Could this be the lifeline the NHS has been needing? Unpacking the NHS Workforce Plan
By Ellie Anderson, Junior Consultant
Unveiled on Friday, the government released their NHS workforce plan, aimed at addressing the staffing shortages within the Service and the issues it now faces, with Britian shifting in its healthcare needs, as an ageing and rapidly changing population.
On the face of it, this is a comprehensive and well-thought-through set of proposals targeting staffing shortages by committing 60,000 more doctors, 170,000 more nurses, and 71,000 more allied health professionals, an increase of 430,000 staff by 2037.
Without question, this will be the most significant increase in staff in NHS history, as it marks its 75th birthday later this week. Detailing how it intends to deliver the proposals, the report has committed to expanding training courses across different sectors of the Service, increasing GP training by 50%, adult nurses by 92%, pharmacists by 29%, dentists by 40%, dental therapy and hygiene professionals by 28%, and healthcare scientists by 13%.
This is in addition to offering retired consultants the option of returning to the NHS on the Emeritus Doctor Scheme, due to begin in September 2023.
The overriding theme of the document was clear: to move away from the recruitment of, and reliance on, foreign staff. The total proportion of NHS workers from overseas has grown to more than 17% in recent years, with the report conceding that it was "particularly reliant on international recruitment" to fill workforce gaps across the NHS as a whole. This comes as figures show only 2% of UK-trained medical graduates joined the NHS between 2017-2023. By comparison, there has been a 121% increase in international medical graduates joining the Service, with over 50% of doctors joining the workforce in 2023 coming from overseas.
To address this, the plan has outlined a set of detailed and ambitious targets aimed at decreasing the amount of overseas staff to just 9-10%, with plans instead to train future NHS staff domestically. This includes training 22% of future staff by apprenticeships, including over 2,000 doctors. By introducing the 'earn while they learn' initiative, the plan hopes to see medical staff enter the profession sooner than they otherwise would, gaining a full degree as they work towards a full qualification. Under the plan, one in six clinic staff will be trained this way by 2028, including 850 medical students.
Faced with challenges unseen since its creation, the government has hailed this plan as a 'lifeline'. With a rapidly growing and ageing population, there are projected to be 1.42 million more households headed by someone over 85 by 2037, which is an increase of 161% over 25 years. With this new and added strain on the NHS, the measures outlined in the plan are seen by many as a way of addressing the emerging issue by recognising the shortfalls in staffing.
With the timing of the plan coming as the general election looms, this will be seen by many to be a politically motivated move, with Jeremy Hunt first calling for a blueprint of this magnitude to be unveiled over five years ago. As much of the NHS threatens strike action, in lieu of a staffing crisis and pay levels, the plan goes a long way in addressing some – though crucially not all – of the concerns raised; omitting pay from the document.
Welcoming the plan, in what he saw as an adoption of Labour's plans, Shadow Secretary of State, Wes Streeting, has asked why the proposed measures weren't implemented sooner. Nodding to the 13 years the Conservatives have now been in power, Streeting argued that the government should have done this over a decade ago, 'then the NHS would have enough staff today'.
The plan has seen further criticism from the General Secretary of Unite, Sharon Graham, who questioned the omission of pay from the plan itself. As one of the UK's largest trade unions for health workers, she expressed concern over the current wage structures, arguing, "If there is not enough money to pay NHS staff a decent wage now, and transform current wage structures, then all the aspirations for more staffing in the training plan will fail to address the current crisis in the recruitment and retention of staff".
The plan has been widely regarded as a necessary move by the government to address the issues facing the NHS, including by leading health experts, think tanks, and others within the industry. With the CEO of the NHS, Amanda Pritchard, praising it as a 'first step in a major and much-needed expansion' of the workforce.
Where the caveat comes, however, is the plan relying on an ambitious labour productivity assumption of up to 2%. With much of the NHS still reeling from the COVID-19 pandemic, with around 371,000 patients waiting over a year for treatment - an increase of 292 times as many patients as pre-pandemic - much of the labour productivity relies on a workforce already tired and likely burnt out. Moreover, though the plan addresses much of the future concerns of the NHS, it does little to bring comfort to short-term issues facing the Service. With NHS hospitals collapsing, needing a £10bn repair service to address the current issues, waiting times for ambulances reaching their worst on record in January this year – levelling off at 93 minutes with patients requiring an ambulance for a stroke, severe burns or chest pains, and junior doctors having suffered real terms (RPI) pay cut of 26.1%, its likely much of the outlined plan will not come to fruition before 2030.
As our NHS turns 75 this Wednesday, it remains to be seen whether this breakthrough is the answer the NHS has sought. What is clear, however, is that this has been a crucial step in supporting the world's 5th largest employer.