It was on 8 November 2017 that Jeremy Hunt, the then health secretary, first promised that the government would bring forward a long-term, comprehensive plan to end the NHS’s lack of staff.
It would, he said, be the “first proper NHS workforce plan that we have had since 2000”. And the plan would emerge quickly, he added, reflecting the urgency of tackling what has become the most debilitating of the NHS’s many problems – shortages of staff, everywhere.
Health Education England would publish a draft by the end of 2017, there would then be a public consultation on that, “and next year we will publish the final plan”, Hunt said.
So the new NHS long-term workforce plan is, by the government’s own timescale, four and a half years late – but at least it is here. And in the scale of the ambition, ideas and recognition of the size of the task ahead displayed across its 151 pages, and in its thoroughness and determination to finally give the health service the personnel it needs, it was worth the wait.
Its publication has induced huge relief among NHS bosses, health charities and staff groups. They had waited and waited for this document that is fundamental to the NHS’s ability to escape from the sorry state it finds itself in. As the health service prepares to celebrate its 75th anniversary on Wednesday, the plan should help it get back to delivering the speedy, high-quality care that was its norm until the early 2010s and increase its chances of surviving intact for another three-quarters of a century.
The most headline-grabbing proposals are colossal increases in the number of doctors, nurses and other staff. If successful, the plan will deliver 300,000 more health personnel in England by 2037. It envisages that by the end of its 14-year timeline the overall NHS workforce will have grown dramatically from 1.4m now to between 2.2m and 2.3m.
Will the plan work? It does not address pay, a key driver of staff discontent – as the current wave of strikes shows. And the lack of an equivalent strategy for social care will mean that the sector’s inability to provide the service expected of it will continue to hobble the NHS’s ability to do the same.
The plan aims to persuade 130,000 staff to stay in the NHS over the next 15 years rather than quit, using flexible working, better workplace environments and improved training opportunities. Poor morale and exhaustion in the workforce mean this is just as important as delivering those new recruits.
Worryingly, though, where a step-change is needed, the plan has nothing new to say that the NHS hasn’t pledged before. “Continue to build on what we know works.” Really? Is that it? New ideas – sabbaticals for long-serving staff, tax incentives to work in the NHS, free accommodation for junior staff – are needed. So too, somehow, is the eradication of the toxic cultures – bullying, racism, dismissal of staff ideas – that bedevil so many NHS workplaces.
Some will see the plan as the Conservatives trying to fix a problem they created, or at least exacerbated: what were 25,000 NHS vacancies in 2010 are 112,000 now. But even they should want it to succeed. The NHS, and anyone who ever seeks its help, needs it to succeed.
