A recruitment and retention ‘crisis’ in the UK’s healthcare profession must be tackled if the nation is to achieve the United Nations (UN) Sustainable Development Goal (SDG) targets for Health and Wellbeing, according to a new report by University of Strathclyde.

The report found that although the UK has access to universal health care, there are significant causes for concern in relation to health inequalities, non-communicable disease and the recruitment and retention of health care workers.

However, the UK performs well on the low numbers of infant and maternal mortality, as well as deaths in road accidents.

The study, written by the University of Strathclyde’s Centre for Sustainable Development, is a chapter in Measuring Up 2.0, a review of the UK’s performance in attaining each of the 17 SDGs, produced by Global Compact Network UK.

The chapter on Health and Wellbeing, which is SDG 3, recommends:

  • tackling inequalities in health as a priority
  • developing and implementing an urgent plan to address the crisis in recruitment and retention of health care workers
  • promoting and investing in the full spectrum of health issues across preventative and curative health services and at all stages of life
  • developing more specific cross-sectoral action plans which are adequately resourced to reduce premature mortality across non-communicable diseases, alcohol, and substance abuse
  • providing a policy and structural environment which is conducive to cross-government and cross-sector action for the benefit of all, especially those being left behind
  • promoting effective learning, from both successes and failures, within and outside the UK to accelerate positive change and action.

The COVID-19 pandemic has brought many health inequalities “into sharp relief” and particular attention should be given to the principle of “leaving no one behind”, the report suggests. In the context of SDGs, this means ensuring the overlap is not overlooked between Health and Wellbeing and other Goals, notably those relating to poverty and inequalities.

The recruitment and retention of health professionals has been “potentially exacerbated by burnout and low morale arising from excessive workloads and press and public criticism following adverse events.” The report adds that “efforts are needed to foster trust between professionals and clients across the health sector and working conditions must be provided that enable professionals to give their best at all levels.”

One area in which inequalities are highlighted is pregnancy and childbirth. Although pregnancy overall in the UK remains very safe, the report finds that black women are four and a half times more likely to die during pregnancy and childbirth than white women, while women living in the most deprived areas of the country are twice as likely to die in pregnancy and childbirth as those who live in the least deprived areas.

Despite the successes of the COVID-19 vaccination programme, vaccination coverage as a whole gave rise to concerns. In 2020-21, for the third consecutive year, no routine vaccinations met the World Health Organization’s (WHO) 95% coverage target. However, the report notes that a number of factors, including “vaccine deniers,” reduced health service access, and school closures during the pandemic, may have contributed to this.

It also warns about the “deprivation gap” in obesity, which, if current adult trends continue, will increase by more than half in England and Scotland, while children living in the most deprived areas are more than twice as likely to be living with obesity as those in the least deprived areas. Concern is also raised over lower respiratory infections, with current air pollution estimated to reduce life expectancy by seven to eight months. National targets on smoking have been found to be “currently off track,” despite major policy changes, notably bans on smoking in public buildings.

“The report states: “It is essential that we do not go back to the status quo of early 2020, and must instead emerge from the pandemic seeking to build a fairer and more equitable society and health care system, with wellbeing at its core.” 

Lord McConnell, Co-Chair of the All-Party Parliamentary Group on the UN Global Goals, said: “No one doubts that the economic and security situation facing the world is very serious, but that is a reason to use the Sustainable Development Goals as the framework for recovery, not a reason to roll back on our ambitions agreed in 2015.”

“National and local government in the UK need to up their game, setting out clear targets and measuring their impact. We cannot afford to leave more people behind, at home or around the world.”

Strathclyde’s Centre for Sustainable Development brings together all of the University’s education, research and knowledge exchange activity on sustainable development within a single strategic approach. The Centre prioritises education and awareness-raising of sustainable development, applies and builds expertise and research capacity in sustainability, grows international partnership working and contributes to and benefits from knowledge sharing and thought leadership.

Strathclyde is a signatory to the SDGs, which the UN has set to pursue justice, peace, good health, responsible use of resources and the eradication of poverty and hunger.