Introduction
The National Health Service (NHS) has recently unveiled its Long-Term Workforce Plan. This is a comprehensive strategy aimed at addressing the current and future challenges of the healthcare sector.
As you prepare for medicine interviews and embark on your healthcare career, it is essential to understand the plan's impact.
Here, we will provide insights into the NHS Long-Term Workforce Plan, focusing on key opportunities and considerations. We will discuss the plan's emphasis on education and training, the expansion of multidisciplinary teams, and the importance of retaining healthcare professionals.
By exploring these topics, we aim to equip you with the knowledge needed to succeed in medical school interviews and navigate the evolving healthcare landscape. You will need to provide some examples of hot topics you can apply during your medical school interviews. Here you will learn everything you need to know about the new NHS workforce plan for the UK.
The NHS Long-Term Workforce Plan is a significant document for aspiring medical students. The plan also identifies several key challenges that the NHS faces, such as an ageing population and increasing demand for healthcare services.
This includes the ethical implications and some example medicine interview questions and model answers for you to look at. Combine your reading here with medicine interview tutoring to boost your answers and delivery.
Section 1: The Need for the NHS Workforce Plan
Current Challenges in the NHS Workforce Planning
The Constant Need for More Staff
Despite a substantial increase in NHS staffing over the past decade, with a rise of 263,000 full-time equivalent staff since 2010, healthcare needs are rapidly outpacing workforce growth. This discrepancy is due to the rising demands of an ageing population with increasing morbidity.
The number of doctors has increased by 42,000 and nurses, health visitors, and midwives by 55,000, leading to an estimated 4,600 more doctors and 2,400 more nurses in general practice. Yet, the NHS faces significant workforce challenges, underscored by the need to continually grow the workforce.
However, without further intervention, the plan predicts a shortfall of 260,000 to 360,000 full-time equivalents (FTEs) by 2036/37.
Doctors
The plan projects a shortfall of around 15,000 fully qualified GPs in the medical staffing sector by 2036/37, despite recent interventions boosting GP numbers. This is due to the projected growth in GP numbers failing to keep pace with expected demand.
Nursing
Nursing staff shortages are also a significant concern. By 2036/37, the plan predicts a shortfall of 37,000 FTE community nurses, up from a 6,500 FTE shortfall in 2021/22. Mental health nursing is of particular concern, with the total mental health nursing shortfall predicted to reach 15,800 FTEs in 2036/37.
Shortfalls are also expected in learning disability nursing and critical care nursing due to fewer nurses entering training in these areas and limited opportunities for international recruitment.
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Allied Healthcare Professions (AHP)s
Among the allied health professions (AHPs), the greatest shortfalls are expected for podiatrists, paramedics, occupational therapists, diagnostic radiographers, and speech and language therapists. This is due to the education and training pipeline not keeping pace with the expected demand.
The non-registered workforce, particularly healthcare support workers, is also anticipated to face significant shortfalls due to limited supply growth and high staff turnover rates.
The plan estimates that the NHS relied on approximately 150,000 FTEs of temporary staffing in 2021/22 to meet demand. This reliance on temporary staffing is used as a measure of the shortfall between workforce supply and demand.
To address these anticipated shortfalls, the plan outlines actions in three broad areas: training to grow the workforce, retaining staff by improving culture and retention, and reforming work and training practices. These measures aim to ensure that the NHS can meet the healthcare needs of the UK population now and in the future.
The Demographic Pressure and Changing Health Needs
Over the next 15 years, England's population will rise by 4.2%. However, a more significant concern is the projected 55% growth in the population aged over 85. Coupled with increasing levels of multimorbidity and frailty, service delivery complexity is anticipated.
By 2037, if current trends persist, two-thirds of those over 65 will have multiple health conditions, with a third of those also battling mental health issues.
Inadequate Education and Training Pipeline
Despite a 25% growth in the workforce since 2010, the number of staff trained hasn't kept pace with the demand for NHS services. To fill these service gaps and maintain safe staffing levels, the NHS heavily relies on temporary staffing and international recruitment.
Half of the doctors who joined the UK workforce in 2021 were international medical graduates, and about half of the new nursing registrants in England in 2022/23 were trained overseas.
Reliance on Overseas Workforce and its Implications
This reliance on the overseas workforce has two-fold implications – it leads to high marginal labour costs and questions the sustainability of services in the longer term due to the rising global demand for skilled healthcare staff.
