The healthcare service has been hugely impacted by the pandemic on every level. Workers are exhausted and burnt out, their pay has only marginally risen despite all their hard work, and looming patient backlogs mean the stress will remain long after the virus passes. The pandemic has taken a huge toll physically, mentally, and financially on everyone within the healthcare sector. It is therefore understandable that we are facing a healthcare workforce crisis.

In order to support healthcare workforce recovery it is vital that we focus on the attraction and retention of staff. The first step is therefore to examine the recruitment and training process. Despite the tough 15 months that frontline NHS staff have had, there is increased interest in joining their ranks:

‘Applications to healthcare courses for the 2021/22 academic year have skyrocketed. Recently published UCAS figures have revealed that Nursing applications are up 21 per cent across the board, with increased demand from both 18 year-olds and mature students.’

Some feel that this increased interest comes from the very positive public messaging about the healthcare service during the pandemic. Over the past 15 months, healthcare workers have been applauded in the streets and have been publicly recognised for their hard work. Arguably they have only received a fraction of the recognition they deserve – after all, public applause does not pay the bills.

Wages and bursaries

The low increase in NHS wages has made regular headlines. The initial 1% increase was met with understandable backlash and NHS workers campaigned against this meagre pay rise. Following the year staff across the NHS have had, people across the health service felt they deserved more financial recognition.

Following the campaigning, the pay rise is now set to be 3%. The government was proud to announce this figure but many feel it is still not sufficient as it only represents a minor increase: ‘for the average nurse, this will mean an additional £1,000 a year, while many porters and cleaners will receive around £540.’  While this pay increase remains small, the government has continued to provide financial incentives to help attract new workers:

‘A few months before the pandemic, the Government partially reintroduced bursaries for Nursing, Midwifery and some allied health courses, which has likely contributed to the growth in applications in 2020/21 and 2021/22.’ 

This came just before the UCAS deadline and likely contributed to the increase of applicants. The bursary of at least £5,000 per year that students will not need to pay back is certainly a wonderful gesture that will support those entering the field, but it does neglect the financial needs of those already working within the sector.

The challenge of training new staff

The large number of applicants looking to study healthcare looks positive, but it won’t necessarily mean that many people end up working in the sector. As other sectors face major worker shortages, the healthcare sector is facing the opposite problem:

‘Health courses require lengthy clinical placements, particularly for nurses and midwives, who need 2,300 hours to be qualified. There are a finite number of placements – and nowhere near enough to satisfy the soaring demand we have witnessed this year. Some University Alliance members have reported 1,000 applications for 40 to 50 places on smaller courses such as paramedic science and radiography. Many healthcare courses are already full for September 2022.’ 

Departments can normally only cater for a couple of clinical placements at any given time. This presents a challenge if you have a mature student body as they are more likely to have family commitments that mean they cannot relocate for placements. This is not only an issue for mature students either – having to uproot your life and move or commute long distances to placements is not always possible for people and their personal circumstances.

During the pandemic, some departments have even reduced their requirements to make it easier to progress through their programmes:

‘​​The Nursing and Midwifery Council has helpfully relaxed some of its requirements during COVID and is undertaking a much-needed review of programme length and use of technology and simulation which could create more placement capacity in the future.’

Remote training through VR and AR technologies has alleviated some of the stress of organising these placements. These remote training technologies mean that trainees have access to quality training wherever they are without needing to travel or relocate to access quality instruction. It is hoped that new Integrated Care Systems will also bring improvements in health education and the processes used in training new staff. 

Speeding up the progression from student to qualified practitioner is risky – this is not the kind of learning that can or should be rushed – but the NHS will need all new hands on deck as soon as possible, so a balance will likely need to be struck.

A stressful time to start

This is also not an easy time to be training new staff on the job. Existing staff are stretched as it is and they have little time and mental capacity left to take on the additional responsibility of training up new workers. New people are sorely needed, but this is not an easy time to be entering the sector. Staff are exhausted, pay is low, and morale is lower still.

PPE has added to the stress of the role for many healthcare professionals. Protecting patients has always been the number one goal, but it has never been such a complex task. The process of cleaning rooms between patients, changing PPE, and ensuring everything is always fitting perfectly adds extra layers of stress to a job that is already mentally tough. Despite masks no longer being compulsory for the public, protective equipment will remain a fixture in health and care settings for a long time to come.

Final thoughts

Attracting, training and retaining staff are all huge challenges that the government will need to address in the coming months in order to protect the NHS from within. Due to long training timescales, any changes that are implemented now will take a while to yield new staff. Though it is positive to see so many people want to train up to join the health service it will be quite some time until they are able to fully support those on the frontlines.

Speeding up the process of training existing students through the use of immersive technologies could massively help the NHS, but it is vital that we do not sacrifice quality for the sake of speed.