Is the answer to the NHS workforce crisis right in front of its eyes?

Richard Griffin MBE,Visiting Senior Research Fellow, King’s Business School, today begins a series of guest posts on the healthcare workforce. He argues that, in the face of the widely acknowledged problem of shortages in this workforce, we should turn to current NHS support staff for part of the solution. (477 words)

Workforce is the biggest challenge facing the NHS. Not only is it short of 50,000 nurses, it also needs more podiatrists, midwives, radiographers and a host of other occupations. Total vacancies are approaching 110,000.

Whilst the government is committed to addressing this shortfall, a key question is – where will all those extra nurses, podiatrists, midwives and radiographers come from?

New supply routes like Technical Levels or career changers will provide some (as will more traditional routes such as A Level students and international recruitment), but these will take time and are unlikely to be able to fully close the gap alone.

The good news is the biggest and most immediate potential sources of new staff actually already exist and moreover could be quickly mobilised. They are working in the NHS. In many settings they provide the bulk of face to face daily care to patients. There are hundreds of thousands of them. They are committed and loyal. They are the existing NHS support workforce: Healthcare Assistants, Allied Health Profession Assistants, Maternity Support Workers (MSWs) and many more (Kessler et al., 2019).

It is very unlikely the NHS will meet its workforce challenge unless it taps into its existing staff who want to develop.

Take maternity. We need nearly 2,000 additional midwifery students. Research undertaken by King’s College London with the Royal College of Midwives (Griffin, 2017) suggests, in common with other groups, that a fifth of the maternity support workforce would like to become midwives – if they could. There are around 10,000 MSWs. That’s a lot of potential new midwives. Critically MSWs have experience of practice and are likely to live close to their place of work. One of the factors contributing to high turnover on midwifery (21%) and other healthcare degrees is students deciding healthcare is not the career for them. People who are already working in the NHS like MSWs are unlikely to think this and so are more likely to literally stick the course.

There’s nothing new about “Growing Your Own”.

Camilla Cavendish wrote about it in her 2013 review of health and social care support worker education and development. The thing is, though, progress has been slow. NHS support workers complain of their frustration in not being able to progress their careers. The creation of healthcare apprenticeship standards, including at degree level, though create an opportunity to help more of the 40% of the NHS workforce in support roles into pre-registration degrees.

There is of course no single solution to the workforce crisis as the forthcoming NHS People Plan will acknowledge but we know plenty of support workers want to become registered nurses, podiatrists, radiographers, midwives (or a host of other professions), they just need to be given the opportunity and in some cases support. If they are, it would go some way to meeting the challenge. Sometimes the solution to problems are closer than we think.


Kessler, I., Bach, S., and Nath, V. (2019) ‘The construction of career aspirations amongst healthcare support workers: beyond the rational and the mundane?’ Industrial Relations Journal, 50, 150–167

Griffin R. (2017) The Deployment, Education and Development of Maternity Support Workers in England. King’s College London; Royal College of Midwives.

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School.

The views expressed in this guest post are those of the author and not necessarily those of the NIHR, which funds the Policy Research Unit in Health and Social Care Workforce, or the Department of Health and Social Care.