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Wednesday, 19 December 2018

Lack of Brexit planning could worsen NHS staff shortages, MPs warn

Written by David Wilcock

Health officials lack a clear post Brexit recruitment plan which could exacerbate current medical staff shortages, MPs have said in a report that also warns that the NHS faces regional funding pressures.

The Public Accounts Committee (PAC) said it had not been reassured by a Department of Health and Social Care (DHSC) "assertion" that there had not been a large exodus of staff since the 2016 referendum.

In a report released on Wednesday it warned that the UK's post-Brexit immigration policy, due to be revealed soon in a white paper, could make things worse, depending on what is in it.

There are currently more than 155,000 staff from EU27 countries making "an important and valued contribution to the health and care system", it noted.

It said there were 108,000 vacant posts in the NHS in June but that officials and politicians' focus on a national picture "hides underlying disparities in specific specialisms and local areas and does not allow them to fully understand the impact of staff shortages".

The report also criticised the DHSC for focusing on a national level for funding.

It said that 101 out of 234 trusts within the NHS Providers trade body were in deficit at the end of the 2017-2018 financial year to a total of almost £1 billion, although this had been mostly offset by savings within the NHS England budget.

The report warned: "At present, the Department focuses on ensuring the whole NHS is in balance, but there is significant regional variation in the finances of individual organisations which we are concerned could pose a risk to patient care in areas with large deficits."

PAC chairwoman Meg Hillier said: "The Department of Health and Social Care must show far more urgency in getting to grips with regional funding imbalances and demonstrate it understands the effects these have at the front line.

"But there are other indicators of an under-pressure Department at risk of losing its way. The Department's lack of clear Brexit planning could threaten the supply of medical equipment. Staff shortages could deepen. The potential consequences for patients are serious.

"These and other uncertainties are amplified by the continued absence of the Government's promised 10-year plan for the NHS, its promised plans for social care, and its promised plans for immigration."

The immigration white paper was expected to be published before Christmas, but reports suggested it could be further delayed due to Cabinet splits.

The PAC report said the DHSC had "asserted that the risk to the NHS in relation to staff from overseas going forward is more about the future immigration policy than about Brexit specifically, as it expects to continue to have more staff from non-EU countries than from EU-countries".

It added: "It told us that it was in close discussions with the Home Office about its forthcoming immigration white paper and the impact this may have on various medical workforces."

The report also warned that health officials had failed to access the Brexit risk to medical equipment supplies, "risking patient care".

It added that while plans were afoot to stockpile six weeks' worth of medicines and smaller materiel like gloves, dressings and syringes which are imported from the EU, officials had told it that "potential disruption" to supplies of larger equipment such as x-ray machines was "not on its radar".

The authors added: "The Department similarly told us that it had not communicated with NHS Providers to establish the impact this potential disruption could have on patient care.

"The Department informed us that it had, however, at the start of October, issued advice to NHS Trusts to perform a review of contracts held with the aim of identifying the potential consequences of Brexit.

"The Department was unable to tell us what level of risk this poses to NHS Providers, services or patient care and has since written to us confirming that it is not putting specific contingency measures in place in relating to the stockpiling of equipment."

A Department of Health and Social Care spokeswoman said it was "training 25% more doctors, nurses and midwives, giving a significant pay rise to over a million staff, and listening to the issues that matter to them".

Copyright (c) Press Association Ltd. 2018, All Rights Reserved. Picture (c) Stefan Rousseau / PA Wire.