The NHS workforce plan is welcome but lacks detail and funding
Prime Minister Rishi Sunak speaks on the NHS Workforce Plan (Credit: Associated Press / Alamy Stock Photo)
The much-delayed publication of the NHS workforce plan is an important moment, and undoubtedly a positive step to have the scale of the NHS staff shortage – including sky-high nurse vacancies – recognised.
This recognition and transparency has been a long time coming, and speaks directly to the need for legal and ongoing accountability for workforce at government level. It is remarkable that this is the first time a comprehensive workforce plan has been produced for the NHS, but the detail and specific funding allocations that are yet to come will be crucial to make it a reality.
The Royal College of Nursing has been calling for years for a fully funded workforce plan to begin to address the systemic and urgent shortage of nursing staff. Vacancy rates remain high, with over 40,000 nurse vacancies in the NHS in England. While the workforce plan sets out ambitious ideas for training, there is little detail on how this will be delivered and how the £2.4bn of funding will be spent.
While the workforce plan sets out ambitious ideas for training, there is little detail on how this will be delivered and how the £2.4bn of funding will be spent
Expanding training places is key, but to make this happen we need to ensure sustainable funding for an academic and clinical education workforce – and free up the capacity of experienced nurses to be able to supervise and support nursing students. The plan says it will work with stakeholders to ensure clinical placements are made available, but this does not address any of the systemic issues around the dire lack of experienced staff to supervise students.
Much has also been made of the apprenticeship route into nursing. But apprenticeships rely on the same pool of clinical placements as students taking the university route. So again, while there may be more training places, it doesn’t mean there will be the capacity in the existing workforce to train them.
While the degree apprenticeship route has been earmarked for more than a fifth of new nursing recruits, many of those undertaking apprenticeships are already nursing support workers or nursing associates. So not only will we have fewer people doing these roles when they qualify as registered nurses, there is no commitment to funding which would pay backfill for temporary staff to cover their role while they’re training.
The plan also continues to devolve training expansion and workforce decisions to integrated care systems and the higher education sector. But before that happens the government must address key issues that the local system has no power over, such as inadequate pay and funding, and measures to increase local supply.
The plan does nothing to address how nursing will be made an attractive profession to join in the first place. Applications to study nursing have fallen since 2021 and there is a daily exodus of experienced nurses. Without increasing pay to attract people and prevent more from leaving, training places will be empty and vacant posts will remain unfilled.
The other important point is that this plan is only for health and does not address social care, leaving a vital jigsaw piece missing in ensuring a sustainable nursing workforce.
Workforce planning needs to be made a legal requirement for government to address – and it is essential government works collaboratively with nurse experts. Otherwise we risk losing a beloved institution that can’t be salvaged – with a sicker and less economically productive population as the outcome.
In its 75th year, the NHS continues to be a source of national pride, and we all want it to remain that way. So I say to you all: show you are as committed to it as those who work in it are committed to their patients. Make sure that the workforce plan is the start of a detailed and fully funded process to address the workforce crisis. Then the NHS can continue towards a happy and healthy centenary.
Patricia Marquis, Director for England at the Royal College of Nursing
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