Constant restructuring of NHS is demoralising staff, survey finds

The number of NHS reorganisations in recent years is a key reason for the health service’s struggle to retain staff, a poll has found.

The NHS has been struggling to meet rising demand with a chronic shortage of staff and the results of a survey, published on Friday, suggest that a feeling of constant upheaval is at least partially to blame.

The poll by Wilmington Healthcare UK of more than 2,000 nurses, GPs and hospital doctors across the UK found that 64% blamed staff retention problems on the continuous and “demoralising” national changes in NHS workforce planning that had occurred since 2000.

The concerns about the state of flux are revealed as as the health service faces further big upheaval, in the shape of the controversial sustainability and transformation plans (STPs), which are intended to improve productivity and efficiency and so plug the NHS funding gap. The STPs will mean some hospitals and beds lost and more services being delivered in the community.

Wilmington Healthcare’s managing director, Gareth Thomas, said: “Our survey shows that continued changes in workforce planning since 2000 have been a major factor in NHS staff retention problems.

“This is of particular concern as the planned introduction of STPs in April 2017 is set to bring the biggest shake-up to NHS services since the publication of the Five Year Forward View.

“As the NHS moves towards a truly devolved health and social care system, it is clear that urgent action must be taken to support staff and help them manage the huge changes that are envisaged.”

Changes in NHS workforce planning, due to organisational changes, and said to have affected staff retention, included the establishment of primary care trusts, workforce development confederations and strategic health authorities, all since abolished (within three years of their creation in the case of WDCs). Primary care trusts were replaced by clinical commissioning groups.

Other key factors cited by respondents as adversely affecting the NHS’s ability to retain staff were low morale (92% of respondents) and poor pay and rewards (72%).

With concerns raised that the UK’s exit from the EU would exacerbate the shortage of NHS staff – 59,000 NHS staff are nationals of other EU countries – the survey also asked respondents about the impact of Brexit. Just under half (48%) said it would bemore difficult to recruit and retain staff, 45% said it would make no difference and 7% said it would be easier to recruit and retain staff. According to the Nuffield Trust, 10% of doctors and 4% of nurses are from the EU.

More than eight in 10 respondents (85%) said access to training and development was the key requirement of the future NHS workforce, closely followed by flexible working and career progression (both 78%).

An NHS England spokeswoman said: “This poll is wide of the mark and at odds with our own thorough and robust staff survey which garnered 423,000 responses. It found 80% of frontline NHS staff say they are able to do their job to a standard they are personally pleased with, 90% of staff say their job makes a difference for patients, and 92% of staff feel trusted to do their jobs, which does not seem to suggest a low morale workforce.”

Constant restructuring of NHS is demoralising staff, survey finds

Novelist Marian Keyes reveals fight against constant "suicidal impulses"

The novelist Marian Keyes has revealed how she battled constant suicidal urges at the height of her mental illness.

The Irish writer opened up to Kirsty Young about her struggle with alcoholism and depression on BBC Radio 4’s Desert Island Discs on Sunday.

At her worst – an 18-month period beginning in 2009 – Keyes said she struggled not to harm herself.

She had stopped being able to eat, sleep and interact with others, and was eventually hospitalised.

“Then the suicidal impulses started and it was very hard to physically to stop myself from going through with it,” she said. “For months and months, every day was an enormous effort not to do the acts of wounding myself.”

Her recovery was “really speedy”, but the experience altered her perception of what it meant to be depressed.

“Nothing worked but the passage of time … It’s an illness and it ran its course.

“I had always described myself as melancholy or depressive but I hadn’t a clue. Anything I had before was a blue day by comparison. This was altered perceptions, a mental illness.”

She wrote her novel The Mercy of Mystery Close in that period. She told the Guardian in 2013 that a scene in which the heroine planned to kill herself in a hotel room was inspired by her own experience.

“I had two goes going out assembling the whole kit and buying paper and Sellotape to write the note,” she said. “The conversation Helen has with the man in the shop, I actually had that, with him asking: ‘What is it you’re proposing to cut?’

“It was so bizarre to be standing in a DIY shop, buying a knife to open my veins with. I was absolutely going through who would find me, leaving money for her to apologise … I wasn’t in my right mind.”

Keyes, 53, also told Young about her experience of alcoholism while living in London in her 20s.

“Alcohol was the love of my life. It was my best friend and, in the end, my only friend … I had stopped eating, stopped hoping, I was constantly suicidal. There was only one way it would go. I couldn’t stop drinking and was preparing to go under.”

Writing was her “rope across the abyss”: she wrote her first short story, then a few months later began a rehabilitation program for alcoholism. She has now been sober for more than 20 years.

“It was that primal urge in all of us to stay alive, saying ‘I can give you this, will you live for this?’ It didn’t get me sober but gave me something to hope for.”

Keyes’ debut novel, Watermelon, was published in 1995.

Her 12 novels to date have sold 35m copies worldwide and been published in 33 languages.

Her 13th book, The Break, will be released in the UK and Ireland on 7 September.

• In the UK, the Samaritans can be contacted on 116 123. In Australia, the crisis support service Lifeline is on 13 11 14. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. Hotlines in other countries can be found here

Novelist Marian Keyes reveals fight against constant "suicidal impulses"