Staff shortages - why?

[Buttalapasta]

I've just read the thread on pharmacist shortages. My mum's GP practice has cut its opening hours due to shortages and the local pub now closes at 9 for the same reason! Why? I know Brexit had some impact but surely not this much? Is it down to poor wages? Early retirement? It seems strange that so many places can't seem to get staff yet they aren't offering higher wages? Any economists know?

I think they will end up means testing state pension, same with the NHS or it will happen by stealth eg the NHS waiting list is 3 yrs so those who can go private.

To be fair, most on-site hospital nurseries that once existed have also closed down which makes finding childcare that works with shifts almost impossible, so it wasn’t wrong even if not what you meant to say!

The problem with means-testing the state pension is it's a fine balance.... just like with other state benefits. What incentivises someone to behave responsibly and save for their retirement, or pay shed loads each month into private pensions if Joe Bloggs down the road has lived it up in his 30s, 40s and 50s, spent his money on nice things rather than saving for the future- and then he gets a full state pension while the muggins who's done the responsible thing gets sod all?

If I knew my state pension would be reduced because I've been paying hundreds a month into my occupational and private pensions, I'd do the maths, reduce or stop working at the point where it would balance out and I wouldn't lose out financially. It's the same principle that kept people working 16 hours maximum for years... they did the calculations and realised they wouldn't significantly get an advantage by working more. And look where that's got us....

This is a really good post.

Lots of private employers simply do not want to pay enough to keep up with inflation. It’s an issue in both the public and private sector - not all of the private sector, but definitely companies like Boots, Lloyds etc. This might be because they can’t afford to, given other COL increases, because they are protecting shareholder dividends, or because they haven’t caught up to the new normal and resent paying more.

And nobody is going to take a stressful, overworked job on low pay (low pay may be absolutely low pay, or low pay relative to the industry norms). They go part time, they don’t return to work after having children, they retire early, they find other income streams.

(I know one pharmacist who has left to set up a successful bakery instead - it was a fun sideline, but pay and conditions led him to look seriously about turning it into a full time career).

I'm professional NHS. We lost swathes of EU staff with Brexit. They have been replaced with non-EU staff. Many are dodgily trained with questionable qualifications. They readily admit, with surprise, the HCPC didn't ask for any proof, how easy it was; thus we have 23 year olds with 2 or three post-grad diplomas on top of their degree, apparently.....

Although largely pleasant people, the majority are nowhere near the standard of the (western) EU or UK trained staff. Many are, frankly, dangerous. We have actually had staff struck off the register. Cast your eyes over the HCPC struck off lists.....

A knock-on effect has been the departure of the British trained staff who can no longer bear the stress of working alongside such dangerous incompetence, abetted by management whose only metric is patient throughput, with staff who are willing to be exploited into working unsafely. The UK trained staff either leave the profession altogether or go private, which is what I'm in the process of doing, unless I decide to retire which is on the cards. I'm 60.

So, 5 years ago our staff were 60% UK trained, 40% EU, 10% Australian. Now we're 80% non-EU trained.

This is largely on Brexit, but also the inflexibility of 13 hour 24/7 shifts working with ancient equipment, dubiously qualified colleagues, hostile management and an increasing demanding public.

I think companies are less willing to put in the work to train someone up, they just want someone who already knows what they are doing.
This is simply not true - you can't recruit people with the skills and knowledge, there are enough out there - you have to train, there is no choice. Graduate opportunities are at an all-time high. Staff turnover is also at an all-time high, you often hear people on here talk about job flipping every two years - it's making investing in staff very costly, but we have no choice. And we treat our staff well, we pay them well above the average but companies are having to promote and pay staff to levels where there is a big risk they are not able to do the job, they hope on a wing and a prayer that they can step up - and that creates its own problems for staff too when they are promoted beyond their abilities and skills.

What could be done to help?

Well, rejoining the single market would be a good start.

Everyone’s been to University nowadays and doesn’t think they should start lower down the scale and work their way up. They all have a huge student debt to pay back and want a wage sufficient to pay it back and have money left over to have a decent lifestyle. Lots of young people believe what they see on Instagram/Social Media and feel that they should be leading an affluent lifestyle now rather than working & saving up for it. This is a sweeping statement as I know not every young person is like this but it’s a significant proportion. When everyone has a degree, it stops being special or something that sets you apart.

Yes, in spades.

I'm not a nurse but in a closely related health care profession. When I started in 83 it was as you described; many often older, experienced staff who did, say, every Thursday and Friday night; or Mon-Weds 9-3. Our core hours were 8-6 Mon-Fri with emergency cover for the rest of it.

Now it's 13 hours shifts, full-time only, 24/7 shifts on a rolling rota, where taking your break is seen as a privilege, with older, heavier more complex and more demanding patients and all but no HCA back up as they were pretty much all EU.

Core hours are 7am to 8pm. Which sounds great to the public. But funnily enough not so great for the exhausted staff. Which is why the 1983 workforce spanned 21-65; whereas now of 20 staff, 3 of us are over 40 (and of those 20, 4 of us are UK trained, the others all non-EU trained and far more willing to be exploited....). I'm 60 and will be gone by this time next year.

If my managers had their way, we'd all have " <name> General Operative" on our badges as an specialisation might lead to a pay rise demand.

So NHS employer attitudes play a big part in staff-shortages.

Improve the working conditions and pay a living wage.

It's not difficult but the UK has relied on cheap labour- (that didnt necessarily care about the working conditions )for too long and now it's not available anymore.

People need to be able to afford to pay their Bill's and dont want to work in horrendous stressful conditions.

