I’ve made no secret of the fact that it is one of my top priorities to make sure people across the UK get access to the care they need more quickly. That’s why the introduction of this plan is so important – a plan for investment and a plan for reform. Developed by the NHS and backed by the Government, the 15-year long term workforce plan will meet the workforce requirements the NHS has for the future.
The underpinning Long Term Workforce Plan for the NHS has several measures of interest to the sector.
Medical school places for student doctors are to double to 15,000 a year (500 new places in 2025), with a 50 per cent increase in GP trainee places for junior doctors. It also includes 24,000 more nurse and midwife student places a year – close to double the number now, along with a 40 per cent rise in nursing associate training places.
There will also be a major new focus on apprenticeships – over the next five years, the proportion of NHS staff (including physios, podiatrists and maternity staff) trained through the route will double to one in six – and a new apprenticeship for doctors will launch next year.
There’s a slow build on some of this stuff.
- Adult Nursing places will be 28k by 28-29, 38k by 31-32
- 22 per cent of clinical staff training are to be via apprenticeships by 31-32 (16 per cent by 28-29)
- Medical degree apprenticeships (as previously announced) will mean pilots in 2024-25 – scaling up to 850 by 28-29, and 2,000 by 31-32
- Dentistry will see an 1,100 places by 31-32, 1,000 by 28-29
- Pharmacy will see 5,000 places by 31-32, 4,300 by 28-29. All newly qualified pharmacists will be able to prescribe
- That will all result in a 10.5 per cent overseas workforce in 15 years time – it’s currently nearly 25 per cent.
Catching Rishi Sunak out with some hamfisted explanation in the Q&A was the question of reform. There’s to be an expansion of associated roles – 6,300 clinicians starting in advance practice by 31-32 (3,000 starting in 23-24 and 24-25, 5,000 by 28-29), along with rises in nursing and physician associates (anathesia and physician associates are to get prescribing roles.)
There are, inevitably, discussions still to happen on geographical and course mix expansion – NHS England will work in partnership with universities on this in the coming years – although there is a commitment to both the expansion of existing medical schools and new ones too.
An eye-catching consultation on whether medical degrees could be reduced to four years was also launched, and NHS England also says that student nurses will be able to enter the workforce as soon as they graduate in May, rather than waiting until September.
The Nursing and Midwifery Council (NMC) was pleased with the announcement:
The firm commitment to nursing and midwifery as graduate professions is a solid foundation to build from. Increasing education opportunities and diversifying the routes to qualification through degree apprenticeships means more people will be ready to join our register to meet rising demand. Expanding the numbers of health visitors, school nurses and district nurses will help deliver care and support where people need it most, in their communities.
The General Medical Council (GMC) was concerned about the system’s ability to train students taking up the extra places:
Increasing medical school places also cannot come without a corresponding growth in trainer capacity. This is vital both for medical students and newer professions, like physician associates and anaesthesia associates. Our own research tells us that trainers are already under pressure, being less likely to feel supported by senior medical staff and more likely to experience compromised patient safety than non-trainers.
There’s lots in the plan on both faster routes and rounding up previous announcements on simulation to reduce demands of placements on existing staff. On the one hand there’s a push to reduce time spent in the classroom – on the other, a push to reduce time on the wards too. Those two aspects may or may not ultimately add up.
There’s a commitment to work with students, HEIs, royal colleges and clinical placement providers to understand and address the reasons students leave training and the variation in their experiences. If that interrogation found a need to spend money on things, that spending isn’t budgeted in. There’s also a commitment to work on widening participation, but again without spending implications.
There’s little in the plan on student finance – in particular no news on fixing the issues embodied in the #LiveableNHSBursary campaign. Presumably the answer to woeful funding in years 5 and 6 is to just point at shorter routes.
There is at least a proposal for a single, consistent policy for funding excess travel and accommodation costs incurred by students undertaking placements – although again no price tag for levelling that up is attached.