NHS staff crisis 'worse than cash woes'
The growing crisis in workforce morale is a greater risk to the NHS than the financial problems it is grappling with, a leading health expert says.
Nigel Edwards, chief executive of the Nuffield Trust think tank, warned staff shortages, disputes with government and bullying were creating a "toxic mix".
He said if the problems persisted, the affinity staff felt for the NHS could be irreparably broken.
The warning comes amid growing tensions between the workforce and ministers.
This year has seen a series of strikes by junior doctors in England, while nurses and midwives have been protesting about plans to scrap the bursaries they receive while they are studying.
Mr Edwards said this industrial unrest was happening at a time when there were looming shortages - last month, a report by the Public Accounts Committee warned the NHS was short of about 50,000 staff out of a front-line workforce of just over 800,000.
The most recent staff survey - published earlier this year - also highlighted the problem, with only 31% of respondents saying there was enough staff for them to do their jobs properly.
The Nuffield Trust also pointed to feedback it had received from health managers warning about deteriorating morale and uncontrollable growth in workload.
One manager said there was a "creeping sense of inevitability and acceptance that failure will happen at some point".
Mr Edwards said the care and compassion of health workers was underpinned by a "psychological" contract.
He said while financial problems - last month it was revealed NHS trusts had overspent by a record £2.45bn in 2015-16 - could be rectified in time, deteriorating morale was harder to fix.
"Once the psychological contract with staff is broken, it may be impossible to reverse," he added.
Siva Anandaciva, of NHS Providers, which represents NHS trusts, said he shared the concerns.
"This is a pivotal time for the NHS, with extreme financial and capacity challenges putting extra pressure on staff," he said.
"Perhaps inevitably, staff morale can take a battering."
A Department of Health spokeswoman said there were signs in the staff survey that some measures were improving.
She added: "Good leadership is the single most critical ingredient to raising morale in any team.
"We also see that the best hospitals combine tight financial grip, an unrelenting focus on improving patient care and high levels of staff engagement."