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What Is The NHS Workforce Plan And Why Is It Needed?

Chief Executive of NHS England, Amanda Pritchard, Prime Minister Rishi Sunak and National Medical Director of NHS England, Professor Stephen Powis launching the NHS Workforce Plan (Alamy)

7 min read

Prime Minister Rishi Sunak has launched the NHS Workforce Plan, a 15 year strategy to overhaul the staffing of the health service.

Health Secretary Steve Barclay has promised a "radical modernisation" to help "tackle the pressures on staff that the NHS has faced in every decade of its existence". 

Relations between government and NHS staff have been strained in recent months, as disputes over pay and working conditions have led to industrial action among numerous staff groups. 

Here is a guide to what the NHS workforce plan is, and what it hopes to deliver in the coming years:

What is the NHS workforce plan and why is it needed? 

The document published today is a staffing plan for the next 15 years so that the health service can grow and cope with changing demands. 

Launching the plan this morning, Sunak accused successive Labour and Conservative governments of having “ducked” NHS reform, and said this new plan would “deliver the biggest ever expansion of doctors and nurses we train”. 

It is the first time in the 75 years of the NHS that the government has asked the service to come up with a comprehensive workforce plan, and has been labelled by NHS chief executive Amanda Pritchard as “one of the most seminal moments in our 75-year history”. 

According to the report, the NHS in England currently has more than 112,000 vacancies, but the shortfall in staff is forecast to increase to between 260,000 and 360,000 by 2036/37. 

The number of older people is also expected to grow significantly, with the number of people aged over 85 set to increase by 55 per cent by 2037. Older demographics are more likely to use the health service than any other. 

Writing in the plan’s foreword, Pritchard said that the lack of staff “is already impacting patient experience, service capacity and productivity, and constrains our ability to transform the way we look after our patients”.

She added: “If the NHS is to continue to be the health service the public overwhelmingly wants and are proud of – one which provides high quality care for patients, free at the point of need – it needs a robust and effective plan to ensure we have the right number of people, with the right skills and support in place to be able to deliver the kind of care people need.”

The plan contains lots of details on individual policies and changes that bosses intend to complete over the next decade and a half, but Pritchard said that all of the actions fall into one of three “priority areas”: Train, Retain, and Reform. 

The government has pledged to train more staff

The promise to train is focussed on growing the workforce, with Rishi Sunak pledging 300,000 new staff. 

This will be achieved by expanding the education, training and recruitment programmes as well as providing more variety when it comes to the route into healthcare work, such as apprenticeships. 

The number of medical school training places will be doubled, taking the total to 15,000 a year by 2031/32. 

GP training places will also be increased by 50 per cent to 6,000 over the same time period. 

Meanwhile adult nursing training places will expand by 92 per cent, taking the total to 38,000 by 2031/32. 

The NHS also wants to train more of their staff domestically to “reduce reliance on international recruitment and agency staff”. In 15 years’ time, they expect 9 - 10.5 per cent of NHS staff to be recruited from abroad “compared to nearly a quarter now”. 

More staff should be prevented from dropping out of the workforce

"Retain" is about keeping more staff in the workforce once they have trained. The plan is designed to improve the culture, leadership and wellbeing within the NHS, in the hope that “130,000 fewer staff leave” over the next decade and a half. 

The workforce has been severely depleted in recent years, owing to a number of factors including pay, Brexit, and staff burnout. 

Thousands of staff have left the NHS since the Covid pandemic, retiring or working elsewhere. The Times reported earlier this year that data from the General Medical Council showed that 4,843 people moved abroad to practise medicine last year. 

From this autumn, retired consultant doctors will be able to offer to work to support outpatient care through an NHS Emeritus Doctor Scheme,. 

The plan also contains details on supporting the health and wellbeing of staff and ensuring that services are in place for that, and the NHS will commit to ongoing national funding for training development for nurses, midwives and allied health professionals.

There will also be more flexible options for staff approaching the end of their career and considering retirement, and in addition there are promises to modernise the NHS pension scheme. 

For staff who are parents or who have caring responsibilities, there will also be supported to help access the new childcare support schemes announced by Chancellor Jeremy Hunt at the Spring Budget. 

Government hopes to improve working practices to make better use of staff

The promise to "reform" means looking at different ways of working to increase the amount of time that NHS staff can spend with their patients. 

Among the pledges to reform are an intention to grow the proportion of NHS staff working in mental health, primary and community care by 73 per cent by 2037 to help deliver more proactive care. 

The health service will also work with experts on new technologies including artificial intelligence and robotic assisted surgery. 

Medical schools will also be encouraged to move from five or six year programmes to four year degree programmes so that students can be at university for a shorter amount of time, but still reach the General Medical Council set standards. 

Experienced doctors will also be supported to work in general practice under the supervision of a GP, to increase the numbers working in that area. 

The NHS will also work with regulators and other experts to see if post-Brexit changes and progress in tech means whether nursing and medical students can “gain the skills, knowledge and experience they need to practise safely and competently in the NHS in less time”.

How has the plan been received? 

Labour has accused the government of "adopting Labour’s plan to train the doctors and nurses the NHS needs". 

Shadow health secretary Wes Streeting said that ministers "should have done this a decade ago - then the NHS would have enough staff today.

“Instead, the health service is short of 150,000 staff and this announcement will take years to have an impact.

“Patients are waiting longer than ever before for operations, in A&E, or for an ambulance," he added. 

The Unison union celebrated there being a plan for "at long last" but suggested that the missing element was a promise on pay. 

Sara Gorton, head of health for the union, said that "finding a fix for pay must lie at the heart of any solution" to filling gaps in the NHS workforce. 

"The pay review body process no longer works," she explained. 

"A new way to ensure competitive wage rises, that are paid to staff on time, is essential if there is to be an end to the industrial unrest plaguing the NHS.

"Plans to recruit more doctors and nurses cannot ignore the desperate NHS shortage of porters, cleaners, 999 call handlers and other support roles. Staff in non-clinical jobs are most at risk of being lost from the NHS for better paid, less stressful jobs elsewhere." 

Professor Azeem Majeed, professor of primary care and public health, and Head of the Department of Primary Care & Public Health at Imperial College London raised concerns about the idea of doctors being trained via apprenticeships.

"There are some positive proposals in the NHS England Workforce Plan," he tweeted. "But I disagree with training doctors via apprenticeships.

"When I speak to senior academic clinicians overseas, they say this will make doctors in the UK the laughing stock of the global medical community."

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