
Unequal impact on BAME community
A number of written submissions to the inquiry set out the specific challenges faced by staff from Black, Asian and minority ethnic backgrounds in relation to workplace culture, burnout and resilience. In oral evidence, Dr. Chaand Nagpaul CBE, chair of the BMA Council, said there was a “very definite and worrying impact on BAME doctors, who feel particularly unable to speak out and are more likely to be blamed. There is a lot of evidence that they experience worse inequalities in the NHS.” The Royal College of Midwives also highlighted similar experiences in relation to its members. The Royal College pointed to data from 2019 indicating that 42% of midwives had reported experiencing discrimination based on their ethnic background. Lord Adebowale commented that “leaders in the NHS, who are mainly white, generally are not held accountable for leading all the people all the time”. He described this situation as a “systemic issue” in which in the 20% of the workforce that come from Black, Asian and minority ethnic backgrounds are not being adequately
represented by their leaders. Lord Adebowale also highlighted the need for leaders to be held accountable; and that it needed to be “a core measure of system performance and individual performance”. While he supported the work of the CQC, he found it “astonishing” that a Trust could be rated “Outstanding” while 30% of its BAME staff stated that they were performing below standard because of bullying and harassment.
Need for systemic solutions Ultimately, the report cautioned against a focus on the resilience of individual staff members, advising instead to consider systems and systemic solutions. Cultural change, effective leadership, practical support and long-term capacity planning will be required to address the problem of workforce burnout both now and in the future.
The Rt Hon Jeremy Hunt MP, chair of the Health and Social Care Committee, concluded: “Workforce burnout across the NHS and care systems now presents an extraordinarily dangerous risk to the future functioning of both services. An absence of proper, detailed workforce planning has contributed to this, and was exposed by the pandemic with its many demands on staff. However, staff shortages existed long before COVID-19.
“Staff face unacceptable pressure with chronic excessive workload identified as a key driver of workforce burnout. It will simply not be possible to address the backlog caused by the pandemic unless these issues are addressed.” Responding to report, Suzie Bailey, director of leadership and organisational development at The King’s Fund, added: “This report provides a stark depiction of
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the chronic excessive workloads endured by staff across the NHS and social care. It is a bitter irony that so many health and care staff are made ill because of their work. It is particularly shocking that ethnic minority staff report worse experiences of working in the health and care system. In the latest NHS Staff Survey, 17% of black and minority ethnic staff reported experiencing discrimination at the hands of their own colleagues. Sustained and concerted efforts are needed to rid health and care services of this systemic discrimination. “The added pressure of the COVID-19 pandemic has left many staff physically and emotionally drained, but health and care services have been dogged by staff burnout and workforce shortages for many years. Despite this, successive governments have seen health and care workforce pressures as a problem for tomorrow. In line with the Health and Social Care Committee, we are calling for a new duty to require the regular publication of independently verified workforce projections. While this alone won’t solve the workforce crisis, it will mean Government can be held to account for ensuring the health and care system has the workforce it needs. “There is an urgent need for a fully funded workforce strategy to increase recruitment, tackle staff burnout, and support health and care leaders to create compassionate and inclusive workplace cultures that staff want to work in. Without such a plan, we will continue to witness the vicious cycle that sees workforce shortages lead to overstretched staff leaving their profession prematurely.” To download the full report, visit:
https://committees.parliament.uk/ publications/6158/documents/68766/ default/
CSJ AUGUST 2021
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