Artikkelit

27.03.2024

Health and wellbeing sector needs more skilled people

The UK needs more health care personnel, both from the UK and abroad. But attracting and retaining skilled labour force is a great challenge because of cost of living crises, in the aftermath of the Covid pandemic

On International Day of Happiness, the World Happiness Report named Finland as the happiest country in the world - for the seventh consecutive year. The UK was ranked 20th. 

This year the report concentrated on the wellbeing at different stages of life. Researchers found that the average satisfaction of young adults and youth wellbeing fell in Western Europe, North America, Middle East and North Africa and South Asia. We can see this both in Finland and in the UK, as well. Young people under 30 in Finland are not the happiest in the world but 7th, and the UK was ranked 32th. For all age groups the high quality health care system is one of the important factors contributing to wellbeing. 

This week, four years ago, the first Covid lock-down hit the UK. Four years of Covid pandemic, inflation, rising rents and other high costs of living, war in Europe, among other things, have certainly affected young people’s lives. Same things have also challenged the national health care system and its workers, and ageing population brings even more pressure to the national health care system in the UK, like in so many other countries.  

Lack of skilled labour force in the health care sector

In the UK, young doctors and nurses have been on strike many times during the last couple of years. They’ve asked for better salaries and working conditions. Nurses in England received a pay rise of 5 % for 2023-2024, but that was the lowest at the public sector. A recent Royal College of Nursing RCN survey showed NHS nurses are worse off than a year ago. According to RCN survey six out of ten nurses have had to use credit or savings over the last year to help them cope with the soaring cost of living. Around half of those who participated the survey are thinking of leaving their jobs. There are almost 361 000 nurses working across NHS, over 60 000 more than before the Covid pandemic. The findings of the RCN survey have added the fears that financial worries would prompt even more nurses to quit the NHS, which is already short of almost 35 000 nurses, 8,4 % of all nursing posts are unfilled. The situation is a bit better than last year when the vacancy rate was 10.7 %. 

The UK needs more health care personnel, both from the UK and abroad. NHS has been heavily dependent on international labour force and has by far been able to attract foreign workers. The challenge is that foreign workers are mobile. The number of UK registered nurses moving to other countries doubled in just one year to a record 12 400 in 2022-2023. Seven out of ten of those leaving were qualified as a nurse somewhere other than the UK or the EU. Most of them had worked in the UK for three years or less. There is a fear that Britain will become a staging post on their way to other countries, mainly to other English speaking countries. 

Some recent and forthcoming changes in the UK visa system might also challenge the health and care sector. The salary threshold across the skilled worker route will be increased to £38 700 a year and the minimum income requirement for a British or settled people sponsoring family members to join them in the UK will also be increased to £38 700. It is not yet clear if health and care workers might have some exemptions, as before. For comparison, the OECD data shows that on average a nurse earned £36 500 a year in the UK. 

National long-term work force plan

In the UK, the overall picture is to cut down net-migration, which naturally puts more pressure on the education and training, re-skilling and upskilling of health care personnel in the UK. National Long-term Workforce Plan, backed by over £2,4 bn, aims at doubling training places for adult nurses by 2031 as well as improving retention. As part of the NHS Long-erm Workforce Plan and to get more people to the health care system, UK Government has increased financial support for healthcare students (nursing, midwifery, allied health professions, medical and dental courses), including special travel and accommodation support NHS Bursary scheme and childcare allowance. 

Medical and dental school places both to home students and international students have been capped in each part of the UK. The intake targets have limited the number of students in higher education. Covid pandemic meant changes also to this. In 2020/2021 the cap in medical and dental schools was suspended. The intake numbers were lifted by 9%. The cap was then reintroduced in 2022. 

The productivity of NHS was slightly growing from 2010 to 2020 but now direction is the opposite. National health data shows that the expenditure has grown from year to year. This is one of the reasons why the Spring budget launched in early March included several measures, including new technologies and better use of data and renewed infrastructure, all aiming at better productivity. As a result, the health spending in the UK, Wales and Scotland is budgeted to fall in real terms in 2024-2025, resulting also less personnel in the NHS. 

Wellbeing data dashboard

In addition to different international surveys and reports, like the world happiness report, based on polls, it is important to have national data on wellbeing. In Finland, we have several longitudinal research projects to follow. One of the good examples from the UK is the Understanding Society Survey, which is the largest longitudinal household survey in the UK. What Works Wellbeing and the Institute for Social and Economic Research at the University of Essex have created a wellbeing data dashboard based on Understanding Society data to support data access and literacy among non-academic users.

Team Finland Knowledge expert Birgitta Vuorinen, London

Photo: Cambridge University by Birgitta Vuorinen

World Happiness Report 2024:  https://worldhappiness.report/ed/2024/
RCN Survey: https://www.rcn.org.uk/news-and-events/Press-Releases/half-of-englands-nursing-staff-could-quit-as-new-analysis-reveals-decade-long-attack-on-pay
Student numbers in the UK: https://commonslibrary.parliament.uk/research-briefings/cbp-9734/
NHS vacancies: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-vacancies-survey/april-2015---december-2023-experimental-statistics
Wellbeing data dashboard: https://whatworkswellbeing.org/blog/improving-wellbeing-data-access-and-literacy-new-understanding-society-wellbeing-data-dashboard/