“More staff not enough - NHS must also be best place to work” says new NHS people plan

As well as growing staff numbers, the NHS needs to rapidly become a much better place to work says the new Interim NHS People Plan, launched today to address the once in a generation workforce challenges the service is currently facing.

The interim report, developed collaboratively with a broad range of partners from across the NHS, including NHS managers, NHS staff unions, the Academy of Medical Royal Colleges, the Royal College of Nursing, and the British Medical Association, argues that, in addition to recruiting extra staff, much more needs to be done to improve staff retention and transform ways of working.

The interim plan acknowledges the scale of the workforce challenge facing the NHS. Despite recent increases in staff numbers, it sets out how the NHS needs to recruit, retain and develop more staff to meet rapidly growing demand for 21st century healthcare.

The interim plan sets out a long term strategy to achieve this, agreed across the entire NHS for the first time. It also confirms a number of immediate actions, with more to follow once the forthcoming Spending Review has confirmed future NHS education and training budgets.

The plan focuses on three key areas - recruiting more staff; making the NHS a great place to work; and equipping the NHS to meet the challenges of 21st century healthcare. It sets out:

  1. How the NHS will rapidly increase the number of NHS staff, deliberately starting with the nursing workforce where the current vacancy pressure is greatest. The plan sets out how the NHS will:
  2. How to make the NHS “the best place to work”, addressing current concerns from frontline staff on the pressures they face, and improving retention rates. The plan sets out how the NHS will:
  3. How to equip staff and NHS frontline organisations to provide 21stcentury healthcare including the need to join up health and care and take advantage of digital technology, genomics and other innovations. The plans sets out how the NHS will:
  • Immediately increase the number of undergraduates studying nursing with an offer to universities of more than 5,700 extra hospital and community placements for student nurses this year
  • Rapidly expand the number of staff in recently created new roles including increasing the number of nursing associates to 7,500, offering a career route from healthcare support work to registered nursing
  • Launch a new campaign, in conjunction with Mumsnet, to inspire more nurses to return to the NHS
  • Quickly grow the number of nurses and doctors recruited from overseas via a new approach that will agree national “lead recruiter” agencies with the expertise to support the local NHS with international recruitment.
  • Rapidly address current pensions issues which are discouraging experienced doctors and nurses from doing extra work for patients and causing them to think hard about remaining in the NHS
  • Conduct a major staff engagement exercise this summer, led by new Chief People Officer, Prerana Issar, to create an explicit offer to staff covering issues they say matter to them for example, access to flexible working, career development and the best possible support from line managers.
  • Ensure more support and development for frontline NHS managers, from ward to board, including the development of a new leadership compact covering the standards and behaviours leaders can expect of each other and a doubling of the size of the NHS Graduate Trainee scheme.
  • Devolve significant responsibilities for workforce planning to the emerging integrated care systems.
  • Develop new models of multi-disciplinary working to support the Long Term Plan’s ambition to integrate primary and secondary care.
  • Launch a national consultation exercise to establish what the NHS, patients and the public require from 21st century medical graduates.
  • Expand the NHS Digital Academy, deliver intensive digital skills training for boards and senior leaders, and develop the pipeline of digital experts in the NHS to support the Long Term Plan’s drive to fully harness digital technology.

The report warns that failure to make these improvements risks delivery of the ambitions in the Long Term Plan, given ever increasing and changing patient demand. Over seven million patients were admitted to NHS A&E departments in England between January and March this year – a record high and 380,000 more patients than the same time last year.

A full People Plan will follow this interim Plan, translating this national vision into detailed, costed action plans, alongside a detailed implementation plan for the NHS Long Term Plan as a whole. The full plan will follow the government’s next Spending Review when the total investment available for education and training and for digital and capital transformation is due to be confirmed.

Speaking ahead of the launch of the Interim People plan at East London NHS Foundation trust, Chair of NHS Improvement Dido Harding said:

  • We haven't waited for this plan to be published. Practical action has already started.  NHS trusts have already identified over 5,500 extra clinical placements for undergraduate nurses, which put us on track to expand nurse undergraduate places by 25% in September.
  • The NHS is its people. This plan clearly acknowledges the workforce challenges the service faces. I want frontline NHS staff to know that we have heard their concerns about the pressures they face and we are determined to address them. The NHS needs more staff to meet the ambitions for patients set out in the NHS Long Term Plan. But that, on its own, is not enough. We need to change the way people work in the NHS to recognise the changing needs of patients and to create a modern, caring and exciting workplace that should be the best place to work in England. This will take time but this interim plan sets out a clear direction of travel and commits to the immediate actions available to us.

Sir David Behan, Chair of Health Education England said:

  • We need to ensure all NHS staff can develop the knowledge and skills they need to work differently in the 21st century NHS. Digital technology, genomics and the integration of health and care are rapidly changing what's required of our staff and we must support them to take advantages of these innovations.
  • The NHS is a complex system, with over 1.3 million staff working in thousands of different local locations from Plymouth to Pontefract. But if we are to meet our current workforce challenges, we have to pull together as one. In developing this interim plan we have role modelled a more collaborative and inclusive approach, which will continue over the coming months as we create the final plan. Working together means we will be more effective, more efficient and ensure that we continue to provide safe, high quality care despite rapidly rising demand.

Health Secretary, Matt Hancock said:

  • We are securing the future of our NHS for generations to come with record investment through our Long Term Plan, but there's no question: we need more staff and a more supportive culture to make that plan a reality. 
  • The interim people plan is the first step. It sets out plans to train more, hire more, and retain more staff. The NHS will take immediate action over the coming year to lay the foundations to grow a future workforce that can truly deliver the highest-quality care to patients from the cradle to grave. 
  • We must also make the NHS an employer to be proud of. We want to eradicate blame culture, deliver massively improved mental health provision and provide greater protection from violence and harassment. 
  • The success of the health service is rooted in the incredible people who dedicate themselves around the clock and we must show our staff the NHS values them as much as they value their patients.

Professor Carrie MacEwen, Chair, Academy of Medical Royal Colleges said:

The Academy very much welcomes the Interim NHS People Plan.

There is now recognition of the inextricable link between the quality of care and the need to have a workforce sufficient in size and properly valued and motivated.

Despite the speed of its construction there has been a feeling of involvement and both the analysis of the issues and the solutions proposed are astute.

We are encouraged too that the plan addresses the three essential pillars of any workforce strategy - workforce supply, improving working lives to support retention of staff and new ways of working and job roles."