Four years on: a workforce for the future

We have made recommendations about ensuring that there are sufficient highly trained respiratory staff in place to work compassionately and efficiently and provide accessible, high standard and evidence-based care for people living with lung conditions at every stage of their journey. Here’s what happened in 2022. 

Comment from the Workforce Working Group Co-Chairs 

As a nation, we recognise the constant challenges faced by NHS and social care providers when delivering safe, effective, and equitable health and social care. There is an ever-present burden on our existing respiratory workforce in terms of recruitment and retention of staff, and we are deeply concerned about the impact this has placed on patient care. This situation has not developed overnight, and we are now witnessing a snowballing effect on the workforce across the country. It is the greatest single limitation in identifying, screening, treating, and delivering timely and high-quality care to people living with lung conditions.  

Taskforce’s concerns about the workforce led to the urgent development of a multi-professional Workforce Working Group in April 2022. An inaugural meeting was held in June 2022, and this was attended by over twenty-five patient, carer, and organisation representatives. We are absolutely delighted to be giving a platform to a person-centred approach to the respiratory workforce challenges the nation currently faces.  

We are all aware of the pressures that the COVID-19 respiratory pandemic brought globally. This extra burden has exacerbated an already present and ever-growing NHS workforce crisis, driving an increased demand for services and rapid research. The pandemic highlighted significant variations in service delivery related to a lack of respiratory specialists, along with the worryingly large gaps in the recruitment and retention of staff. There are currently shortages across all disciplines, including nursing, medicine, allied health professionals, scientists, and researchers and across all healthcare settings, to the detriment of everyone’s lung health.  

The pandemic has worsened existing respiratory workforce pressures as services have been put under more strain by the redeployment of respiratory healthcare staff, leading to a disruption of normal service and working practices. This continues to have a lingering effect on respiratory healthcare provision both for people at risk of developing, and living with, lung diseases and for those with long Covid symptoms.  

We very much welcomed the Health and Social Care Select Committee workforce report, published in June 2022 and led by the then committee chair, the Rt Hon Jeremy Hunt MP. It provided helpful evidence and gravitas about the workforce situation, with the bleak conclusion that the ‘NHS and social care sector are facing the greatest workforce crisis in their history’. It is of deep concern that 9 out of 10 British Medical Association members surveyed earlier this year think the government’s aim to tackle the COVID-19 backlog is unachievable with current staffing levels.   

We remain troubled that despite this clear evidence about the number and impact of issues facing the workforce, there is a political reluctance to take meaningful, decisive, and timely action to avert any further damage.  However, we hope there is a chance this may change now that the Rt Hon Jeremy Hunt MP is Chancellor of the Exchequer, given that he has repeatedly called for a cross-party approach to a sustainable NHS workforce strategy and remains committed to addressing the committee’s recommendations.  

We were very encouraged by his Autumn Statement in November 2022, where the Chancellor announced that the Department of Health and Social Care and the NHS would be publishing ‘…an independently verified plan for the number of doctors, nurses and other professionals we will need in 5, 10 and 15 years’ time…’ taking full account of the need for better retention and productivity improvements – a policy he advocated while Select Committee Chair. We look forward to reviewing the details when it is published in spring 2023.  The repeated delays in the publication of a much-needed robust NHS Workforce Strategy are concerning; however, the delays have afforded us an important window of influencing opportunity that we intend to fully utilise in the months ahead.  

We are committed to raising awareness of the pressures faced by those working in respiratory care, which may not be as widely recognised as they are in other areas of medicine and public health, and the impact of these pressures on patient experience.  

So, in 2023, our main objectives as a Taskforce are to campaign on behalf of people living with lung disease and collaborate with policymakers to set out a shared vision on what is required of a 21st century respiratory workforce to ensure the delivery of timely and effective patient-focussed respiratory care. We will identify innovative models of service delivery that use multi-professional respiratory teams to support the co-delivery of inspirational respiratory care and excellence. We will also work with the NHS England Workforce Strategy delivery team and other key stakeholders, to share these models and influence policy and practice changes that are consistent with our patient-focussed vision. Most importantly, we will continue to prioritise the needs and views of people with respiratory conditions and ensure their voices are heard.   

Co-Chairs of the Taskforce Workforce Working Group 

  • Maria Parsonage, Respiratory Consultant Nurse and Chair of Respiratory Diseases Subcommittee & Pleural Lead of the Association of Respiratory Nurse Specialists (ARNS) 
  • Dr Charlie Addy, Respiratory Consultant and Chair of the British Thoracic Society Workforce and Service Development Committee 

The number of respiratory medicine doctors (full time equivalent) increased by 775 from January 2017 to July 2022, an increase of 33%.  

Recommendation 6f: The Royal College of Radiologists (RCR), supported by the British Society for Thoracic Imaging, to introduce national standards for speed of reporting  

The Royal College of Radiologists and the College of Radiographers (the Colleges) have collaborated on the Benefit of the Quality Standard for Imaging (QSI). The QSI provides a staged approach to quality improvement that is offered by the Colleges at no charge in order to support clinical radiology services to reach their performance and quality goals.  

Recommendation 6h: Create regional thoracic imaging networks to share expertise between hospitals  

A Diagnostic imaging network implementation guide was published by NHS England in 2021 in consultation with The Royal College of Radiologists, Society of Radiographers and Institute of Physics & Engineering in Medicine. It provides NHS providers of diagnostic imaging services with guidance as they begin the process of forming the imaging networks across England by 2023, as set out in the NHS Long Term Plan. It also includes criteria by which NHS England and NHS Improvement will assess each network’s progress towards being operational. 

Recommendation 6m: Include consultant pharmacist posts in strategic workforce plans   

In 2020, Health Education England published guidance on how healthcare systems can support the creation and approval of consultant pharmacist roles and HEE have also developed a curriculum. Alongside their practice role, it sets out that consultant pharmacists will be at the forefront of generating and disseminating evidence to drive improvements in care. It also states that consultant pharmacists will be role models for others, mentoring, supporting, and developing current and future pharmacy professionals so that their knowledge and skills meet the ever-changing needs of the NHS. Taskforce hopes that with implementation of this guidance that consultant pharmacists will be able to have an even greater role in supporting people’s health and wellbeing. 

As a Working Group we have discussed and agreed that we will no longer put a specific emphasis on an increase in specific numbers of the respiratory workforce, as set out in recommendations 6d, 6i and 6j given that these figures, first identified by the Taskforce in 2018, are likely to now be out of date. Some other original Taskforce recommendations are also no longer relevant as the policy framework has moved on.