Intended for healthcare professionals


NHS workforce shortages and staff burnout are taking a toll

BMJ 2022; 377 doi: (Published 11 April 2022) Cite this as: BMJ 2022;377:o945
  1. Miriam Deakin, director of policy and strategy
  1. NHS Providers

“We have witnessed senior experienced staff crying with frustration and anger…[they are] mentally drained and despite their best efforts have seen patients suffer and have received negative comments from distraught relatives and carers.”

These are the widely reported words of managers at Royal Preston Hospital in a letter describing how NHS employees are being reduced to tears.1 It’s an eye opening account of what’s happening in our health service.

All across the NHS, widespread workforce shortages and staff burnout are taking their toll on hard working, but overstretched professionals under sustained pressure.

Over the past few weeks, covid-19 infection rates have soared again in England. Hospital admissions and deaths have risen too, although not as high as before thanks to a successful mass covid-19 vaccination by the NHS. There has been a worrying increase in the number of NHS staff off work due to covid-19 which is having a knock-on effect on patient care, on efforts to deal with care backlogs, and on meeting ongoing demand for services.

The last two years have undoubtedly been the most challenging period in NHS’s history. Staff continue to work flat out, doing their best for patients, but many of the problems we face now existed long before the pandemic and won’t disappear overnight. There are currently 110 000 job vacancies across NHS trusts and many thousands more in primary care.

The whole NHS wants to get back to pre-pandemic levels of activity as soon as possible, but some necessary infection control measures must remain while covid-19 cases stay high to protect vulnerable patients, constraining how quickly we can deal with the backlogs.

At the same time, NHS trust leaders are doing their bit to ease the strain on the public purse, working hard to find more efficiencies, cut costs, and find the £330million savings asked of them. That’s an increasingly tough task as inflation and the cost of energy and fuel soar.

Staff satisfaction with pay is at its lowest in five years too. In the face of the mounting cost of living crisis, staff must see a meaningful pay rise from the government this year. As collective employers of 1.4 million people, trust leaders know the spiralling day-to-day costs which their workers face and worry about the impact on younger and lower paid staff.

It's no surprise that all of this has dented morale and wellbeing, reflected in the results of the latest NHS staff survey.2 Barely one in four (27 per cent) people working in the NHS feel that there are enough staff in their organisation to allow them to do their jobs properly, while there are also concerning increases in the proportion of staff suffering work related stress and, sadly, thinking about quitting the NHS.

Trust leaders take the effect of workforce pressures on their people and services extremely seriously. Almost all respondents who replied to a recent NHS Providers survey said that staff shortages are having a serious and detrimental impact on services and will hinder efforts to deal with those major care backlogs. Trusts are doing all they can to tackle the situation but need more staff to be able to reduce delays and to treat patients as quickly as possible.

It’s tough too to see a sharp drop in public satisfaction with the NHS, although given the impact of the pandemic it isn’t completely surprising.3 We want the public and politicians to understand the pressures which the whole of our health service is under, with huge strain on exhausted staff. They need to see that the government will offer support to help boost morale and retention.

NHS Providers, along with more than a hundred health and social care organisations, have supported the inclusion of measures in the Health and Care Bill going through parliament requiring ministers to publish regular independent assessments of the number of health and care workers needed to make workloads sustainable. This has so far been resisted by the government.

As workers and employers start paying for the welcome extra investment from the Health and Care Levy it’s vital too that the government comes up with a fully costed and funded long term plan to ensure that we have the workforce we need to meet increased demand for NHS and social care services today and in the future.


  • Competing interests: none declared.

  • Provenance and peer review: commissioned, not peer reviewed.