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The NHS workforce plan is welcome – but just one part of improving the health service

The NHS workforce plan is backed by Jeremy Hunt and Rishi Sunak – and is a huge commitment to substantial health spending increases.

Nick Davies, Cat Little, and Professor Bart van Ark in discussion on stage at the Institute for Government.
The NHS workforce plan could mean the health service has an extra 60,000 doctors, 170,000 more nurses and 71,000 more allied health professionals in place by 2036/37.

The NHS workforce plan is full of sensible ideas, but Nick Timmins says there are many other steps that need to be taken to improve NHS performance

The oh-so-long awaited NHS workforce plan has finally landed. Perhaps the first and most important thing to say about it is something that it does not itself say. Namely that if all its promises are honoured – a big if – this is a huge commitment to a really substantial increase in health spending.

There is, after all, no point in planning to have some 60,000 extra doctors, 170,000 more nurses and 71,000 more allied health professionals by 2036/37 if you are not going to employ them. Employing them will dwarf the £2.4bn that has been announced today for the first five years of this 15-year plan.

And it is that, of course – the long-term spending implications of training more staff – that has always made the Treasury decidedly wary of such long term plans. However, Jeremy Hunt as chancellor, backed obviously by the prime minister, has overcome that – delivering what Jeremy Hunt the health secretary and Jeremy Hunt as chair of the Commons Health and Social Care Select Committee has long said is needed: a proper plan. If nothing else, that is honourable.

And it is, of course, entirely sensible to have a plan: no business of any size should operate without a good understanding of what its future workforce needs are likely to be. Doing so is not always easy – particularly in an area as complex and evolving as health care.

The NHS workforce plan is for 15 years – but will need to be constantly refreshed

Technology has always driven medicine and is arguably driving and changing it faster today than ever before. In the past the arrival of keyhole surgery and of interventional radiology changed, over a remarkably short number of years, the skills and staff numbers needed for a wide range of procedures. Robotics is starting to do the same, as is AI – which will clearly change the management of health as well as its procedures. A little like the general’s cliché that the best laid battle plans rarely survive entirely intact after the first contact with the enemy, so a workforce plan can very rapidly look out of date unless it is constantly refreshed.

Which makes the promise to revisit this every couple of years a good one. Needs, and thus staffing numbers, will change and the plan will need to adapt continuously to that.

As for the plan itself, at the first glance much looks very sensible. Not just the additional doctors, nurses and other staff but the additional ways, such as apprenticeships, to get into these roles. More medical and clinical schools will in time have economic benefits for the places in which they are located. Implementing all this will, of course, be a challenge. Training doctors, for example, is not just a case of getting them through medical school but creating good on-going training in the junior doctor years that lead to consultant and GP appointments.

Workforce planning is crucial – but is only one part of improving NHS performance

And it is equally true and obvious that the immediate impact of this will be limited. There are some measures to seek to improve retention, but it does not, by definition, resolve the acrimonious on-going pay disputes in the NHS. Implemented well, it could well improve NHS productivity in the long run. But as the Institute for Government’s recent report on the NHS productivity puzzle makes clear, there is much else that can be done and needs to be done in the short to medium term to improve that.

Workforce planning is crucial. But it is only one part of improving an NHS that is too often failing to deliver timely care. Others include the capital needed to provide the modern IT, equipment and buildings that this expanded workforce will require. And some solutions to the never ending problem of social care – which has its own, glaring, workforce issues.

Nonetheless, today is an important day – if this is all seen through and not allowed, quietly and slowly, to run into the sand. It also comes with big implications for spending.

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The NHS crisis will only be solved with capital investment, increasing management capacity and staff retention – not just more doctors and nurses.