THE NHS is broken, but it is not beaten. We know this as citizens and patients, but no-one feels it more keenly than our members — the staff who hold it all together. 

The NHS in England alone employs 1.5 million people — people who care, who fix us, who research and develop new ways of keeping us healthy. They feed us, wash us, pick us up when we are broken. They are very important people — workers who deserve better.

Much of the ambition of the NHS 10-year plan is to be welcomed, but it will not succeed unless the government takes immediate action to retain existing staff. The NHS faces over 121,000 vacancies in England alone. Poor pay, work-related stress, and limited progression opportunities continue to drive staff out of the service, undermining delivery of the 10-year plan.

The ambition to prevent illness and tackle inequality must be matched with the investment, workforce planning and infrastructure needed to deliver it. Many of the services mentioned, from personalised care planning to community rehabilitation, require a properly resourced dietetic workforce. Yet right now, vacancies across the profession remain high, and there is insufficient capacity in many areas to meet existing demand, let alone expand provision.

Workforce retention must be a national priority. The latest NHS staff survey showed 44.8 per cent of respondents had felt unwell due to work-related stress. Over the past 16 years, many NHS staff have seen a real-terms loss exceeding 20 per cent, fuelling record vacancies and undermining safe staffing.

The disaster created by previous health secretaries such as Andrew Lansley needs sorting out. We had hope when the government announced the abolition of NHS England he created in 2012, but the announcement was handled without any prior warning or engagement with unions or staff, leaving members employed at NHSE shocked and with uncertain futures. 

However aspirational a plan looks on paper, it won’t work without fixing the staffing crisis. Without a meaningful plan for the workforce, none of this will be effective and any plans for the workforce must be subject to a full and meaningful consultation with health unions.

NHS workers have had enough. British Dietetic Association (BDA) members accepted a 3.6 per cent pay award this year — not because they are happy with it, far from it, but because they are resigned to it and frankly too exhausted and demoralised to fight. 

We engaged in the pay review body process this year to give a new Labour government the benefit of the doubt and one last chance. Well, last chance it was, so we are now disengaging and want a new system that includes collective bargaining.

Our members are working thousands of hours of unpaid overtime. Why? Because they care about patients, they are committed, skilled and kind.

Leadership is poor, accountability is lacking and vacancies remain too high. Pay has fallen year on year with many staff seeing real-terms losses of over 20 per cent in the last 16 years. Safe staffing remains an aspiration and CPD and flexible working are out of reach.

Pay and reward is vitally important, but we need to see a well-trained, properly supported workforce with career progression opportunities. We must address vacancies and we must have the right staff in the right place, in communities, primary care, mental health and acute hospital settings.

So, change is needed and needed fast. The delivery of the plan depends on it. It is so often said that the NHS belongs to us all and that we should all be very proud of it — it is the “jewel in our crown.” All true, but it will not continue unless we value the true jewels, those who work tirelessly every day and every night to look after us.

Annette Mansell-Green is director of trade union and public affairs at the British Dietetic Association.