NHS launches much-anticipated workforce strategy

NHS England has finally announced its long-term workforce plan to address the chronic labour and skills shortages facing the NHS, with the vacancy shortfall across the NHS currently standing at 112,000. The strategy focuses on three core pillars:

1) Train: This strand focuses on increasing education and training (including apprenticeships), and on the expansion of training routes across all professions within the NHS. Key aims include:

• Double medical school training places, taking the total number of places up to 15,000 a year by 2031/32. The first new medical school places will be available in September 2025.
• Adult nursing training places to increase by 92% in 2031/32, taking the total number of places to nearly 38,000. This involves ambitions to work with 20% of registered nurses qualifying through apprenticeship routes compared to just 9% now.
• Increase the number of GP training places by 50% to 6,000 by 2031/32.
• Train more NHS staff domestically to reduce reliance on international recruitment and agency staff.

2) Retain: This component outlines how the NHS plans to keep more staff within the health service, including better support, and flexible working. This includes:

• Further expand national funding for continuing professional development for nurses, midwives, and allied health professionals.
• Working with local leaders to offer integrated occupational health and wellbeing services for all NHS staff.

3) Reform: This part outlines ways the NHS intends to improve productivity through innovative models of training, building broader teams with flexible skills, and ensuring staff have the right skills to take advantage of new technologies. Key highlights include:

• A focus on advanced and associate level roles to modernise the profession, with greater emphasis on the generalist and core skills needed to care for patients.
• Growing the number and proportion of NHS staff working in mental health, primary, and community care by 73% by 2036/37

The NHS workforce plan is being billed as a much-needed document to ensure the longevity of the NHS workforce, and there are commitments to address the flexibility of the workforce (one of the key asks in our Overcoming Shortages report). However, this strategy is only the start and more needs to be done - particularly with recruitment agency partners - to ensure the NHS can work as effectively and efficiently as possible.

The REC View

1. The role of agency staff

One of the key concerns the REC has is its explicit intent to reduce the use of agency workers. The strategy sets out how over the three years up to 2021/22, expenditure on agency staff

has increased by 23% from £2.4 billion to £2.96 billion - but this included responding to the COVID-19 pandemic.

However, we know from REC members and external stakeholders that this should not be the focus. The plan back them up -by highlighting how the NHS is more over-reliant on banks than ever, with bank spend rising by 51% to £5.2 billion in the same time period. In many cases we are seeing NHS trusts simply moving agency workers to banks to artificially reduce the amount spent on agency workers, which does not solve the wider staffing issues this plan seeks to address.

There should be further investigations into appropriate staffing models from the government. Taxpayer money should be spent effectively and transparently, so REC will continue to assess how best to engage with government and NHS trusts on this. We know our members operating in the healthcare sector are committed to working collaboratively with NHS Trusts to ensure that there is enough of a talent pipeline right the way through. The NHS workforce strategy doesn’t account for or appreciate the expertise and labour market insight that recruiters bring to address labour and skills shortages. As part of our ongoing work around this, we have called for a Public Accounts Committee inquiry into value for money NHS staffing and the role of agency work in sustaining delivery for the NHS. It is a clear failure of the plan not to address this properly.

2. Building on our industry's expertise

Another area of concern is also around the deliverability of the plan - and the actions needed in the short to medium term to address the state the NHS finds itself in. With most of the identified actions in the plan not being implemented in full until 2031 at the earliest, there really is a need to get recruiters, education providers, industry experts, relevant healthcare professionals and the government to work together to map out immediate actions to increase the numbers of people filling open vacancies. That can't happen without talking to the staffing industry. The lack of recognition in the plan for this is extremely worrying and something we will continue to make the case for - loudly and assertively.

We are interested in hearing feedback from members on the NHS workforce plan and the impact it will have on businesses operating in the sector. To share your thoughts, please contact Patrick Milnes (Senior Campaigns Advisor) on patrick.milnes@rec.uk.com or Usman Ali (Campaigns Advisor) on usman.ali@rec.uk.com