The numbers game: retention and reward

Sean King

Sean King is a policy manager in the NHS Employers employment relations and reward directorate. In this blog he shares his views on pay, reward and the global workforce challenge.

A recent press release included the comment that “there is now general agreement that the hospital consultant recruitment and retention crisis is giving rise to significant patient care and safety concerns, including unacceptable waiting lists, and that this needs to be addressed urgently”.  This sounds all too familiar, but it refers to the consultant workforce crisis in Ireland. When it comes to concerns about the healthcare workforce, there are no borders.

In March this year, the Health Foundation, King’s Fund and Nuffield Trust published closing the gap, a joint report on the workforce challenge.  There are currently more than 100,000 vacancies across the NHS, with more than 40,000 nursing posts vacant. The report estimates that if current trends continue, there will be a shortfall of 108,000 full-time equivalent nurses by 2021.  As a result, the authors suggest action in five key areas, including:

  • the supply of new staff, including education and training
  • pay and reward, ensuring that pay policy supports recruitment and retention
  • making the NHS a good employer
  • workforce redesign 
  • the supply of new staff, including international recruitment.

The Public Accounts Committee has noted that the NHS appears to be banking on either drastically improving its retention rate or attracting more employees from overseas to fill the gap. However, they say that this seems to be a risky strategy as there is no guarantee that enough staff will be recruited from overseas. 

Mark Britnell has written about the global workforce crisis. He cites a World Health Organisation estimate that we will be short of 18 million health workers by 2020. Countries that have traditionally been a source of overseas recruitment for the NHS are struggling with their own workforce pressures, with India alone some 4 million workers short. The global market for healthcare staff is growing. The United States is forecast to be 105,000 doctors short and will need a million more nurses by the middle of the next decade, and Germany expects it will need a further 300,000 nurses by 2030. 

Such turbulence in the global supply and demand for health care professionals underlines the importance of retaining and developing the current NHS workforce, as well as making the NHS an attractive place to work for both domestic and overseas staff.

Closing the gap makes the important point that pay and reward are tangible signs of how far staff are valued and have a clear impact on retention. It is also well known that motivated, engaged and valued staff deliver high quality, safe and effective care. All of those working on pay and reward strategies are making important contributions to the current workforce challenge and ultimately, the delivery of patient care, in the face of significant global workforce pressures. 

In just a few days, NHS Employers will join reward leaders from across the country to explore these issues in more detail. Reward in the NHS takes place on 9 May in London to discuss how reward is being used strategically currently, and how we can address the challenges of the future. We hope to share more with you in the coming months to continue to support you to make the NHS the employer of choice.


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