NHS staffing shortages: Why do politicians struggle to give the NHS the staff it needs?

This content relates to the following topics:

The workforce crisis has been a prominent issue for years, but there has been little concerted action from governments to tackle the challenge.

For almost two decades now there has been no clear plan to address the crisis and the staffing gaps have continued to worsen, because, for whatever reason, the UK political system seems unable to respond properly to this very real public concern. Given this long-running gap in solutions from national politicians, The King’s Fund and Engage Britain commissioned Bill Morgan, a former Conservative special adviser, to explore what can get in the way of ministers taking meaningful, long-term action to address NHS workforce shortages.

The resulting report, NHS staffing shortages; why can’t politicians give the NHS the staff it needs?, focuses on the role of politicians in workforce planning and delivery. It sets out the scale of the workforce crisis and the impact that it has, and the causes – identified in the report as difficulties in workforce forecasting, a tendency to train too few staff in the UK, and the insufficiently strategic use of international migration to compensate. It also considers the political reasons around why it has historically been so hard to fix and considers three factors that could contribute to tackling the current shortages:

  • transparency in workforce forecasts
  • the establishment of an independent workforce-planning organisation
  • accepting the NHS’s historical reliance on recruitment from outside the UK as explicit future policy and planning accordingly.

The accompanying long read from Sally Warren, Director of Policy at The King’s Fund, looks to place Morgan’s report in a wider policy context to briefly consider the range of actions that the long and often-promised comprehensive workforce plan for health and care needs to cover. For those leading on workforce away from national policy, the long read provides an overview of the key factors to keep in mind to act comprehensively across the range of levers to grow and support the workforce.

About this project

This report was funded by The King’s Fund and Engage Britain. It was independently developed, researched and written by the author and all views are the author’s own. The author undertook this project between May and October 2022.



Comment date
23 January 2023

2 of the 4 comments here are from patients. As a director, you should be taking this feedback and asking the relevant people managers and staff what they can and will do to stop these issues happening any more. How on earth can you say “ because you will meet people…..”


Director of Quality & Safety,
Comment date
03 January 2023

You make incredibly value and important points, please continue to do so, because you will meet people who will use your experience and your feedback to influence others care positively. Thank you for speaking up, I personally always welcome what patients and their families have to say...

Melvyn Wood

Not applicable
Comment date
14 December 2022

It's pretty clear that the MHS has problems but continuously getting reports from "so called experts" who can't see the onvious won't fix them. Clearly the management needs to be centralised and the trust system dismantled, thus reducing layers and layers of incompetent managers and their little empires. The wage issues can then be addressed and it is not just nurses and doctors as all these relorts seem to focus on. There are thousands of support staff who are undervalued and underpaid. There is no incentive system in the NHS! everyone is on band grades, nobody is the same in this world, there is always someone who is better. Pay people for improving themselves in their jobs, if your a care wirker and can do say for instance blood taking or transfusions, then there should be an incremental payment for this skill. It's not rocket science, it's common sense, managers don't have this!

Fran Priestley

Nurse Practitioner,
GP surgery
Comment date
28 November 2022

It is as simple as looking after your staff, listening to them and working WITH them as they are at the coalface. The times J have been happiest in my job have been when J had a manager who supported and listened to me, and stood up for us to more senior management. If a nurse is overworked, underpaid and taken advantage of, they will look for alternative employment. Give them priority NHS health support, then if I'll can get back to work quickly and efficiently.

jane Aylott

Cancer Patient and patient representative,
Comment date
25 November 2022

As a cancer patient diagnosed at late stage due to missed red flags, I have a unique insight into the workings of the NHS. I am a stage 4 metastatic Neuroendocrine cancer patient with extensive metastases. I have been treated for 6 1/2 years, and am very grateful for that fact to the clinical staff, doctors and nurses.
I am not an NHS ‘ Basher ‘ but I can see where there are inefficiencies, management staff that have no benefit whatsoever to actual patient outcomes or well being or survival. I recently brought up a real time example of how diagnostic availability is wasted within the nhs to the senior director Responsible for NHS cancer delivery. Two days previous the Staff were there, equipment was there, but two DNA meant two other patients could not be seen. They managed to call me on the day at 12-30 to say could I come in early - presumably so they could go home early,- but why not phone patients on a wait list for urgent MRI. That to my patient orientated mind is two missed opportunities to get two patients on their way. ( in context I think the total number of MRIs was about one an hour so out of 7, 2 did not attend)
Two days later I went for a CT scan, one of the scanners was being serviced, creating a bottle neck. I knew from 3 days earlier the CT unit is closed on Sunday, why not get it serviced then? it may cost a bit more but it would go some way to reducing wait times for diagnostic tests.
This is just one example of the waste I see. To date , two monthly chemo cycles later I still have not received an answer from that nhs cancer delivery department. They have been busy apparently, probably producing more graphs to present again and again about the difference about available diagnostics and diagnostic need!! Without looking at different ways to improve efficiency. What benefit are they doing for patients if they cannot take on board simple, common sense adjustments to procedures. Only patient reps are willing to rise above the parapet and say what needs saying as management are so busy not offending so they stay in post, after post after post with no continuity of service .
I recently wrote about an ordinary day in the life of a chemo patient, bloods not ordered, chemo drug prescription lost, not seen soon enough in clinic to allow time to get said prescription. All whilst being immuno compromised. I raised it with my cancer alliance. The middle management suggested ‘they help me contact PALS’. They missed the entire point, I am not seeking a polite letter from PALS to say lessons will be learned, but I was offering examples of where the system could be streamlined in order that chemo patients did not have to hang around all day In hospital. The lead clinician in my cancer alliance did see what I was trying to do. But those numerous middle managers, no idea of what it is to be a patient. Next time I will be able to make sure that I don’t wait an hour before seeing my script disappear from the notification board in the pharmacy, I will be firmer in saying I need to be seen because I need to get my prescription made up. But what I am trying to do is ensure other patients have a better experience.
My final bug bear, and this comes up again and again and again, postage and the enormous wastage caused by inefficient admin staff. 3 nhs letters arriving on the same day, one advising of an appointment, one cancelling same appointment and a third advising of an appointment 10 minutes later.

Veronica Brinton

Patient Representative/Advocate,
Comment date
25 November 2022

I have been working in HealthCare for around 20 years.
Successive governments have allowed NHSE to employ more and more managers and administrators. Many of them are poorly trained, and the level of professionalism and understanding of Patients and Public is at an all time low. There seems always to be funding for more managers, yet the real people, our frontline nurses and doctors are not paid what they deserve.
No government is qualified to run the NHS. It takes a long time to understand healthcare, and if they do learn, then they move jobs. Only an expanded Health Select Committee should be the chief advisers and commissioners, never politicians.
I think the current situation is disgraceful and patients are suffering because of an unhealthy NHS, with too few GPs, nurses, midwives - the list goes on, but there are plenty of mediocre civil servants around.
Patients and Public should be asked for their views, instead of putting the Patient Experience at the bottom of a long ladder of hierarchy in NHSE. And we are always just a tickbox.
Why doesn't the RCGPs poll their members and ask them what would attract more people to train, and stay, as GPs? Same for nurses and midwives. Asking the people what they need is fundamental.

Add your comment