NHS Workforce Plan
As you may have seen over the weekend and this morning, the Government has said that the NHS workforce plan will be published this week, and they’ve been previewing it in the media.
See below for the Prime Minister’s comment piece in yesterday’s Sunday Times. As expected, there’s no mention of social care and the Guardian has published an editorial calling for care to get more attention, which is also below. They’re endorsing the Fabian Society’s calls for a professional body and register for social care.
Sunday Times – Rishi Sunak: NHS staff must be fast-tracked out of the classroom
Last Sunday I joined a late shift at Watford General Hospital. During the evening I spent with those brilliant people, I experienced a fraction of the work nurses do every day — taking blood pressure, making up beds or settling patients for the night. Their hard work and their dedication to the job is awe-inspiring.
In just over a week, our National Health Service turns 75, and that devotion to duty has been the story throughout its history. I come from an NHS family. My dad was a GP and my mum a pharmacist, and I remember well how my own parents put their hearts and souls into looking after other people.
Most recently we saw the extraordinary way NHS staff rose to the unprecedented challenges of the pandemic. And I’m acutely aware of the real challenges the service faces as it deals with the Covid-19 backlogs and the mounting pressure on an overstretched workforce.
Many doctors and nurses are run ragged with competing demands that mean they can’t spend enough time with patients. Too much time is spent by highly trained professionals on jobs that could be done by others. And we know we could do more to make better use of the talents and abilities of existing staff.
Unless we fix this, we won’t be able to deliver our promise to fix the backlogs. Nor to pursue our vision of a better, long-term future for the NHS — an NHS that is ready to deal with the changes we see all around us, as our population grows and ages; as the burden of disease changes; and as technology opens new opportunities.
To address that, we’re already investing record sums in the NHS, including up to £14 billion of extra funding for health and care over the next two years. There are now more staff working in the NHS than at any other point in its history. We have record numbers of doctors and nurses, and we are 90 per cent of the way there on meeting our goal of 50,000 more nurses by the end of next March.
And this investment is working. We got through the surge of flu and other winter pressures, and waiting lists are coming down. So far, waits of over two years for treatment have been almost eliminated in NHS England, and we’ve reduced the number of patients waiting over 18 months by more than 90 per cent.
But we need to do more. We’ve known for decades that the NHS doesn’t train enough doctors and nurses. Governments of all colours have failed to solve this challenge. And that’s left us relying too much on attracting talented people from overseas rather than recruiting at home.
Technology, we know, is part of the answer. Advances such as artificial intelligence can lend a helping hand to medical staff. And new innovations such as virtual wards have the potential not only to achieve better results for patients, but to reduce the cost to taxpayers.
Fundamentally, we also need to train more doctors and nurses and to make the NHS a more attractive place to work. This week, in conjunction with the NHS, we’ll announce a series of new policies to transform the way we deliver healthcare — including a plan to revolutionise the way NHS staff work and to build the health workforce of the future.
The NHS Long Term Workforce Plan will be the biggest workforce training expansion in the NHS’s history.
It will ensure we train, retain, reform and make the most of our talented and experienced staff. It will be a 15-year plan to give the NHS certainty, because we recognise it takes time to train these staff, who are among the most highly skilled in our society.
We will be using the latest techniques and innovations to streamline the journey from classroom to clinic, to get more patients the care they need.
And it will be backed by government funding and support, balanced against the wider pressures on the economy.
This is something no other government has done. It will be one of the most significant commitments we will make in this parliament. And it is the cornerstone of our vision for a better, more modern healthcare system.
For me, securing the future of our NHS is personal. In this 75th year of our NHS, I feel a great responsibility to ensure our NHS endures. Not just to honour the memory of all that my parents — and so many others — contribute, but to secure its future for our children, and their children too.
The Guardian – The Guardian view on care workers: undervalued and underpaid
Any week now, an NHS workforce plan will be published. Already delayed several times, it is expected to set out proposals for training doctors, nurses and other health service staff in England. But the crisis of recruitment and retention in the care sector will not be addressed. If the plan encourages more care workers to seek jobs in the NHS – where pay and conditions are better – it could make the position of social care even more precarious than it already is.
This is an alarming prospect. In February, figures from the Office for National Statistics (ONS) showed that one in 10 of all vacancies in the UK are in health or care roles – a total of almost 300,000. In December last year, there were 31,870 support worker vacancies advertised nationally – more than any other job.
Difficulties in finding and holding on to workers, both for care homes and agencies that employ care workers in the home, are part of a broader recruitment problem in the public sector, which is also damaging schools. This is the result of prolonged underinvestment by successive Conservative governments, which has led to uncompetitive pay levels. Brexit also led to disruption, although gaps are increasingly being filled by workers from India and elsewhere.
But there is an additional problem in social care, and that is the low status and meagre rewards attached to it – as well as to unpaid care by relatives. Historically, care work has been undervalued because it is not regarded as productive or skilled. As in nursing, the workforce is overwhelmingly female (the latest figures are 82% in social care, and 88.6% for nurses and health visitors). Care, long viewed as women’s work when unpaid, is also predominantly done by women, particularly women of colour, when it is paid work. While researching her book Labours of Love, Madeleine Bunting met care workers who love looking after people. She also interviewed a woman who said friends would fall silent in embarrassment when she tried to talk about her job.
This is an unsustainable, and at times inhumane, situation, particularly when we know that the number of adults needing care either due to disability or old age is set to keep rising. As a society, we have to get over our disdain for tasks such as feeding, toileting and keeping other people company. Last year, eligibility for health and care visas was widened due to gaps in the workforce, and the number granted rose to 76,938 (a 142% increase since 2019). But migration is not a solution to the long-term, labour-market shift necessitated by demographic changes. Low morale, low wages, rapid turnover and the use of temporary staff feed a rolling crisis that also affects the health service.
The care workforce is fragmented, making strikes unlikely. But means must be found to improve pay and conditions. Employers should be able to attract people who take an interest and pride in their work. The creation of a professional body and register could play a part in a system change, as the Fabian Society and others have argued. New Zealand and the Netherlands are two countries where training and career structures have been improved. Additional funding is desperately needed, as it has been for years. Politicians, but also the public, must break the habit of seeing social care as low-skilled work and reform of the sector as a low priority.