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Workforce strategy: DH has ‘turned on all the taps’, but can still do more

Health Education England (HEE) has released a draft of its 10-year workforce strategy which is looking to create a long-term staffing plan for the first time in almost 25 years.

The strategy describes the current state of the NHS, pointing to an increased focus on quality while demand rises at an extraordinary rate, meaning understaffing has become a serious problem despite a real term rise of £3.7bn on staff spending since 2012.

It says there have been some key policies which will pay off in the long run, with HEE and government nursing investments expected to bring through around 26,000 more nurses by 2027.

The report lists new graduates, returning practitioners and recruitment from abroad as three workforce supplies, adding that HEE has “turned on all these taps” in an effort to solve staffing issues – but acknowledges that there is still much more to do.

Focusing on retention, the strategy concedes that spending on new workforce production has reduced the ability to invest in current staff, which needs to be collectively worked on to improve the situation for employees.

Worryingly, HEE said that if no action is taken to reduce demand through prevention or through better productivity and service transformation, then the number of staff needed by 2027 would have to grow by 190,000 to meet demand.

Providers: HEE has recognised ‘scale and urgency’ of staff crisis

NHS Providers has applauded this long-term view of staffing, describing it as “definitely needed,” but explained that the next step is to fully look through the financial and funding requirements of the plan.

“We strongly support the long-term approach in assessing workforce needs 10 years from now that this report outlines. This is the first time the NHS has taken such a long-term view, but it’s one that’s definitely needed,” said the organisation’s chief executive, Chris Hopson.

“It is particularly encouraging to see that Health Education England has recognised the scale and urgency of staff and skills shortages across both health and social care – highlighting the fact that patients and service users often do not distinguish between the two, and emphasising the importance of high quality social care services to the NHS.”

He added that the final version of the strategy must be clear on the split of responsibilities between national and local bodies.

Danny Mortimer, chief executive of NHS Employers, added: “Employers particularly welcome the commitment to a full and extensive consultation of this NHS workforce strategy. 

“It is an important step to set out a clear national narrative which describes the impact of the plans to date regarding our workforce whilst recognising the vital work which is still to be done.”

HEE has also called for a set of six shared principles which would underpin future workforce decisions, including securing the supply of staff within the UK, enabling a flexible workforce, providing a broad pathway for careers in the NHS, and widening participation in NHS jobs.

In addition, it recommended ensuring the NHS and other employers in the system are inclusive modern model employers, and that service, financial and workforce planning are intertwined, so that every significant policy change has workforce implications thought-through and tested.

Dr Chaand Nagpaul, BMA council chair, said the union welcomed the workforce strategy for trying to deal with the significant staffing problem but added that any solutions that arise from the draft consultation had to realistic.

“Most importantly, the solutions that arise from this consultation must be genuinely deliverable and matched with the necessary investment,” Nagpaul explained.

“It is imperative that the government gets to grips with the current workforce crisis - failing to act will result in the NHS being unable to attract and retain the necessary doctors and staff to meet the population’s health needs, and it is patients who will suffer as a result.”

Responding to the strategy, health secretary Jeremy Hunt stated: “NHS staff are our health service’s greatest asset, but for too long, governments of all parties have taken a short-termist approach to NHS workforce planning.

“We need a proper plan that stretches beyond any electoral cycle, and secures the supply of NHS staff for future generations. This important work kickstarts that process.”

Professor Sir Malcom Grant, chair of NHS England, argued that the strategy was extremely important to the future of the health service, saying that any agreed plan needed to “meet the needs of a diverse and ageing population.”

Chief executive of Public Health England, Duncan Selbie, pointed to the prevention aspects of the plan.

He said: “Helping people to stay well for longer and to stay in their own homes for as long as possible is dependent on investment in a confident and forward-facing health and care workforce and this consultation is a big step on the way to securing this.”

Niall Dickson, chief executive of the NHS Confederation, commented: “The government and Health Education England are to be congratulated on this consultation on workforce. We will have to study the detail but this is an important and welcome initiative.

“For many of our members, workforce (or the lack of it) is their number one concern, as it affects the quality of care being delivered every day and shortages increase the stress on existing front-line staff.

“For too long employers have felt excluded from policy development on workforce and for that reason this consultation is very welcome and such an important opportunity for them to help shape the way forward. 

“It is difficult to overstate the pressures already being faced across health and care, not just with unprecedented demand but with vacancies and shortages in many areas.

“Here at last we have a chance together to map out a better future for our staff and make sure we create a sustainable well-motivated and well-trained workforce to meet the enormous challenges ahead.”

The consultation for the strategy starts on 13 December and finishes at 5pm on 23 March 2018. You can submit responses here.

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