Four common NHS myths busted
Dean Royles, February 28, 2014
Although media headlines often feature events when care has gone wrong, sometimes tragically, there is a lot of misinformation about the National Health Service. Here, NHS Employers CEO Dean Royles sets the record straight on a few common myths.
NHS staff have featured in the media quite a lot recently. There are 1.3 million of them working in England. While the media often focuses on the negative aspects of healthcare, there are also a lot of stories featuring examples of great care, new developments and service improvements, as well as ground breaking research.
Social media has also been a great a place for people to try and counter what sometimes appears to be endless negative news stories; for example Twitter hashtags such as #bigupthenhs and #nhssupersunday, to name a couple.
Negative stories and reports are really important because they shine a light and remind us not to be complacent, ignorant or dismissive when things go wrong. But they also often feature incorrect or misinformation about the size, scope, skills and experience of NHS staff.
For example, there was a recent provocative story about the contribution of women in medicine that said that most women work part-time and retire early. It generated a few comments! And we corrected some of the data in a piece entitled Some People Are Women, Get Over It.
I think it's time we put the record straight about other aspects of the NHS workforce. Here are four common myths that I will now correct:
Myth 1. The NHS relies heavily on an untrained workforce
Healthcare Assistants often get referred to as ‘untrained’. This is hugely offensive to them and the patients they treat.
The truth is many commentators confuse 'unregulated' with 'untrained'.
According to 2012 figures from Skills for Health, approximately 87% of staff held a qualification equivalent to National Framework Qualification (NFQ) level 2 and above. In addition, 64% held a qualification equivalent to NFQ level 4 and above, equivalent to a higher education qualification.
In her report, Camilla Cavendish said the public image of healthcare assistants is outdated and they have the skills and attributes to give high quality care with good training and supervision, but without regulation.
Myth 2. The NHS workforce are all doctors and nurses
Many newspapers write as if the only people that work in the NHS are doctors and nurses, and that there now far less of them. In reality, fewer than half the NHS workforce are doctors and nurses and their numbers are rising.
There are now 370,000 nurses (320,000 full-time equivalents) – 40,000 more than in 2002. There are 146,000 doctors (137,000 full-time equivalents), which, again, is about 40,000 more than in 2002.
The NHS also employs 32,000 ambulance staff and 31,000 qualified scientists. Then there are the psychologists, physiotherapists, speech therapists, occupational therapists, radiographers, pharmacists, engineers, electricians, plumbers, carpenters, IT specialists, admin staff, photographers, dieticians, dentists, midwives, optometrists and so on.
Myth 3. The NHS is over-managed, mostly by people who add no value to the front line
Creating a definition of management is tricky because most people who directly manage and supervise staff are also clinicians, such as matrons, ward managers and department heads in physiotherapy, pharmacy and pathology.
Then there are managers and supervisors dealing with catering, cleaning and trades such as plumbing, as well as medical engineering - all essential to front line direct care. And there are administrative managers in finance and HR, ensuring bills are paid and invoiced and staff are trained and paid on time.
Using the Office of National Statistics’ (ONS) definition of management, The King’s Fund calculated that 4.8% of people in the NHS are managers. This is higher than the official NHS number of a bit over 3%, but it’s much lower than the ONS estimate of managers for the whole UK workforce – 15.4%. There’s more on this here.
Myth 4. The NHS is not diverse, and largely made up of part-time women
Female staff make up 77% of the NHS workforce and 83% of these women work 30 hours or more.
It is painfully true, given the size of the female NHS workforce, that there are fewer women in leadership positions than you would expect and want.
Only 41% of NHS chief executives are women, although this is a higher proportion than in the judiciary, higher education, local government and FTSE 100 companies. There are far fewer senior BME people in organisational leadership positions, too. That can’t be right given the makeup of our workforce.
In all, 16% of NHS Hospital and Community Health Service staff are from BME backgrounds, including 37% of hospital doctors and 19% of nursing staff. There are now an estimated two hundred different nationalities in the NHS.
I hope this helps put some context around what is probably one of the world's most qualified, diverse and complex workforces.
I'm proud to be a part of it.