Will it deliver the much needed workforce expansion required to meet rising demand?
The NHS's Plan for the next ten years has been broadly welcomed by the health and care sector. But real and palpable concerns have been raised by health commentators, including Nigel Edwards of the Nuffield Trust on issues of staff shortages and the prospect of a no deal Brexit which he comments “threaten” to undermine the ambitious NHS Plan. While he says that the “goals of this plan look right”, he says that the “biggest obstacle of all is the lack of key staff” – calculations show a shortfall of 250,000 by 2030, which would make delivering even current services near impossible”.
However, Edwards suggests that resolving the workforce crisis is out of NHS England’s control – only policies on training, immigration and Brexit can deliver enough nurses, GPs and therapists for the next few years.
So, what is there in the Plan on workforce?
A number of commitments are made in areas of workforce supply, international recruitment, nursing and Continuing Professional Development but there is little detail on funding – we understand that the Government’s Spending Review will detail workforce, education and training budgets.
Workforce headlines
- A new workforce implementation plan will be published later in 2019 once Health Education England’s budget has been finalised.
- The Plan provides for a series of initiatives to increase workforce supply.
- Nursing workforce. The aim is to improve current retention rates and reduce the nursing vacancy rate to five per cent by 2028. A series of initiatives are made to help reduce the nursing shortage from increasing the number of undergraduate nursing degrees, nursing apprenticeships, offering newly qualified nurses a five-year job guarantee, new entry routes such as online qualification and “earn and learn” opportunities, and further expansion of the nursing associates career pathway starting this year.
- Medical workforce. The medical colleges will be working on initiatives to encourage more doctors to train as generalists reversing the current “dominance of highly specialised roles”.
- Existing commitments to increase the number of GPs to 5,000 remains but efforts have been offset by the number of early retirements and part-time working.
- Newly qualified doctors and nurses entering general practice will be offered a two-year fellowship, a scheme suggested by the GP Partnership Review.
- The Government has committed to a new state backed GP indemnity scheme from April 2019 to address the rising NHS indemnity costs.
- International recruitment. The workforce implementation plan will set out new national arrangements to support NHS organisations in recruiting overseas. NHS England has committed to work with government to ensure the post-Brexit migration system provides the necessary certainty for health and social care employers, particularly for shortage roles.
- Supporting current staff. The Plan commits to adopting a modern employment culture for the NHS – promoting flexibility, well-being and career development, and improving efforts to address discrimination, violence, bullying and harassment. Work will continue on changing the culture of NHS organisations with a continued focus on the new Workforce Race Equality Standard and implementation of the Workforce Disability Equality Standard.
- Improving workforce productivity and reducing reliance on costly temporary staff. By 2021, NHS Improvement will support NHS trusts and foundation trusts to deploy electronic rosters or e-job plans.
- A new NHS leadership code and pipeline to support leadership and talent management in the NHS.
- Doubling the number of NHS volunteers over the next three years with £2.3 million investment to scale volunteering programmes across the country.
The Plan acknowledges that new ways of working will need to be adopted by health and care organisations to meet the challenges and demands of the next ten years and avert the workforce crisis.
You can read the NHS Long Term Plan here – Chapter 4 has the detail on workforce issues.
Jog Hundle, Partner
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