I mean why are there so many striking at the moment?

I work in the NHS unfortunately I cant go abroad for personal reasons so am working hard to try and retire as soon as possible.

I actually very much doubt that Europeans would move back here now. And I don’t blame them.

"As an aside I can see the advantage to a nurse having a 3 day week but isn’t a 12 hour shift just too long? It sounds terrible when you have to be top of your game all shift long."

It is too long. Ours are 13 hours. Staff are not giving patient 50 on day 3 anything like the attention they gave patient 1 on day 1. I see it all the time. But management like it because it's easy to rota, and 25 year olds like it because it compresses their working week to three days (though all concede they sleep through day 4...). However, once they start getting older, or having kids, and discover it is exhausting, that there is no 15 hour childcare provision, or they tag team with their spouse so never see each other, or find they're working at least part of more or less every weekend..... it becomes considerably less attractive.

Many then get themselves promoted into NHS management (quite easy to do with all the staff shortages, but increasing the poor-quality of NHS management) which, unsurprisingly is still 9-5, Mon-Fri...., go private, change career or do agency.

Oh, and 5 years ago, we were given 20 minute appointment slots. It's now 15, and they're eyeing up 10.

These are some reasons why people are leaving in droves. I'm 60 and will be gone by this time next year.

I agree 100% about reasonable, flexible, convenient hours. Years ago I remember working alongside colleagues who worked 10 am until 2pm or 9.30am until 2.45pmctbise sort of hours. It fitted I with their family. Nowadays all the part time staff I work with have to do full days.
Wbere dh works they no longer set on these types of hours and staff have to work either 6-3 or 3pm until midnight.
They also have to work a shift pattern. None of this fits in with a ring for a family. They could offer purely weekend work but they don’t. Everybody has to cover 7 days.
I think it’s such a shame parents (both men and women) can’t both work less hours.
We have vacancies at work. The roles could be filled but management will not alter the hours slightly, so the roles remain unfilled . All the staff would be happy with the flexibility the interviewees asked for but no.

I have a friend who has quit her job. She did part time regular hours. Management have now decided she must rotate so she will no longer work set days so her childcare is buggered.

Also because it’s part time her employer will struggle to get a man to do the job.

@Fordian it’s interesting you say that - the registrars in our department, both HEE trainees and fellows, are all international medical graduates (all very good, luckily). Recruited in December for two fellow posts, and had not a single UK graduate apply. It does make things harder, as both appointees had visa issues and delayed start dates, and one appears to have given up battling the red tape and withdrawn.

I also interview nationally for both my specialty and SHO level training programs, and now I think of it the vast majority of applicants there are overseas-trained as well.

I interviewed about 25 people for SHO training rotations last week, and only 6 graduated med school in the UK. Though obviously most of them had already worked in the NHS in F2 or junior fellow posts. Some were excellent, some were less so (and weren’t appointed).

No idea where all the UK grads are, but they don’t seem to be applying for IMT. This is a new thing, I think literally all of our department’s consultants are UK trained. Diverse ethnically, but graduated and trained here.

But the flipside is that because of her inflexibility, someone else with similar childcare hour requirements couldn't be employed. I know teams where over half the staff are only willing to work school hours and all of the late/unsociable hours must be picked up by the same child-free individuals. And they're not happy. Rotating shifts evens out the antisocial bits.

The issue is a wider one of childcare - availability and affordability.

If the unsociable hours paid more there would be more takers.

So 1 person would not be lumbered with them. And likely there would not be enough unsociable hours to go round.

When I was younger.

My sister used to work in a factory.

It used to be time and a half for the evening/ late shifts and double time for the bank holidays.

They used to fight for that work.

@Fordian Yep.. thats my DD experience, even went to a talk about the challenges of overseas staff in the NHS, very welcome for them but training and language skills are very hit n miss or as the speaker said "they present their own issues"

But then... if it gets rid of the hated EU and their citizens in our lives, then who cares if you get treated by a semi skilled person who administers the incorrect drugs or sends you home when you shouldn't be (that happened very recently in the area my DD works in) couldn't read the notes.

This is an issue for the professional body though. They are responsible for ensuring those registering are at the same standard as the UK. So what’s going wrong? There are certainly overseas pharmacy/ medical degrees that aren’t recognised in this country. Is this an issue with rcn/ hcpc?

They won’t means test directly, they’ll just increase the taxes - putting NI contribution on pension payments seems a good place to start.

I agree that employers need to change their mindsets. Lots of talk about getting over 50s back into the job market but over 50s jobseekers report employers aren't interested in employing them. Employers expecting people to be available at random times instead of shift patterns - not going to work for students who want to work weekends or parents who want to work around school hours. Experience required for absolutely everything, eg I saw a minimum wage taxi co-ordinators job advertised this week saying experience was essential. If there is a worker shortage, employers need to realise they will have to train up their own staff.

Exactly, and now it isn’t and employers wonder why they can’t fill those shifts. Lots of these issues basically come down to not paying people enough to want to do them.

If they were paying £250per hour they’d have a queue out of the door. At min wage they don’t. The market rate is somewhere between the two, they need to raise rates until they find it.

In our community pharmacy we have no staff shortages. We are paid more than minimum wage and trained in house, with wage uplifts for each level of training. There is currently an 18 year old training in the dispensary, and a 45 year old training as a counter assistant. (I trained up as a counter assistant at 51... 7 years ago... a mum returning to the workplace)

It's not a great job, too many "entitled " customers who think shouting at staff will get them what they want quickly... but our terms and conditions are generally OK. Hence no staffing issues.

We attract trained staff too... from supermarkets and Boots in particular.