With more than 112,000 vacancies across the NHS workforce as of March 2023, the UK lags behind the average OECD country in terms of the number of nurses and medics per population size.
The Workforce’s Role in Preventing Ill Health
Currently, the NHS workforce is largely reactive, focusing more on responding to health and care needs rather than actively working towards preventing ill health. With the rise in people with multimorbidity, frailty, and complex needs, the NHS will need to shift from episodic care to ongoing, chronic care.
For this to be successful, there is a need for a more flexible workforce with more generalist and core skills alongside specialist skills.
The Long-Term Plan and Learning from the Pandemic
The NHS Long Term Plan outlines the changes needed for a 21st-century NHS, including bolstering primary and community care, investing in mental healthcare, early cancer diagnosis, and focusing on population health, integration, and prevention. Learning from the COVID-19 pandemic experience, rapid expansion of the necessary workforce and more flexible, integrated teams are needed.
The experience of working in the NHS varies significantly among staff, learners, and volunteers. Despite being the most diverse it has ever been, with nearly 25% of the staff coming from an ethnic minority background, not everyone working in the NHS has a positive experience.
The Impact of Technological Advancements
Developments in science, research, technology, digital, and data will inevitably continue. Specific advancements such as genomics and artificial intelligence (AI) will drastically improve our ability to prevent, diagnose, treat, and manage diseases. As these technologies become more prevalent, NHS staff must continue building digital skills and capabilities.
The unique challenges facing the NHS workforce and the time it takes to train new clinical staff necessitate a comprehensive, long-term approach to workforce planning. Implementing this approach is key to ensuring that the NHS can provide high-quality care in the face of changing population health needs.
The NHS, like many healthcare systems worldwide, is grappling with significant challenges. Workforce shortages, an ageing population, and the ongoing impact of the COVID-19 pandemic have all placed immense pressure on the system. Our previous article on the NHS GP shortage and crisis provides an in-depth look at one aspect of these challenges.
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The Imperative for a Comprehensive Workforce Plan
In light of these challenges, a robust and forward-thinking workforce plan is more crucial than ever. The NHS Long Term Workforce Plan aims to ensure that the right number of people, with the right skills, are in place to deliver the care that patients need.
Section 2: Key Components of the NHS Workforce Plan: Summary
Part 1: Train – Growing the Workforce
The first component of the plan focuses on increasing education and training to record levels. This includes expanding apprenticeships and alternative routes into professional roles, which will result in more doctors, nurses, and other healthcare professionals.
The plan aims for a significant expansion in medical training to meet future healthcare needs. Here are the key points:
Medical School Expansion
The plan proposes a 60-100% increase in medical school places, aiming to provide 12,000-15,000 places by 2030/31. This will be achieved through the expansion of existing medical schools, the establishment of new ones, and the introduction of medical degree apprenticeships. The goal is to double the number of medical school training places to 15,000 per year by 2031/32, with an intermediate target of 10,000 places by 2028/29.
GP Specialty Training
To meet the demand for GPs, the plan outlines a need to increase the number of GP speciality training places by 45-60% by 2033/34. The ambition is to increase the number of places by 50% to 6,000 by 2031/32. An initial increase of 500 places is planned for 2025/26, with further expansion to 5,000 total places by 2028/29.
👉🏻 Read more: NHS GP Shortage and Crisis
Foundation and Specialty Training
The plan recognises the need for growth in foundation year placements and speciality training to match the expansion in undergraduate medical training. Future expansion will support planned growth for mental health, cancer and diagnostic services, as well as 1,000 more speciality training places for areas with the greatest shortages.
Medical Degree Apprenticeships
Starting in 2024, NHS England will pilot a medical degree apprenticeship to attract and recruit from a wider pool of people in local communities. The plan funds 200 apprenticeship places for pilots running in 2024/25, with an ambition for up to 400 places by 2026/27. The goal is to have 2,000 medical students training via this route by 2031/32.
👉🏻 Read More: NHS Medical Apprenticeship Programme
Changing Workforce Shape
The plan anticipates changes in the medical workforce over the next 15 years, with more doctors choosing alternative career paths and working less than full-time. It also recognises the future need for more generalist doctors and those with generalist skills, particularly in general practice. The plan commits to working with medical schools, royal colleges, the GMC, and employers to support this shift.
