Today we mark the 75th anniversary of the founding of the NHS, and the Council of Deans of Health reiterates its support for NHS England’s Long Term Workforce Plan (LTWP). It provides a pathway to ensuring the sustainability and success of an institution we cherish but know must adapt.
The Council has been involved throughout the LTWP’s development, meeting with NHS England, and across government, including the health secretary and Prime Minister, to ensure our members’ voices were heard. Being a critical friend isn’t always easy, for either side, but the plan is better for it and we are supportive of its aims.
At the heart of the system
At every stage, universities are crucial to the plan’s delivery. Our members’ role in educating nursing, midwifery and the allied health professionals is recognised with very ambitious expansions in provision.
These include almost doubling adult nursing training places – to reach nearly 38,000 by 2031-32 – as part of an overall aim to increase the number of nursing and midwifery training places to around 58,000 by 2031-32, including continuation of funding for shortened midwifery courses for registered nurses.
A 38 per cent increase in training places for mental health nursing is planned, as well as 46 per cent increase for learning disability nursing by 2028–29, alongside exploration to extend dual registration courses in children and young people and learning disability nursing.
Also in the plan is a significant increase in nursing associate training places to 10,500 by 2031–32 – with an aim to increase the 4,600 nursing associates in the NHS to 64,000 – as well as an increase to allied health professions (AHP) training places by a quarter to more than 18,800 by 2028-29, with an aim for the training of around 150 additional advanced paramedics, and 150 enhanced practice radiographers, annually.
The routes in
Much has been made of the role apprenticeships will play in the future of the NHS. Apprenticeships are planned to account for 80 per cent of operating department practitioners, therapeutic radiographers and podiatrists but will be important to the expansion of many professions. Universities will remain essential to such a growth in apprenticeships, with many of our members already delivering these routes.
It should, however, not be lost that the LTWP also underlines the graduate foundations of the professions which Council members educate, a key position the Council was keen to embed when engaging on the plan. The NHS needs professionals trained through a wide range of routes and universities are at the heart of the far-reaching aims to expand these.
Similarly we need to recruit and retain the students to take up these expanded places. Prospective healthcare students face daily negative headlines about careers in the NHS but sometimes just as challenging is the fact that many of those wider careers are simply unknown to them.
We need to signpost the range of careers to prospective students but also career paths so that even more widely known professions like nursing, midwifery and paramedicine are shown in their fullness, setting out routes to vital academic and research positions alongside clinical roles.
Ranging wide
A focus on increasing the number of UK-educated healthcare professionals supports sustainability for the NHS workforce but also expands opportunities across the country in education.
A significant number of nursing, midwifery and AHP students are drawn from under-represented groups, with a larger number of mature students than many other courses. Healthcare careers offer a path to levelling up for individuals and communities but, despite our members’ best efforts, the cost of living crisis can particularly impact our students.
One thing we have long called for is a streamlined and speedier approach to expense claims. The plan’s commitment to a national model for this is a useful practical step that will benefit students and retention. The route in to working sooner after graduation could also be a sensible step for nursing students as well as the NHS.
Similarly, the commitment to address geographical inequity, particularly in terms of placements and provision, will be welcomed by many members who face these challenges.
Innovation, and balancing risk
The LTWP truly embraces innovation, be it through applying new technological developments adopted to benefit patients, cutting-edge digital approaches to education – which health secretary Steve Barclay saw up close yesterday at a visit the Council coordinated to University of West London, one of our member institutions – or the application of blended learning and greater regulatory flexibility which emerged as a response to the challenges of the pandemic. The plan is right to recognise the progress made on the latter by regulators like the Nursing and Midwifery Council.
Further work towards a model of fewer placement hours and a more competency-based approach to nursing assessment could free up time and space in the system to match the ambitions of the plan. It is clear from discussions during his visit yesterday that the health secretary is keen to do more on this. The Council of Deans of Health will be engaging closely in this area, not least as the changes proposed in this (England-only) plan would, if adopted, also have regulatory implications for healthcare education in universities across the rest of the UK.
Most members would welcome this evolution and it feels like a question more of when, and how quickly, rather than if – but it must be approached in partnership with universities and regulators, and work to safeguard patients, professionals and students alike. Balancing risk here will be critical.
In constant conversation
Indeed, underpinning the plan is genuine partnership across the healthcare and education sectors. This has been inherent to the development of the LTWP and is reflected throughout it. The plan is predicated on regular dialogue, biennial reviews and – an ongoing call from us – much better join-up between DHSC and DfE.
That partnership is going to be needed to ensure universities are supported to have the resources required to match their will to deliver the LTWP. The £2.4bn of funding is obviously important, but with 50 per cent of our members’ academic staff over the age of 50, the plan’s explicit recognition that building educator capacity is needed to meet the workforce growth aimed for is very welcome. The inclusion of educator frameworks and the need for routes to academia and research speaks to our ongoing message that a healthcare workforce requires a healthcare education workforce to deliver it. The LTWP has to deliver on this to achieve its ambitions for the NHS.
Much more will be written about the Long Term Workforce Plan and we will be engaging with members to maximise opportunities and identify, and mitigate, any challenges. The plan is a great achievement but implementation is the real test.
The health secretary’s visit to mark both the plan and the 75th anniversary of the NHS emphasises the ongoing partnership between NHS, government and universities needed to ensure many more anniversaries to come. The Council of Deans of Health will continue working with our members to achieve this.
The desired outcome is to adequately staff the NHS, and that is welcome. However, without robust action on pay and working conditions, which is a leading cause of staff attrition, the planned additional staff will have negligible impact.
I agree with Patricks comment, pay and conditions is a huge problem, with many newly qualified Nurses and Dr’s moving to better pay and conditions in the USA, Canada and Australia as soon as they can, rather than suffer the further indignities of working for the failing, soon to be sold off if the US Health Insurance industry have their way.
I note the usual statements, but what’s still missing is a commitment to stamp out the misandry that stalks the nursing corridors of learning, perhaps that’s why “A 38 per cent increase in training places for mental health nursing is planned” is included, so there’s something for the boys? Too many male nurse trainee’s still suffer from the gynocentric tendencies of many older female nurse lecturers, often being constantly marked down compared with their female class mates, even when putting in comparable work.