What are the biggest issues facing the NHS and what has Liz Truss promised to do to fix them?

·5-min read
NHS staff on a ward (File photo)  (PA Wire)
NHS staff on a ward (File photo) (PA Wire)

No Prime Minister in the 21st century has faced a tougher in tray.

With inflation soaring, families facing £5,000 annual energy bills and a war in Europe, the scale of the challenges facing Liz Truss would test a seasoned leader.

The state of the NHS will be among Ms Truss’s priorities in Government. The latest figures make for grim reading: there are 6.7 million people waiting for routine hospital treatment, record waits for ambulances and thousands of patients waiting more than 12 hours to be admitted to A&E.

Bubbling underneath the surface is an exhausted and demoralised workforce, severe staffing shortages and a broken social care system in desperate need of reform.

During the two-month leadership contest, Ms Truss made only vague pledges on the NHS – but the issue could soon consume her premiership. Therese Coffey, the current minister for work and pensions and a longtime ally of Ms Truss, is tipped to take over the health brief.

The Standard looks at the crisis facing the health service and what the incoming PM has promised to do to fix it.

Staffing shortages

Around one in 10 full-time equivalent posts in the NHS in England are currently vacant – the highest proportion since current records began in 2018. Staff shortages, which are spread across various healthcare sectors and regions, lie at the core of the problems in the NHS.

MPs and union leaders have warned that the shortages have a direct impact on patient care. In July, a report released by the cross-party Health and Social Care Committee said that the “persistent understaffing of the NHS now poses a serious risk to staff and patient safety both for routine and emergency care”.

Current Health Secretary Steve Barclay has pledged to ramp up recruitment of foreign workers to plug staffing gaps, according to the Guardian. This could pave the way for nurses and dentists from countries such as India, Sri Lanka and the Philippines to come and work in the UK.

But James Buchan, a senior fellow at the Health Foundation thinktank, told the newspaper that recruiting staff from overseas would only “plug the gap short-term” and “should not distract from the need to train and retain more nurses in the UK”.

It is unclear whether Ms Truss and Mr Barclay’s successor will pursue the policy once in Government.


Discontent with pay and working conditions is growing among NHS staff. Later this month, some 100,000 NHS workers in England and Wales in the Unite union will be balloted for industrial action after being offered a “miserable” 4 per cent pay offer. The Royal College of Nursing is also balloting its members for strikes over pay after demanding a 10 per cent pay rise.

The potential strikes pose a political headache for the incoming health minister, as they have widespread public backing. A YouGov poll released last Friday found that almost two-thirds of the public support nurses taking strike action.

But Ms Truss has so far taken a hard line on strikes. Last month, she told the Daily Express that she would introduce new laws to make it more difficult for workers to strike in the wake of widespread industrial action on Britain’s railways.

But maintaining her tough stance faced with a nursing strike backed by public opinion could prove politically difficult.

 (AFP via Getty Images)
(AFP via Getty Images)

Record waits for ambulances and in A&E

Accident and emergency departments in England had one of their worst months in July, with record numbers of patients waiting more than 12 hours to be admitted.

Ambulances, meanwhile, took an average of 59 minutes and seven seconds last month to respond to emergency calls - up from 51 minutes and 38 seconds in June and well above the target of 18 minutes.

The reasons for the crisis are complex. A lack of social care provision has meant that nearly 13,000 medically fit people a day are not discharged from hospitals in England, in turn creating a shortage of spare beds for emergency staff to transfer patients to.

Ambulance crews waiting to hand over their patients to A&Es cannot be sent to other incidents – leading to delays for critically ill patients calling emergency services.

To combat the issue, Ms Truss has backed shifting £13bn of healthcare spending to social care, claiming this would help free up capacity in hospitals.

“We have people in beds in the NHS who would be better off in social care. So put that money into social care,” she has said.

However, health leaders have criticised the plan. Victor Adebowale, chair of the NHS Confederation, on Sunday claimed that Ms Truss’s proposed diversion of funding from the NHS to social care was not “good enough”.

While he acknowledged that problems in social care were “blocking the system”, he told Times Radio that it was “not a choice between one or the other”.

Hospital waiting lists

The Covid pandemic caused treatment wait times to soar as operations were cancelled to deal with those suffering from the virus.

The latest NHS England figures show that the number of people in England waiting for routine hospital treatments stood at a record 6.7 million at the end of June. It has sparked fears of a two-tier system as more wealthy patients seek out private healthcare while others are forced to wait for NHS care.

To help tackle the waiting list, Ms Truss has vowed to halt the exodus of doctors from the NHS by reforming pension rules that are causing many medics to retire early. Under rule changes introduced in 2016, people who earn more than £110,000 face higher taxes on pension contributions.

The rules mean doctors have been turning down additional shifts and retiring early because taking on extra hours can see them hit with an increased tax bill of tens of thousands of pounds.

A source told the Daily Telegraph that Ms Truss would consider changing the rules to allow doctors to continue working after reaching their lifetime pension cap.