How many warnings can you ignore?

Suspicions were raised about asbestos as far back as the 1900’s and in 1938 a report from the industry swept the issue under the carpet. Today, the substance is outlawed in the majority of the world.

The first medical reports about the dangers of smoking emerged in 1920.

The banking crisis of 2008, the forecast was ignored.

Why are warnings ignored?

My guess is, warnings are based on other people’s experiences and if the people whose job it is to act on the warnings are not experiencing any negative consequences, or the true situation is masked from them… nothing gets done. Also…

A ‘Danger, No Trespass’, sign requires you to plan a new route. If you don’t have a map, you might take a chance.

If the sign said; ‘Danger, Alternative Route Here’. You’d probably comply.

How many warning have there been about NHS workforce?

They are ignored because Ministers don’t work at the front line, they visit, people don’t tell the stripped-pine truth and there is no alternative route.

There’s another workforce warning this morning. This is from the Public Accounts Committee;

‘NHS staffing shortages are “rapidly reaching crisis point” and MPs warn it will not deliver its long-term plan

The NHS will not be able to deliver its long-term plan without addressing staff shortages…

The situation will “rapidly reach crisis point” if the health service continues to lose staff and fails to attract more overseas workers

The committee said it was… concerned that officials have “painted an overly positive picture”… and played down the challenges ahead.’

There are currently 100,000 vacancies across the NHS and every day about 90 nurses leave the NHS. We are thousands of GPs short, nowhere enough midwives. We are at the point where I’m told, more people are leaving than joining the NHS.

The workforce predicament is putting the delivery of the Long Term Plan in jeopardy.

The workforce group have parked their work until after the Spending Review, in the hope that the Chancellor may make more money available, which might help resolve some of the problems.

Frankly, this is not going to be resolved by money alone but it is not the gamble it might seem.

I take this as a strong hint that money will be forthcoming. If no money was in the offing there would be no point in delaying workforce planning.

An interim report is likely to set some sort of direction. If NHSI is really taking this seriously, I don’t see why it shouldn’t be out in the next couple of weeks.

Make no mistake this is really serious. Everyday the situation goes unresolved, the implications are compounded.

In the meantime it is a foolish Board that is not making its own plans.

What can we do with no money and do right now.

There are four things that I would do:

Appoint a non-Exec director to oversee mandatory, independent exit-interviews, analyse why people leave and fix it.

Really understand the root-cause of why 90 nurses a day leave the NHS and your Trust.

There will be a variety of reasons and many will be location specific. Dig into the ‘why’ and create the foundations to build a fix!

End the national return-to-work programme. It’s not working. Let Trusts manage it locally,

Get all returners onto the wards, doing something useful. Risk-manage and train from there.

It is inconceivable that a return nurse cannot be at least as useful as a HCA.

Provide the Trusts with local contacts for the 10k people who applied to be a Doc but couldn’t get on a training place and the 20k who couldn’t get on a nurse course… offer them alternative routes in, or other health related careers.

Oh, and organise a creche facility in every Trust!

What about nationally?

Fix the apprentice scheme. On the wards they are supernumerary. HCA’s are not. There must be a compromise.

Stop Trusts buying rota planning software that does no allow truly, flexible hours rostering. Most doesn’t.

Start work, now to stop the pension penalties fiasco that makes people leave early, or down-tools.

We don’t have the luxury of time. This is a worse-case-denial from the top that is cascading through the management hierarchy.

Because the lights are still on and people are busy doesn’t mean the system is working.

Contact Roy – please use this e-address – roy.lilley
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Reproduced at by kind permission of Roy Lilley.