Healthcare groups raise Welsh NHS workforce shortage concerns with First Minister

33 health and social care organisations have written to First Minister Mark Drakeford calling on him to take action over workforce shortages.

The joint letter – calling for the long-awaited publication of the national workforce implementation plan for health and care – comes following the release of the most recent waiting times figures for Wales.

Serious challenges face the NHS as we head into a difficult winter, and the impact of workforce shortages on patient care cannot be underestimated as waiting times reach record levels in Wales, the joint letter says.

It adds that cancer lists, and ambulance performance times, are currently the worst on record, and overall, waiting list numbers passed 750,000 for the first time in October 2022.

Commenting on the joint letter, Dr Olwen Williams, vice president for Wales at the Royal College of Physicians said: “Staff shortages mean longer waiting lists. Yet despite repeated promises from the Welsh government, we still don’t have a funded national workforce plan for health and social care – or indeed, any idea of when it will be published. 

“These delays are making a difficult situation worse: without up-to-date vacancy data, we simply don’t know the scale of the problems facing us. 

“Anecdotally, we know that health and care staff are overwhelmed and at risk of burnout, and what’s worse, we’re flying blind without the information we need to plan ahead. Royal colleges, professional bodies and the third sector should be included in these discussions – between us, we represent hundreds of thousands of staff and patients across Wales.”

Plaid Cymru’s spokesperson for health and care, Rhun ap Iorwerth MS, joined those calls. 

“The workforce across our health and care service need to feel like they are supported.

“We can’t expect the kind of ongoing commitment that health and care workers give to their work and to patients, without ensuring there are enough people to do the job, that they are supported in their work – and of course, that those workers are properly and fairly rewarded.

“Having the right person in the right place is fundamental, and being able to plan for that is at the heart of a sustainable health and care service.”

Professor Jon Barry, director in Wales at the Royal College of Surgeons of England said: “The NHS in Wales is bracing for a winter like none it has seen before. With signs of an early flu season, the continuing effects of Covid-19, and looming industrial action, the period will be exceptionally difficult. 

“At the same time, hospitals are grappling with low staff morale and burnout, leading to gaps in work rotas. In surgery, the reality is, without more nurses and anaesthetic staff to support surgeons in theatre, we will struggle to bring record waiting lists down. There is no overnight fix. While we acknowledge that there are many other factors at play, it is difficult to see how, without a clear workforce strategy, we can begin to emerge from the crisis our health service is facing.

“We cannot wait any longer – the Welsh government must set out a timeline for publishing its much-anticipated workforce strategy. As clinicians, we do not want to let our patients down, but I fear that the longer they remain on waiting lists, the greater the chances become that we do.”

Findings reported

• Only 36% of advertised consultant physician posts in Wales were filled in 2021 (RCP)
• 49% of consultant physicians in Wales have an excessive workload ‘almost always’ or ‘most of the time’ (RCP)
• 89% of pharmacists feel at high risk of burnout, with a third considering leaving their roles and the profession (RPS)
• 70% of pharmacists report ‘inadequate staffing’ and 64% highlight ‘long hours and a lack of work/life balance’ (RPS)
• A fifth of the emergency medicine consultant workforce in Wales plan to retire by 2027 (RCEM)
• Wales has the lowest ratio of specialist clinical oncologists to patients in the UK (RCR)
• A third of GPs expect to leave their role within 5 years (RCGP)
• Frontline social worker teams are carrying vacancies that equate to 10% of the social work team workforce (BASW)
• There is a shortfall of around 150 anaesthetists (including consultant and SAS doctors) in Wales (RCoA)
• The number of dentists working for the NHS has dropped nearly 8% since 2020 (BDA)

Performance data response

Responding to the latest NHS Wales performance data, a Welsh Government spokesperson said: “Our NHS continues to face unprecedented demand and is seeing thousands of people every day. In hospitals alone, more than 361,000 consultations were carried out in September.

“Over 99,000 patient pathways were closed in September, back to pre-pandemic levels and 6% more than August, and an all-time record 13,856 people were seen and told they don’t have cancer.

“Progress continues to be made on the longest waits. The number of patient pathways waiting more than two years for treatment has fallen for the sixth month in a row and is down by 19 per cent since the peak in March. Waits over 36 weeks also went down in September, by 3% compared to August.

“Primary care, ambulance and emergency department staff remain under intense pressure. As an example, October saw the highest number and proportion of ‘red’/ immediately life-threatening calls on record. A further indication of the complexity of patient need is the number of patients admitted to the same or a different hospital following attendance at a major emergency department, which was 27.1% higher than September 2022. 

“Whilst we acknowledge ambulance performance is not where we expect it to be, we are driving improvements, including extending same-day emergency care services to open seven-days a week, managing calls better to reduce hospital admissions and recruiting more staff. Without all this the pressure on the system would be even greater.”

Letter signatories

• Asthma + Lung UK Cymru
• British Association of Social Workers
• British Dental Association Cymru Wales
• British Liver Trust
• British Society for Heart Failure
• Cancer Research UK
• College of Paramedics
• Faculty of Intensive Care Medicine
• Fair Treatment for the Women of Wales
• Hospice UK
• Kidney Wales
• Marie Curie Cymru
• MS Society Cymru
• Parkinson’s UK Cymru
• Prostate Cancer UK
• Royal College of Anaesthetists
• Royal College of Emergency Medicine
• Royal College of General Practitioners
• Royal College of Nursing
• Royal College of Physicians
• Royal College of Physicians of Edinburgh
• Royal College of Occupational Therapists
• Royal College of Podiatry
• Royal College of Radiologists
• Royal College of Speech and Language Therapists
• Royal College of Surgeons of Edinburgh
• Royal College of Surgeons of England
• Royal Pharmaceutical Society
• RNIB Cymru
• Society and College of Radiographers
• Stroke Association 
• Tenovus Cancer Care
• Wales Neurological Alliance