The Nuffield Trust has published a new NHS workforce report that shows that NHS physiotherapist numbers have only increased by 3.3 per cent over the last ten years – despite a far greater growth in the overall number of qualified physiotherapists in the UK during this period.
Responding to the report’s findings, CSP’s director of practice and development, Ash James, said: ‘The CSP welcomes the Nuffield Health report on NHS workforce numbers. Whilst it’s positive that the report indicates a 31 per cent increase in physiotherapy staff between 2010 and 2023, this is only a third of the total growth in HCPC registered physiotherapists.
‘This clearly shows there is further potential for the growth of physiotherapy as a vital part of the NHS workforce. The 3.3 per cent increase in roles for physiotherapists set out in the NHS Long Term Workforce Plan for England is under ambitious.
The broad range of skills physiotherapists possess make us well placed to manage the growing complexity we see in a patient population who are ageing and having increasing comorbidity. We can be a useful and viable solution to helping care for people across the UK
More funding needed to grow the workforce
The report shows 31 per cent increase in physiotherapists working for NHS employers in England.
However, it doesn’t point out that, in contrast to most other professions, numbers of registered physiotherapists in England grew by more than 93 per cent (June 2012 to June 2023).
Significantly, the report draws attention to the additional funding that will be needed to increase staffing by 2031 in line with the ambitions in the NHS Long Term Workforce Plan, and the additional numbers of academic and clinical educators and supervisors that will also be required.
It also highlights the time-lag in growing the workforce – with additional training places for doctors not starting till 2025.
Commenting on the report, CSP’s head of policy Rachel Newton said:
It is critical that funding is made available for additional NHS staff as well as for training places, and that this is done now so that the NHS can take full advantage of the workforce solution offered by a burgeoning physiotherapy workforce
Vacancy rates are not the whole story
The report also places a heavy emphasis on vacancy rates as a measure of the shortfall in staffing. The CSP argues that this is limited as a measure and that a more accurate and revealing measure is a comparison of the shortfall in staffing numbers against a calculation of staffing requirements to meet the needs of the population in line with guidance on what patients should receive.
Rachel Newton added that ‘by focussing on vacancy rates only, historic understaffing of all areas of rehabilitation in the NHS is obscured. NHS England must work with professional bodies and unions to establish realistic staffing requirements to deliver services that meet quality standards and guidance on provision’.
Poor retention, burnout and discrimination
The report highlights how staff shortages are a vicious cycle, contributing to burnout and poor retention, and impeding the ability to educate and supervise those in training, compounding the staffing issue.
While the report focusses on the rate at which nurses leave the NHS, the same data sources also reveal the leaver rate for physiotherapists and physiotherapy support workers is on a par with nursing with this, and for physiotherapists there is a particularly high proportion of leavers doing so within the first five years of their careers in the NHS.
The report points to the numbers of health service staff who not only leave the NHS but also their professions.
‘The good news for all sectors is that this isn’t the trend in physiotherapy,’ said Rachel Newton.
‘But the difficulties that the NHS has in retaining its physiotherapy staff is a problem for the NHS and a worrying trend in the face of the gap in healthy life expectancy in the population.’
‘There are a number of things that need to happen to turn this around. These include planning for the appropriate level of physio staff, which includes time for workplace training and CPD, implementation of apprenticeships at all levels in physiotherapy, and implementation of flexibly working for physiotherapy staff.'
On top of this, the discrimination experienced by Black and ethnic minority staff in the NHS compared to white staff is a major factor in poor retention.
Ash James said, ‘The report reveals the depressing reality for Black and minority ethnic NHS staff who continue to be more likely than white staff to experience discrimination in the workplace and less likely to be shortlisted for roles or become senior managers.
We must do everything we can as a profession to prevent Black and minority ethnic physiotherapy staff from experiencing the discrimination illuminated in the report and have the same opportunities to develop and progress
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