Part 2: Retain – Embedding the Right Culture and Improving Retention
The second component of the plan aims to improve the culture, leadership, and well-being within the NHS to ensure fewer people leave the service. This includes implementing actions from the NHS People Plan and improving flexible opportunities for prospective retirees.
The NHS Long Term Workforce Plan emphasises retaining staff by creating a supportive and inclusive culture. Here are the key points:
Retention: The plan aims to reduce the overall leaver rate for NHS-employed staff from 9.1% in 2022 to between 7.4% and 8.2% over the modelling period, equivalent to retaining 55,000–128,000 full-time equivalents (FTEs).
Culture and Flexibility: Significant improvements in retention will depend on a changed culture across the NHS and more flexible working options. The NHS People Promise and NHS People Plan set out a consistent approach for all staff.
Diversity and Inclusion: The plan emphasises the need for a compassionate and inclusive culture. Progress has been made in increasing representation at senior levels, but there is more work to do to ensure equal opportunity.
Recognition and Reward: The plan proposes actions to ensure staff are recognised and rewarded fairly. This includes modernising the NHS Pension Scheme to allow more flexible retirement options and developing a clear employee value proposition (EVP) that covers national and local benefits.
Voice and Engagement: The plan emphasises the importance of staff feeling valued and respected at work and ensuring their views are welcomed. This includes having a clear Freedom to Speak Up approach and better using national tools and employee engagement metrics.
Health and Wellbeing: The plan highlights the importance of looking after the health and well-being of NHS staff. This includes developing and implementing plans to invest in occupational health and wellbeing services, providing good physical working environments, and supporting staff who experience domestic abuse and sexual violence. Read more about BAME and Racism within the NHS.
Learning and Development: The plan emphasises the importance of continuous development of staff skills, knowledge, and expertise. This includes ensuring staff have access to continuing development, supportive supervision, and protected time for training.
Flexibility: The plan recognises the changing expectations of work and work-life balance. It proposes actions to ensure the NHS goes beyond statutory requirements in terms of flexible working and encourages organizations to consider flexible working options for every job.
Teamwork: The plan emphasises the importance of team development and collective, inclusive, and compassionate leadership. It proposes strengthening multidisciplinary leadership and management across the NHS and adult social care.
Part 3: Reform – Working and Training Differently
The NHS Long-Term Workforce Plan outlines several key strategies for reforming the NHS workforce to meet the changing needs of patients. Here are the key points and statistics:
Workforce Reform: The plan emphasises the need for staff to work differently, including with each other and with patients, to provide high-quality care. This includes growing the skills and capacity to deliver care closer to home and supporting people to stay well for longer.
Primary, Community, and Mental Health Services: The plan aims to increase the number of NHS staff working in these areas as a proportion of the overall workforce.
Education and Training: The plan calls for a reform in how staff are educated and trained to support the ambitious level of expansion. This includes training healthcare professionals with generalist skills who can work effectively in multidisciplinary teams.
Productivity Recovery: The plan projects that productivity recovery in the short-term and continued improvements in the medium to longer-term will help mitigate the scale of workforce growth that would otherwise be required.
Labour Productivity: The plan outlines opportunities to boost labour productivity through sustained investment in the NHS infrastructure, a significant increase in funding for technology and innovation, and delivery of the broader proposals in the plan.
Shift Skills and Capacity into Community: The plan aims to move more care out of hospitals and invest in primary, community, and mental health care. The total nursing staff working outside acute settings is projected to increase from the current 30% to 37%, and the total community workforce nearly doubles in size over the modelling period.
Digital and Technological Innovations: The plan emphasises the need for the NHS workforce to take full advantage of digital and technological innovations. The NHS AI Lab currently has 86 projects in 444 live settings, with 99 hospitals and 344 PCNs involved with 3–5-year trials showing promising results.
Robotic Process Automation (RPA): The plan highlights the benefits of RPA in automating back-office tasks in the NHS. Most organisations report a 20–30% cost reduction and a 30–50% return on investment on RPA projects. If all trusts implemented processes that have been ‘time validated’, this could save more than 7.2 million hours annually, equivalent to over 965,000 working days released.
