News / Analysis reveals scale of training challenge

Analysis by the Health Foundation has revealed the scale of the challenge facing universities and healthcare providers in meeting a 50,000 increase in clinical student intake. This workforce plan would see 125,700 students start their clinical training in 2031/32, up from 76,300 in 2022/23 (not including GP specialty trainees).

The analysis assumes that student numbers overall will continue to increase by just 1.1%, in-line with the average in the years running up to the Covid pandemic. If this is the case, clinical students would account for one in six of all students starting higher education by 2031/32, compared with just one in nine currently.

The biggest increase would be in nursing and midwifery students, which would account for 9% of the projected total of all first-year enrolments by 2031/32 – a 3.4 percentage point increase on the current proportion.

The Health Foundation looked at three aspects of the feasibility of the planned expansion. First it said there was a simple capacity challenge for both universities and NHS providers in providing both the classroom and clinical placement elements of the training. It pointed out that the long-term workforce plan had noted that ‘a lack of capacity and supervision has long held back growth in clinical placement numbers’. Addressing this will take ‘sustained discussion and action on behalf of the government, NHS England, NHS providers and universities’.

The proposals will also require an urgent and significant increase in trainer or educator numbers and improved retention of this workforce, the think tank said. Even with simulation-based learning taking some of the strain, the recently proposed educator workforce strategy will need to be implemented effectively.

Finally, the Health Foundation considered the potential supply of applicants to clinical training. With the 18-24 age group projected to grow from 4.4 million to around five million between 2023/24 and 2032/33, the long-term plan is well timed. This should mean that the increased numbers taking up clinical training could have a smaller impact on those available to join other professions than they might have done, it said.

‘Nonetheless, some other sectors may face challenges in recruiting sufficient numbers of university-educatied workers relative to demand in the years to 2031/32 if the long-term workforce plan commitments are fully implemented,’ it added. And after 2032/33, the current trend reverses and the number of 18-24 year-olds is projected to fall, which could have implications for the quality of applicants for clinical roles and the numbers available to work in other sectors.

The foundation said there was a question mark over whether the number of placements could be increased at sufficient pace. And it called for more details on how the funding – just £2.4bn of which has been announced up to 2028/29 – will be phased.

Nihar Shembavnekar (pictured), economist at the Health Foundation’s REAL Centre, said the NHS long-term workforce plan was rightly ambitious about increasing the number of trained NHS staff. ’However, the implications for universities and health care providers, and the speed at which they will need to increase capacity for training health care workers, should not be underestimated,’ he said. ‘Boosting healthcare training places is vital to address chronic staff shortages and meet the future needs of the NHS, but it is just as crucial to improve staff retention.’

He added: ‘The government should also commit to the long-term capital investment needed to give the NHS the modern buildings, equipment, and technology it desperately needs to make the plan work.’