Workforce threat to long-term plan

Staff shortages could lead to longer waiting lists, a deterioration in care quality and the risk that some of the additional £20.5bn allocated to the service could go unspent, the King’s Fund, Nuffield Trust and Health Foundation said.

Their briefing, The healthcare workforce in England: make or break?, said the health service risked not having the staff to deliver the long-term plan. It predicted vacancies would rise from more than 100,000 at present to almost 250,000 by 2030 – a vacancy rate of more than one in six. And, if the NHS continues to lose staff and fails to recruit from abroad, the figure could rise to 350,000.

The service’s approach to workforce at national level was incoherent, the briefing said, with poor planning, restrictive immigration policies and inadequate funding for training places. It added that education and training funding fell from 5% of health spending in 2006/07 to 3% in 2018/29 – the equivalent of £2bn. Funding was under further threat as the overall Department of Health and Social Care budget, excluding NHS England and capital allocations, will fall by £1bn in real terms in 2019/20.

The three organisations set out five tests for the long-term plan. They said it must:

·         Address the immediate workforce shortages

·         Deliver a sustainable workforce over the next 10 years

·         Support new ways of working across the health and social care workforce

·         Address inequalities in pay, career progression and recruitment

·         Strengthen workforce and health service planning.

Anita Charlesworth, director of economics at the Health Foundation (pictured), said the NHS was already overstretched and services were being compromised by staff shortages. ‘As things stand, this problem will only get worse over the next decade, putting access and quality of care at risk,’ she said.

‘Unless the government and system leaders take radical action and prioritise the NHS workforce, staffing shortages will more than double to almost a quarter of a million by 2030. The NHS can’t sustain current services, let alone improve, with such a large and growing gap between the staff it needs and the people available to provide care.’

Nuffield Trust policy director Candace Imison said the NHS had a ‘woeful’ record on workforce planning. She continued: ‘This has now reached a critical juncture: unless the NHS long-term plan puts in place urgent and credible measures to shore up the workforce both in the short term and in the longer term, it risks being a major failure. Solving the acute and systemic problems affecting the healthcare workforce will not be easy, but we owe it to patients, staff and taxpayers to start now.’

Richard Murray, director of policy at The King’s Fund, added: ‘The NHS cannot meet increasing demand from patients without the workforce to staff services. Unless the NHS long-term plan is linked to a credible strategy for recruiting and retaining staff, there is a real risk that some of the extra funding pledged by the government will go unspent and waiting lists for treatment will continue to grow.’