Hospital Dr News

More nurses needed in the NHS to support consultant productivity

NHS consultants are becoming less productive, a report warns.

The report, called A year of plenty? An analysis of NHS finances and consultant productivity, warns that systemic problems are preventing the NHS getting the most out of its consultant workforce.

With rising costs and demand in a labour intensive sector, finding ways to improve workforce productivity will be vital, it says.

The Health Foundation research says that despite the hard work of consultants, productivity has been falling and several factors need to be addressed to make the most of the NHS’s highly skilled workforce.

A link was found between a higher proportion of nursing and support staff working in a hospital and improved consultant productivity.

This suggests that a more coherent workforce strategy which invests in a balanced increase in staff would improve productivity.

In the last six years the number of NHS consultants increased by over 20% compared to a 1% increase in the number of nurses.

Ineffective use of staff means the productivity challenge set in the Five Year Forward View is becoming increasingly difficult.

Consultant productivity across 150 NHS acute hospitals fell by an average of 2.3% a year between 2009/10 and 2015/16.

The analysis says consultants must be supported by strong teams within well organised systems.

Hospitals with the lowest consultant productivity have fewer nurses and support staff working with consultants, a higher number of delayed transfers of care, and pay rates that are less competitive for their area.

Anita Charlesworth, Director of Research and Economics at the Health Foundation, said: “Getting more NHS funding flowing to NHS hospitals is necessary but not sufficient to turn round the health service’s finances. The NHS has got to use the skills and talents of its workforce much better.

“Consultant productivity has been falling but not because staff aren’t working incredibly hard. NHS consultants work in a system and if that system isn’t well designed they can’t be productive.

“Much better workforce planning is critical. Increasing the number of consultants by a fifth without investing in nurses is a prime example of short term cost savings undermining the essential task of improving long-term productivity. With no obvious end to austerity there must be a decisive shift from short-term policy making.”

Furthermore, the research finds that the NHS in England used almost half of the £2bn real terms increase in funding it received in 2015/16 to commission care from non-NHS organisations and support the under-funded social care system.

Hospitals are increasingly focused on meeting rising demands for emergency care, for which they receive a lower financial return, making it harder to break even.

NHS hospitals, mental health, community and ambulance trusts received relatively little of the £2bn real terms uplift to the NHS commissioning budget last year. NHS providers’ operating income rose by just £0.8bn in real terms, while their costs rose by £2.4bn.

Despite the government making mental health a priority, planned spending on adult mental health for 2016/17 is £20.8m short of the additional funding needed to meet the parity of esteem target for 2016/17.

The president of the RCP, Professor Jane Dacre, said: “We have another report which outlines that our consultant workforce is overstretched in an underfunded NHS. Where, each day, such circumstances hamper consultants’ ability to provide effective, timely and high quality care to patients who often have complex, long term diseases.”

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