Staffing matters; funding counts examines the profile and features of the NHS workforce in England, including; health labour market trends; relevant international data and comparisons from other countries; and a series of specific ‘pressure points’ (see below).

Download Staffing matters; funding counts.

General practice and nursing workforces in particular are examined in detail – two key components that have been the subject of much recent policy analysis and media scrutiny – as areas that continue to need a strong policy focus. There is also a supplement giving more detailed information about the profile and recent trends of the workforce of the NHS in England.

Key findings

  • Mismatches between funding and staffing levels, along with repeated reorganisation, have led to a ‘boom and bust’ approach to the NHS front line.
  • The less costly, reactive and short-term solutions – being used by national and local leaders to tackle current problems – are quick fixes, and will only put a sticking plaster on deep-seated and systemic problems for the NHS.
  • Effective use of temporary staff and international recruitment will help to buy time while a more long-term, sustainable approach is introduced.
  • Investment in current staff should not be downplayed by an over-emphasis on new roles; some new roles are necessary but will not have a major impact unless there is significantly more central support for scale up.

Ultimately, the report concludes that the greatest threats to the delivery of the NHS’s Five year forward view are funding constraints and workforce shortages. Policymakers need to look at how targeted and aligned policies covering the effective use of temporary staff, retention of existing employees and international recruitment can be used to address current shortages in staffing and skills in order to buy time, while a more long-term sustainable approach is introduced.

Pressure points

During the research to inform the report, six particular pressure points were identified for the workforce of the NHS in England. They were chosen based on feedback from a stakeholder roundtable, held in October 2015, and analysis of recent policy reports.

The pressure points are: