Has the NHS hit rock bottom?

Over the past decade, the NHS has undergone significant changes, including increased funding pressures, the expansion of digital healthcare services, workforce challenges, and structural reforms aimed at integrating care through initiatives like Integrated Care Systems (ICSs). With 18 years’ experience recruiting into the NHS, I have seen firsthand the pressures, stresses and challenges faced by staff and patients.

The NHS needs strong, compassionate, and decisive leadership. The pressure on NHS leaders is immense, with competing priorities, financial constraints, and political complexities all adding to the burden. However, leadership is not just about managing resources; it’s about inspiring, advocating, and making bold decisions to protect the future of the NHS.

We must acknowledge that staff retention is as crucial as recruitment. It is not enough to simply bring new talent into the system if we cannot keep the dedicated professionals we already have. Addressing burnout, valuing expertise, and ensuring that staff feel heard and supported should be at the top of every leader’s agenda. This is not just about wellbeing: it is about patient safety, service sustainability, and the long-term survival of the NHS.

Too often, responses to NHS pressures are reactive rather than proactive. We cannot afford to keep firefighting; our healthcare system requires long-term, strategic planning that addresses root causes rather than just reacting to demand. Will the 10 year plan provide this? In short, this means:

• Investing in Workforce Wellbeing: Staff are not just numbers on a spreadsheet; they are the heart and soul of the NHS. Flexible working, mental health support, and sustainable workloads should be non-negotiable priorities.
• Improving Operational Efficiency: Technology and innovation must be harnessed to help manage pressure, reduce inefficiencies, and ultimately improve patient care.
• Pushing for Sustainable Funding: Leaders must be vocal in calling for realistic, long-term investment in the NHS. Short-term fixes and budgetary constraints, leading to continued skill deficits, will only deepen the crisis.
• Rebuilding Public Trust: Patients need an NHS that works for them. Transparent communication, patient-centred care models, and community engagement are vital to maintaining confidence in the service.

These points have been shared publicly by many, but worth highlighting are: The Kings Fund, who support the need for transformation and have made recommendations (December 2024) and the Health Foundation recently shared their take on what the 10 year plan should look like (February 2025).

The NHS simply isn’t equipped to manage demand and deliver the service needed in its current form. Will these poignant points have any bearing?

A Call to Action?

This is not just a crisis; it is a turning point. The decisions made now will shape the future of the NHS for generations to come. Leadership in times of crisis is not about maintaining the status quo; it is about challenging it. It is about having the courage to push for change, to demand better, and to champion the people who make the NHS what it is.

During the COVID-19 pandemic, we clapped for the NHS like the heroes they are; we clapped for their courage, passion, and commitment, and we need to clap for them again. But applause is not enough; action must follow.

NHS leaders have the power and the responsibility to steer our health service through these turbulent times. The question is: will the government rise to the challenge or let the NHS drift further into crisis? Only time will tell.

Sian has over 17 years’ experience supporting organisations with their recruitment needs. Specialising in senior interim management and consultancy services to the NHS, she provides her clients with the flexible talent needed to solve business problems and deliver transformation and change. Specialising across the system, Sian works with providers, commissioners, regional and national teams, and regulatory bodies to enable NHS organisations to achieve their business outcomes.

You can connect with Sian on LinkedIn or email her at sian.williams@andersonquigley.com.