Recovery means different things to different people—there is personal recovery and organisational recovery. The NHS is embarking on a decade (at least) of reform and continues to face unprecedented challenges brought on by the COVID-19 pandemic. The pandemic, the worst public health emergency the country has experienced for over 100 years, resulted in around 7 million patients in England alone who did not come forward for treatment (Cabinet Office et al, 2022). Provision has to be made to administer that treatment, free at the point of need.
The NHS Confederation (2021) has produced a manifesto for recovery. This details how the health and care sector can address the challenges and sustain the beneficial changes that have been brought about by the pandemic. For many outside the sector the pandemic has shone a light on the ongoing chronic problems in our health and social care system, even as it added to those problems. For example, when COVID-19 emerged, there were already thousands of registered nurse vacancies. However, nurses were already acutely aware of what these deficiencies are and what challenges they pose.
Before the pandemic, 9 out of 10 people were waiting fewer than 25 weeks in England for non-COVID-19 care; this has now risen to 44 weeks. The number of NHS patients who are waiting for tests, surgery and routine treatment in England has reached a record high of 5.5 million, with the possibility that this could reach 13 million over the coming years (Cabinet Office et al, 2022). Health services in other parts of the UK have faced similar challenges.
Caring for patients and service users during the pandemic has had an immense impact on nurses, other health and care providers and the whole NHS. There is a major backlog of treatment across all settings with an extraordinary surge in demand for mental health services. The relentless demands of COVID-19 and its variants, along with enduring inequalities, make clear that in recovery, a focus on staff health and wellbeing and addressing inequality must remain a priority. Plans devised need to be delivered at a local level and supported by national policy, planning and funding decisions.
The pressures experienced by nurses across the UK continue to be exacerbated by malignant long-standing staff shortages. Data from NHS England and NHS Improvement show a vacancy rate of 10.5% as at 30 September 2021 within the registered nursing staff group (39 813 vacancies). This is an increase on the same period the previous year when the vacancy rate was 10.1% (37 144 vacancies) (NHS Digital, 2021a). The total full-time equivalent staff vacancies (April 2015-March 2021) stood at 93 806 (NHS Digital, 2021b). Running a complex and already challenged NHS with such vacancies and even contemplating any form of recovery is a tall order.
If our NHS is to make any attempt at recovering, to build back better, then radical action is required now and a concerted, joined-up collective response is what is needed. I would suggest that, as the largest group of NHS employees, nurses are a key part of any plans, any decisions and any strategies that are formulated to help ‘reset’ with regard to the changes that are needed as our NHS works hard to deal with a significant backlog of care along with unacceptable widening inequality. The government must stop burying its head in the sand and recognise the extraordinary contribution that nurses and other health and social care staff are making in helping the country through the pandemic, in part by ensuring that they are appropriately remunerated, that they have the support they need and they are listened to. An exceptional investment in health and social care is what is required, for our own futures and to allow us to care for others.