Remote Monitoring: The plan highlights the benefits of remote monitoring in bringing diagnostics and monitoring closer to the patient across primary, community, and acute services. The use of remote monitoring increased during the COVID-19 pandemic; this reduced emergency department attendance and hospital admissions from care homes, and improved patient experience.
Efficient Workforce Entry: The plan outlines strategies to bring people into the workforce more efficiently, including promoting uptake by education institutions of the opportunity for newly qualified nurses to join the NMC register on qualification at the end of the third academic year. This permits new registrants to be in paid employment up to four months earlier and can reduce employers’ reliance on temporary staff, and reduce costs and vacancies.
Understanding these key points from the NHS Long Term Workforce Plan is highly beneficial for medical school interviews for several reasons. Firstly, it demonstrates a deep understanding of the current challenges and future direction of the NHS, which is a crucial context for any medical professional.
Interviewers are likely to be impressed by candidates who can discuss these issues intelligently and show that they have thought about the implications for their future careers.
Secondly, it shows that you are keeping up-to-date with healthcare policy and are proactive in your learning, which are important qualities for a medical student and future doctor. It also provides you with material to discuss in your interview, such as how you might contribute to these changes or how they might affect your practice as a doctor.
Lastly, understanding these reforms can help you answer scenario-based questions or ethical dilemmas that might come up in your interview.
For example, you might be asked how you would handle a situation where resources are limited, or how you would approach a decision that involves balancing the needs of individual patients with the broader goals of the NHS.
Having a good understanding of the NHS's strategic direction can help you answer these questions in a way that aligns with current healthcare policy.
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Section 3: Analysis & Perspectives Of The NHS Workforce Plan - A Guide
As with any major initiative, the NHS Long Term Workforce Plan has been met with a range of reactions. Some have praised its ambitious goals and comprehensive approach, while others have raised concerns about its feasibility and potential impacts.
The NHS Long Term Workforce Plan is seen as a bold and ambitious initiative that aims to transform the recruitment and retention of staff within the NHS. The plan's focus on increasing healthcare productivity, doubling medical school places, and expanding apprenticeships are seen as positive steps. However, achieving the productivity goal will require significant capital investment, and the plan acknowledges this need.
The absence of social care from the plan is a concern, and there are calls for a social care equivalent plan to raise the status of careers in social care settings, transform staff experience, and invest in pay and conditions.
The plan's commitment to increasing placements for mental health and learning disability nurses, clinical psychologists, and child and adolescent psychotherapists is welcomed, but there are concerns about the lack of plans to increase the number of educational mental health practitioners.
The plan also aims to increase GP training places and create opportunities for training placements in general practice, which is seen as necessary to address workforce shortages. The expansion of training places for roles that form part of the Additional Roles Reimbursement Scheme (ARRS) is also seen as a positive step.
The plan's commitment to increasing placements for the specialist public health workforce and training more healthcare scientists is seen as a positive step towards focusing on disease prevention and health creation, as well as embedding health research into the NHS.
However, training more healthcare workers will require significant funding for both commissioned medical staff and placements for non-commissioned roles like nurses. The government's commitment to increasing training budgets in the plan is seen as a positive step.
The NHS Long Term Workforce Plan includes measures to improve retention, such as flexible working, culture, and training time. It aims to provide reassurance to staff and improve care for patients. However, international competition for healthcare professionals and the decline in pay relative to other professions pose challenges to retention.
The plan does not address pay issues and contract issues, and the government should reach an agreement with trade unions to prevent industrial action and support staff retention.
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While international recruitment is important, the plan aims to reduce reliance on overseas and agency staff in the long term by developing the domestic staff pipeline. The development of technology is seen as important, but it should not replace adequate staffing levels.
The need for digital, data, and technology staff to support the plan's ambitions is highlighted, and a separate workforce plan in this area is expected to be published.
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There is an anticipation of reviewing the detailed modelling behind the plan and working with relevant stakeholders to ensure the necessary capacity and infrastructure are in place. Integrated Care Systems (ICSs) are recognised as playing a central role in implementing the plan and tailoring it to local populations. The commitment to implementing the plan and supporting future iterations is acknowledged.
In conclusion, while the NHS Long Term Workforce Plan is seen as a positive step towards transforming the NHS workforce, there are concerns about the absence of social care from the plan, the ambitious productivity goal, and the need for significant capital investment.
