16 August 2023
The government has published the first-ever NHS workforce strategy. Clive Makombera, RSM UK’s head of NHS, examines the key highlights and considerations for NHS leaders.
The publication of the NHS workforce plan is a landmark moment and heralds a major milestone for the NHS. For the first time, the health service has a plan for meeting its staffing needs based on projections of future demand for care and supply of people resources. This marks what is the first comprehensive long-term strategy for the NHS workforce, and this is an integral development to help overcome the current workforce crisis.
The plan comes after years of NHS staff shortages, as well as existing staff being stretched thinly, with parts of the health service striking over the staffing crisis.
Analysis by the OECD shows just how much a new approach is needed. It compared the UK to international healthcare systems and found the UK has strikingly low levels of key clinical staff, with fewer doctors and nurses per head than most of its peers.
More than 13,000 doctors who trained in the UK worked abroad in 2020, according to OECD data, and the exodus appears to have worsened since then. Figures from the General Medical Council shows that last year alone, 4,843 doctors emigrated to practise medicine.
Currently, half of new doctors and nurses must be recruited from abroad as the UK supply route has struggled to keep up with demand. One out of every 10 posts remain unfilled – totalling more than 110,000 vacancies. Without action, this could rise to 360,000 by 2037, modelling for the plan suggests.
To help address these challenges and achieve the goals of the workforce plan, the government has promised £2.4bn over the next five years. The targets for 2031 include:
- doubling medical school places for student doctors, to 15,000 a year;
- a 50% increase in GP trainee places for junior doctors; and
- 24,000 more nurse and midwife student places a year - close to double the number now.
One of the key elements of the new NHS long-term workforce plan is a widening of NHS capacity for homegrown staff. By 2031, annual places for medical students in England will rise from 7,500 to 15,000, GP training will increase by 50%to 6,000 places, and adult nurse training places will almost double.
The plan aims to reduce reliance on expensive agency spend, which would cut the bill for taxpayers by around £10bn between 2030 and 2037.
The plan will focus on the retention of staff, with better opportunities for career development, improved flexible working options, and government reforms to the pension scheme. It’s hoped will keep 130,000 staff working in NHS settings longer.
While publishing the workforce plan is a significant step forward, making it work in practice will depend on broader action and investment from government and NHS leaders. Leaver rates among NHS staff are close to record levels. Last year alone more than 40,000 nurses left the NHS. Training more staff is essential, but this will be little good if the NHS is unable to retain the staff already in the system.
NHS Leaders must ensure that there is a major drive on retention - including more flexible-working options, career development to provide clear routes to senior jobs and greater focus on measures to improve staff experience, including flexible working, changing culture and working conditions.
The ambitions around apprenticeships and degree apprenticeships are increasingly important. The NHS is the biggest provider of apprenticeships in the country, and we have seen through our work at RSM, the impact that degree apprenticeships can make. The government will need to ensure that all areas of apprenticeship policy support the apprenticeship ambitions in the workforce plan.
The plan rightly highlights how AI might be used to improve logistics and scheduling, equipment, facilities and patients as seen in community and social care services in Shropshire and Surrey already. Digital investment in the NHS will be an integral enabler to delivering the ambitions of the plan.
Once this plan for the NHS has been published, the government will need to mobilise quickly to create a similar plan for social care, with its own funding and associated projections. This will be pivotal to achieving the ambitions in this NHS plan.
How RSM can help
At RSM, our workforce management team works with a range of organisations to help them to optimise their human resource (HR) function and maximise the way staff work throughout the employee lifecycle. They also support organisations to identify strengths and priority areas across their HR function, identifying potential transformation programmes and associated return on investment (ROI) to support the people strategy. This enables process redesign, business case benefit calculations, and building a case for change.
This article is a collaboration with contributions from David Gibbens, head of HR consultants, and James Whybrow, apprenticeships consultant.