May's 'long-term plan' for NHS: HR community reacts
Rachel Muller-Heyndyk, January 08, 2019
Prime minister Theresa May has launched a 10-year plan for the NHS, but many are concerned the proposals fail to tackle workforce pressures
May said the plans were about "reshaping the NHS around the changing needs of patients". However, unions and campaigners are concerned that staffing shortages in the NHS could undermine this ambition, with one in 11 posts currently sitting vacant.
Many NHS Trusts across the UK are falling short of all three key waiting time targets (A&E, cancer care and routine operations) and are struggling to balance the books financially.
The plan, unveiled by NHS England chief executive Simon Stevens and May, commits to allocating a third of an additional £20 billion in funding to GPs, community care and mental health services. Currently these areas account for less than a quarter of spending, while hospitals take up around half of the £114 billion frontline budget.
The prime minister asked for the plan to be drawn up when she unveiled extra funding for the health service in the Summer to mark the NHS’ 70th birthday. The budget will grow by £20 billion a year by 2023 – equivalent to annual rises of almost 3.5%.
She said a long-term plan is needed to ensure the money is wisely spent and cited it as a "historic" moment for the NHS that will help pay for "world-class" treatments.
Stevens told the BBC that the NHS plans to train between 25% and 50% more nurses and has five new medical schools ready to train doctors.
However, senior fellow at The King’s Fund Michael West, told HR magazine that the plans do not tackle the real difficulties facing the NHS. “With a shortage of 100,000 NHS staff and many more planning to leave, Theresa May’s announcement does not address the most significant challenge the NHS now faces,” he said.
High absenteeism and stress continue to plague the health service, he explained: “The context is that more than one in three NHS staff are reporting illness as a result of work stress and this is affecting care quality, staff absenteeism, financial performance (for example through agency spending), error rates and staff retention. Until these problems of short-staffing and work overload are addressed, progress in grappling with the other serious problems facing the NHS will not be possible.”
Dean Royles, president elect of the Healthcare People Management Association, agreed that the plans do not go far enough. “The NHS long-term plan is a step forward from the five-year forward view, which barely mentioned workforce at all," he said.
"However, when it comes to the NHS workforce this plan falls considerably short of what is needed. It is bizarre that a workforce strategy will follow later. The way we recruit, retain, lead and deploy staff is the very essence of a long-term service plan, not an appendix to it.”
He added that HR professionals in the NHS have long called for the government to take action on staffing issues. “HR professionals in the NHS have been highlighting the growing recruitment problems and the increased pressure this places on committed staff for a number of years. HR professionals have been innovative and creative to help alleviate some of the problems but it is not a sustainable solution,” he said.
Royles added: “We need targeted resources that not only meet the increased need in the supply of staff, but also focus much-needed attention on retention, staff health and wellbeing, effective people management practices, training and development, and help in improving the working environment for staff.
"It is also essential to work effectively, in partnership with trade unions, to develop workable solutions with them that will reap significant rewards for staff and patients.”
Ben Morrin, director of workforce at University College London Hospitals NHS Foundation Trust, said that HR leaders within the NHS will play a crucial role in addressing changes in the workforce. “The NHS long-term plan provides us with a compelling vision for what outstanding health outcomes can achieve. Delivering the plan will rely upon authentic action to motivate the current and future NHS workforce,” he said.
“There is now a great opportunity for HR leaders across the NHS to inform future workforce plans so they are credible.”
May’s plan comes as Brexit creates uncertainty around NHS staffing, with about 5% of the current NHS workforce from Europe. The government has pledged that those currently working in the UK will have the opportunity to obtain 'settled status', and that there will be a new skilled migrants system similar to the one that operates for workers from the rest of the world.
But unions have raised concerns that some lower-paid nurses and non-clinical staff will not be covered by such a system; because the cut-off salary is at least £30,000 a year.