At long last there is a plan. Now that the NHS Long Term Workforce Plan has been published (NHS England, 2023), we must all be committed to making our NHS flourish again as we focus on the challenge of filling the massive gaps in the workforce. Retaining staff is key, there are too few staff across all jobs in all aspects of the service. These vacancies make it difficult for the NHS to function as a modern health system.
The King's Fund (2023) has suggested that the publication of the workforce plan could prove to be a landmark moment. This is the first comprehensive long-term strategy for the NHS workforce. It is an essential first step to overcome the current workforce crisis. With a national focus on training and reform, and some initial financial commitment from government to back the plan, it should begin to place the NHS workforce on a sustainable footing.
The workforce plan covers the next 15 years, it is extensive in length, scope and ambition. Nurses are pivotal to the success of this plan and they are a key aspect of it. The plan focuses on three areas: to train, retain, and reform with a commitment to substantially grow the number of nurses, doctors, allied health professionals and support staff, underpinned by a £2.4 billion funding commitment.
Recruitment and retention are key challenges. There are high and growing vacancy rates along with low and falling staff satisfaction. The plan is set to tackle these problems. It aims to fix staffing shortfalls in the service through consulting with the General Medical Council and medical schools with a view to offer a shorter, 4-year medical degree. Along with increasing apprenticeships (earn while you learn), these are radical plans. There do not appear to be any plans to reduce the current 3-year nursing degree. Increasing the number of apprenticeships and nursing associates are important aims, as is growing the domestic workforce. These aspirations have to be backed up with appropriate funding and a well-equipped infrastructure.
Reforming the NHS in England requires a different approach to work; to work differently and deliver training in new ways (using universities to promote retention in the NHS through lifelong learning). Advances in technology and treatments have to be explored further and implemented to help the NHS modernise and meet future requirements.
The plan also outlines how it intends to meet the challenges of a growing and ageing population.
This once-in-a-generation opportunity to put staffing in the service on a sustainable footing will be key to the survival of the service as we know it. There are plans to employ 300 000 extra staff in the coming years. The commitment to review the plan every 2 years and plans to ensure that this process includes an assessment of whether patients feel their access to care is improving, is welcomed.
Plans to recruit more nurses and doctors cannot overlook the dire shortage of porters, cleaners, 999 call handlers and other support roles. Non-clinical staff are most at risk of being lost from the NHS as they seek better paid, less stressful jobs elsewhere.
The absence of proposals to attend to the challenges in social care is a significant omission. Without action to address issues the sector is facing, the NHS will have to continue picking up the pieces of that system. A national care service inspired by the creation of the NHS is needed, publicly owned, publicly funded, free at the point of use. Doing this will help the NHS achieve its ambitions, ensuring people have the care they expect and deserve.
Perhaps if a robust and sustainable workforce plan had been produced 10 years ago, the NHS would, today, have enough staff. The plan is indeed long term, it is a blueprint for the future (Leary, 2023). It will not address the immediate shortages we have in the service today. It does not address key issues such as pay and conditions. A fix for the NHS can only come about where pay and conditions of service are at the centre of any solutions discussed.