NHS plans criticised for lack of detail on staffing and recruitment

Experts unhappy with delay to discussion of workforce issues, as government unveils objectives for £20bn annual budget

The highly anticipated plan for the long-term future of the NHS has been published, but industry experts have criticised a delay in the details around how a new workforce strategy will support its delivery.

Prime minister Theresa May billed the document, which was scheduled to be released last month, as an “historic step” to secure the future of the health service. 

The 10-year plan sets out how the £20.5bn annual budget will be spent, and the government promised it would focus on benefiting patients while helping relieve pressure on already strained hospitals. 

The plan prioritises improved access for mental health services, expansion of personal health budgets, improvements to maternity care and support for the ageing population in England, with other parts of the UK being funded separately. However, the government announced the vital details on workforce planning will be published “later this year”.

In a statement on the NHS England website, chief executive Simon Stevens said that “funding, staffing, increasing inequalities and pressures from a growing and ageing population” were concerns, and the long-term plan “tackles head-on the pressures our staff face”. 

However, experts have criticised the new plan, saying it failed to address the “harsh realities” caused by difficulties in recruitment and increased pressure on staff. 

The Royal College of Nursing (RCN) warned that England “is already short of more than 40,000 nurses, and the figure is rising”. Dame Donna Kinnair, acting chief executive and general secretary of the RCN, called on NHS England and the government to “urgently address” [these] chronic shortages to make the plan the success it deserves to be”. 

“When existing services are already under strain, NHS staff are waiting for a further plan to address the extra staff needed to keep care at the highest quality,” Kinnair said.  

“If the NHS is to better meet the needs of patients and the public in these important areas of mental illness, cancer and long-term conditions, it must recognise the value of the highly skilled and qualified nursing workforce and the harsh realities on the NHS frontline.”

Niall Dickson, chief executive of the NHS Confederation, expressed disappointment in the delay to the workforce planning strategy, saying the NHS needed the “right staff with the right skills” to meet the government’s ambitions for the next decade. 

"With 100,000 vacancies across the NHS in England, even if you gave the health service its £20bn up front, it would not be able to provide the care people need,” Dickson said. 

Nuffield Trust chief executive Nigel Edwards said the NHS’s system of workforce planning has “failed”, and that it needs “deep reform”.

"However, the biggest levers to resolve the workforce crisis are out of NHS England’s hands,” Edwards added. “Only bold policies on training, immigration and Brexit can deliver enough nurses, GPs and therapists for the next few years.”

In November, the Cavendish Coalition – set up to examine the effects of Brexit on staffing in the health and social care system – forecast a shortage of between 5,000 and 10,000 nurses by 2021. This was on top of existing vacancies, which currently stand at 41,722. 

The organisation warned that health and social care services relied heavily on staff from the European Economic Area (EEA), and estimated more than 5 per cent of the regulated nursing profession, 5 per cent of allied health professionals, 9 per cent of doctors and 16 per cent of dentists came from inside the EEA. 

Its report recommended international recruitment should form part of a costed workforce strategy.

But the newly announced plan pointed out that additional investment in training, education and continuing professional development had not yet been formally agreed by the government. 

Stevens told BBC Radio 4 there had been a 25 per cent increase in medical school places and five new medical schools in order to alleviate immediate concerns over recruitment, adding: “We want to see a big expansion in the number of nurses in training and undergraduate programmes.”

The General Medical Council (GMC) suggested the UK should consider migrant workers in future workforce planning after a poll revealed many doctors were considering quitting the NHS or cutting their hours because they felt stressed or overburdened.

Its research revealed almost two in five (38 per cent) practising doctors were considering either going part-time or reducing the hours they worked; a fifth (23 per cent) said they had thought about practising abroad; and 14 per cent considered moving to the private sector. 

The GMC said non-UK workers presented opportunities to support NHS locations that were short of doctors as migrants joining the workforce may have higher mobility when they first came to the UK.