Clinicians are exiting the NHS at a faster rate and in greater numbers than ever before. This is not hearsay: recent BMJ polling suggests that 1 in 5 medics are seriously considering a different career. Many cite the stress of working through the pandemic and ongoing excessive workload as primary drivers of exit. 
For all the talk of recruitment drives and new training places, we’re staring a shortfall right in the face. There are almost 90,000 vacancies across the NHS, and, according to the latest staff survey, two thirds of staff believe that they cannot do their job properly as a result. This is not just financially draining, it’s a threat to patient safety and to the wellbeing of the overstretched staff and doctors that remain. 
It’s clear to see that workforce reform and pressure-relieving efficiency measures ought to be pursued as a priority if the NHS is to swerve the impending staffing crisis. But, of course, it’s never going to be possible to retain every single worker. Contrary to popular belief, pay rises are not a panacea.
What clinicians really need are solutions that alleviate the root causes of stress, dissatisfaction and burnout in the sector. We need to dig deep into the multifaceted issues that are driving the doctor exodus, so that we can build solutions to transform the lives of clinicians and their patients. 
Digital solutions for analogue problems 
Since the start of the pandemic, we’ve seen countless examples of how digital solutions can be leveraged to incredible effect in the NHS. I believe that the power of digital can also heal some of the organisation’s most chronic pain points, including those that fuel staff exit. 
For example, throughout my own 13 years spent working as an ENT surgeon, it was abundantly clear that the entire patient referral system was stuck in an analogue age. 
Writing letters for referrals was incredibly slow and inefficient and wasted valuable time. Subsequently, cases moved slowly and sometimes patients would slip through the net. Most frustratingly, thanks to broken chains of communication between the different arms of the NHS, primary care clinicians seeking advice and guidance were more often than not left with no option but to send their patient to overstretched A&E departments. This made the system sluggish, exacerbating long A&E waiting times and contributing to care backlogs. Lots of these issues remain to this day and contribute to clinician burnout, by leaving primary and secondary care frustrated at the inefficiency of the systems they must operate within.
In this age of incredible technological progress and potential, there is no reason why we cannot apply cutting-edge innovation to make accessing specialist advice in the NHS much smarter from start to finish. For a start, we can replace letters, emails and phone calls with multimedia instant messages and secure direct-to-mobile communication. Then, we can make sure that all communication is automatically saved and uploaded to patient records, guaranteeing that nothing gets missed and the admin burden on doctors is significantly lessened. Finally, we can hardwire expert knowledge regarding treatment pathways directly into digital systems, meaning that best practice can be easily adhered to and experts in various fields can be accessed quickly.
These are not ‘nice to have’ modernisations. They are the changes that can really make a difference to the everyday working lives of NHS staff, and the factors that impact their stick-or-quit decisions. That’s exactly why streamlining intra-NHS collaboration and modernising care delivery were the top priorities and the goals behind the creation of Cinapsis, the clinical communications platform I launched in 2018.
Empowering clinicians is the secret to retaining talent 
It won’t come as a surprise that the majority of NHS staff don’t want to leave their roles. It’s the shortcomings of the system that makes many feel they have no choice. What they really want is to work in an environment that allows them to do the very best for their patients without sacrificing their own mental and physical wellbeing. They want to share and exchange knowledge with their colleagues, to see proactive rather than reactive care delivery, and to feel supported when they show up to do their job.
When we hand clinicians the tools that make this a reality, we multiply the number of patients who directly benefit, and we increase the amount of time and resources saved for those who need it most. And crucially, by empowering clinicians with tools that help them do their jobs effectively, we eventually retain their talent, their passion, their experience and their knowledge. 
From tackling the still-mounting elective care waiting list to overhauling internal communication systems, the coming years will be make-or-break for the NHS as we know it. To give the organisation a fighting chance of emerging stronger, we need to stop hand-wringing about medics leaving the profession and instead focus our energies on understanding and fixing the problems that drive them to leave in the first place. 
Ultimately, by listening carefully and innovating quickly, we can harness and galvanize our clinical talent instead of watching it leach out of the NHS for good.  Dr Owain Rhys Hughes
 www.cinapsis.org