The Government has announced that the number of places in medical schools will rise from 7,500 to 10,000 by 2028 and could reach 15,000 by 2031 as a result of the NHS’s first long-term workforce plan.
The Long Term Workforce Plan sets out how the NHS will address existing vacancies and meet the challenges of a growing and ageing population by recruiting and retaining hundreds of thousands more staff over 15 years and working in new ways. It was commissioned and accepted by the Government, which has backed the plan with over £2.4 billion to fund additional education and training places over five years on top of existing funding commitments.
For the first time the Plan sets out long term workforce projections. Staffing shortfalls have been an issue since the foundation of the NHS and vacancies now stand at 112,000. The growing and ageing population, coupled with new treatments and therapies, means that without action, the gap could grow up to 360,000 by 2037.
The NHS plan aims to reduce reliance on expensive agency spend that could cut the bill for taxpayers by around £10 billion between 2030/31 and 2036/37. With demand for healthcare staff rising, the Long Term Workforce Plan sets out the path to:
- Double medical school training places to 15,000 by 2031, with more places in areas with the greatest shortages
- Increase the number of GP training places by 50% to 6,000 by 2031
- Almost double the number of adult nurse training places by 2031, with 24,000 more nurse and midwife training places a year by 2031.
Taken with retention measures, the NHS Plan could mean the health service has at least an extra 60,000 doctors, 170,000 more nurses and 71,000 more allied health professionals in place by 2036/37.
Advances in technology and treatments mean that staff numbers and roles will change over time so the NHS will refresh the Long Term Workforce Plan at least every two years to help meet future requirements.
This plan will kickstart efforts to address current shortages with an immediate boost in training numbers. By 2028, government investment will mean half a million trainees will have begun clinical training, on a path to increase by over 60% by 2031.
Over the next five years alone medical places will increase by almost a third, nursing degrees will increase by more than a third and GP training places will jump by a quarter.
To ensure the NHS can draw on the widest pool of talent, more training places will be offered through degree apprenticeships so staff can “earn while they learn” – gaining a full degree while ensuring they meet the high clinical standards required by the relevant professional regulators, including GMC and NMC. One in six (16%) of all training for clinical staff will be offered through apprenticeships by 2028 – including more than 850 medical students.
The growing number of nursing degrees will be accompanied by a 40% rise in nursing associate training places over five years, with increases in other associate roles which will support and free up other clinical colleagues.
The Government says that a renewed focus on retention, with better opportunities for career development, improved flexible working options, alongside reforms to the pension scheme, should mean that up to 130,000 staff stay working in NHS settings longer. Investment in new technology will also help to close the gap and free up staff to focus on using their expertise to help patients.
The NHS will continue to harness advances in AI, with an expert group being set up to identify advanced technology that can be best used across the country.
Other measures to boost the NHS workforce include:
- Trainees will be on wards and in practices sooner, with plans to work with the GMC and medical schools to consult on the introduction of four-year medical degrees and medical internships, allowing students to start work six months earlier.
- More student nurses will be able to take up jobs as soon as they graduate in May, rather than waiting until September, with more reaching the frontline and treating patients more quickly.
- New medical schools could also open up in areas of the country where there is the greatest staffing shortfall, with similar plans for postgraduate medical training places.
- Train around 150 additional advanced paramedics annually, including to support the delivery of same day emergency care.
- Expand training places for clinical psychology and child and adolescent psychotherapy, on a path to increasing by more than a quarter to over 1,300 by 2031.
Amanda Pritchard, NHS chief executive, said: “This is a truly historic day for the NHS in England – for 75 years, the extraordinary dedication, skill and compassion of NHS staff has been the backbone of the health service – and the publication of our first-ever NHS Long Term Workforce Plan now gives us a once in a generation opportunity to put staffing on sustainable footing for the years to come.
“As we look to adapt to new and rising demand for health services globally, this long term blueprint is the first step in a major and much-needed expansion of our workforce to ensure we have the staff we need to deliver for patients.
“We will take practical and sustained action to retain existing talent, we will recruit and train hundreds of thousands more people and continue to accelerate the adoption of the latest technology to give our amazing workforce the very best tools to provide high-quality care to millions of people across the country each day. Crucially, this plan will also ensure there is an NHS career choice that works for everyone now and in the future."
Responding to NHS England’s workforce plan, Richard Murray, Chief Executive of The King’s Fund said: "The plan comes after years of chronic NHS staff shortages, as well as existing staff being stretched thinly. Our analysis shows just how deeply a new approach is needed as we compared the UK to international healthcare systems and found the UK has strikingly low levels of key clinical staff, with fewer doctors and nurses per head than most of its peers.
"Of course, the plan needs to be delivered but the commitment to updating the plan every two years provides hope that it will be a lasting way out of the recurrent workforce shortages that have plagued the NHS over decades. The future projections of workforce supply and demand it provides should help politicians and policymakers to lift their heads up from immediate crises and consider the long-term challenges coming down the track. But the projections are likely to be based on ambitious productivity assumptions. There needs to be realism about the investment in buildings, technology and equipment that is needed to realise those productivity gains.
"While the announcement includes a welcome commitment to boost staff training places, we are yet to see much of the detail on the measures to retain current NHS staff, or to improve the culture and working environment of the health service. More NHS strikes are planned and the latest staff survey shows work culture, bullying and harassment continue to be a real issue, and nearly one in 10 staff experience discrimination. There is much more that can be done to make the NHS an attractive place to work and build a career.
"The expansion of training places comes with some additional funding, but we haven’t yet seen the detail of how this funding will be phased – and whether it will be sustained – over many years. Delivery of the wider ambitions of the plan will need sustained investment, and therefore will rest on any future governments throwing their weight behind the strategy, to give the NHS the support and stability it needs."
Dr Jennifer Dixon, the Chief Executive of the Health Foundation, said: "The publication of the NHS workforce plan is a major milestone for the NHS. For the first time in two decades, the health service has a plan for meeting its staffing needs based on plausible projections of future demand for care and supply of labour.
"The Health Foundation has independently assessed the modelling approach used by NHS England to inform the staffing projections set out in the plan. While we welcome the promise to update the projections every two years, health policy is littered with good intentions that have fallen by the wayside, so we continue to believe the commitment to publish independently verified staffing projections should be enshrined in law, as the Chancellor himself has argued...
"While publishing the workforce plan is a significant step forward, making it work in practice will depend on broader action and investment from Government. Leaver rates among NHS staff are close to record levels, and years of below inflation pay settlements mean the wages of many NHS staff have fallen behind comparable occupations. Training more staff is essential, but this will be little good if the NHS is unable to retain the staff it’s already got...Urgent action is also needed to support the social care workforce, where staff shortages are chronic and 1 in 5 care workers live in poverty."
