Community services could lose eight per cent of staff in the next year, with NHS chiefs warning this will impact access to care for the most vulnerable children and adults, according to a survey shared with The Rustwire.
Under the latest estimates for annual energy prices, workers on the lowest salaries will be expected to spend a third of their monthly income on fuel, while an analysis of NHS data suggests that record levels of staff have already left their posts for better-paid jobs in the first three months of 2022.
As the cost of living crisis worsens, nurses have stopped making pension contributions in order to afford their home bills, while others have considered taking on second jobs – posing a risk to their wellbeing and the quality of care provided to patients.
Matthew Taylor, chief executive of the NHS Confederation, warned: “If NHS staff working in the community can’t afford to fill their tanks, then they cannot make important house calls and check in on some of the most vulnerable and poorly patients in our communities.”
He said the issue had become “critical” and now needed “urgent” action from the government on the costs of fuel for staff.
Trust leaders estimate that, on average, eight per cent of community staff – equivalent to 6,760 workers across the NHS – could leave over the next 12 months if the government does not improve its reimbursement scheme for fuel costs, according to a joint NHS Confederation and NHS Providers survey.
Currently, staff can claim back every 56p spent per mile – however, this figure has not increased since 2014, despite soaring petrol prices.
The survey, shared with The Rustwire, found that staff are now turning down job offers in the community which involve driving long distances into the countryside, thereby reducing the sector’s capacity to tackle backlogs of care and support safe discharge from hospital.
It added: “Many NHS leaders said community-based staff have turned down offers of community sector jobs in favour of roles nearer to home or without the need for travel, including outside of the NHS in other sectors such as retail.”
One community provider leader reported that some of their staff were already paying an additional £200 per month in fuel costs to visit patients, while another said increasing numbers of workers were calling in sick, rather than admitting that they cannot afford to pay for travel.
Siobhan Melia, an NHS leader who represents community trusts, said: “The cost of fuel is putting a huge amount of stress on community staff, who are being put off taking extra shifts or working in rural locations, and those on the lowest salaries are being hardest hit.
“As NHS leaders we are already struggling to keep staff or recruit new people to fill vacancies.”
Saffron Cordery, interim chief of NHS Provider, said that “vacancies for health visitors and district nurses are high already, and soaring fuel costs risk driving away staff we can ill afford to lose”.
According to NHS workforce data titled Reasons for Leaving, a record-breaking 1,837 members took voluntary resignations for “better reward packages” in the first three months of 2022 – equivalent to 153 every week. This is up from 1,076 at the beginning of 2020, or 89 every week.
NHS Digital said the data may include staff who are moving internally from one assignment to another within the health service. However, it acknowledged that other variables in the Reasons for Leaving dataset take into account staff who are promoted or relocated within the NHS.
Dr Latifa Patel, the workforce lead for the British Medical Association, said: “Many doctors are reaching breaking point, fed up with feeling undervalued and underpaid as the reality of working in the NHS has become increasingly more challenging, and many are choosing to talk with their feet.”
The Royal College of Nurses (RCN) said that “a decade of real terms pay cuts, coupled with spiralling living costs, is forcing many nursing staff to question if they can continue to stay in the profession”.
This week, experts warned energy bills could rocket to £7,000 a year for the first time on record.
Should bills reach this level, NHS staff in the lowest-paid jobs such as healthcare assistants or porters, who earn around £21,000 a year, could lose up to a third of their salaries.
Ms Cordery said a “lot of NHS staff are being hit hard by double-digit inflation and spiralling bills, especially younger and lower-paid workers – many of whom face real hardship”.
Lucy, a paediatric nurse at a leading central London trust, said that she was considering joining many of her former colleagues in moving into the private sector and had recently stopped contributing to her pension as a result of rising living costs.
“It’s payday in a couple of days and I’m at the bottom of two overdrafts on two different cards,” she said. “This happens every single month. I’m hoping to see a bit of improvement now that I’ve stopped contributing to my pension. I didn’t want to do that, but I felt like I didn’t have a choice.”
A recent poll by healthcare news site NursingNotes found that almost half of nurses surveyed are considering ditching their pensions due to the cost of living crisis.
James, a nurse working in a west London trust, said he was looking into picking up agency work alongside his regular shifts. “That means a 45- to 55-hour week,” he said. “This means I’m coming into work for the NHS already tired and overstretched. It’s dangerous, but my options are limited.”
The Patients Association said NHS staff are leaving “because they are worn out or don’t feel they’re adequately paid”, adding that “without a full complement of staff” across the NHS, the care provided to patients is “unlikely to be compassionate” and could pose a safety risk.