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Potential Medicine Interview Questions on the NHS Workforce Plan:
How does the NHS Long Term Workforce Plan address healthcare workforce retention?
What opportunities does the plan present for future medical professionals in terms of training and education?
How does the plan aim to increase productivity in the healthcare sector and meet the needs of an ageing population?
What measures are proposed in the plan to attract and retain healthcare professionals from diverse backgrounds?
How does the plan address the need for more staff in mental health, community care, and primary care roles?
What are the implications of the plan for the integration of social care and health services?
How does the plan address the challenges of increasing pay to compete with other nations and retain healthcare professionals?
What role does technology play in the plan's vision for the healthcare workforce, and how does it complement staffing levels?
How does the plan aim to develop the domestic staff pipeline and reduce reliance on overseas and agency staff?
How will Integrated Care Systems (ICSs) contribute to the implementation and success of the NHS Long-Term Workforce Plan?
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FAQs on the NHS Workforce Plan
What is the purpose of the NHS Long-Term Workforce Plan?
The purpose of the NHS Long-Term Workforce Plan is to address the current and future challenges faced by the healthcare sector. It outlines a comprehensive strategy to ensure that the NHS has the right number of skilled professionals to meet the increasing demands of an ageing population and changing healthcare needs.
How does the plan address the current challenges in the NHS workforce planning?
The plan acknowledges the constant need for more staff in the NHS due to the rising demands of an ageing population. It aims to bridge the workforce gap by expanding medical training, increasing the number of GP speciality training places, and addressing shortfalls in nursing and allied healthcare professions. The plan also focuses on retaining staff by improving culture, flexibility, recognition, and well-being.
What are the projected shortfalls in the medical workforce, particularly in GP and nursing roles?
The plan projects a shortfall of around 15,000 fully qualified GPs and 37,000 community nurses by 2036/37. There are also expected shortfalls in mental health nursing, learning disability nursing, and critical care nursing. The plan aims to address these shortfalls by increasing training places and creating opportunities for training placements in general practice.
How does the plan propose to expand medical school places and GP speciality training?
The plan proposes a significant expansion in medical school places, aiming for a 60-100% increase by 2030/31. This will be achieved through the expansion of existing medical schools, the establishment of new ones, and the introduction of medical degree apprenticeships. The plan also aims to increase GP speciality training places by 45-60% by 2033/34, with an initial increase of 500 places by 2025/26.
What measures are outlined in the plan to improve staff retention and create a supportive culture?
The plan emphasises the importance of improving culture, leadership, and well-being within the NHS to enhance staff retention. It focuses on diversity and inclusion, recognition and reward, voice and engagement, health and well-being, learning and development, flexibility, and teamwork. These measures aim to create a supportive and inclusive culture that values and retains NHS staff.
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How does the plan address the need for more healthcare professionals in primary, community, and mental health services?
The plan aims to shift the focus of care from hospitals to primary, community, and mental health services. It proposes increasing the number of NHS staff working in these areas and expanding the community workforce. The plan also outlines actions to address shortfalls in mental health nursing and other allied healthcare professions to meet the growing demand for these services.
What role do technology and digital innovation play in the plan's vision for the NHS workforce?
The plan recognises the importance of technology and digital innovation to improve healthcare delivery. It highlights the need for NHS staff to develop digital skills and mentions remote monitoring and robotic process automation to enhance efficiency and patient care.
How does the plan aim to reduce the reliance on overseas and agency staff?
The plan aims to reduce reliance on overseas and agency staff by developing a domestic workforce. This includes expanding medical training, increasing training places, and improving working conditions. The long-term goal is a sustainable workforce that meets healthcare needs.
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What strategies are being proposed to reform the NHS workforce and work more efficiently?
The plan proposes working and training differently to meet the changing needs of patients. It emphasises the importance of team-based care, expanding skills and capacity in community settings, and investing in future workforce planning.
Conclusion
Regardless of the path chosen, preparing for medical school interviews is crucial. At The UKCAT People, we have created a comprehensive guide and 280 practice medical school interview questions to assist applicants. Familiarising yourself with medical ethics interview questions can be particularly beneficial.
The NHS Long Term Workforce Plan represents a significant step towards addressing the challenges faced by the UK's healthcare system. While it presents opportunities and challenges for future medical professionals, with the right preparation and guidance, students can navigate this changing landscape and build a rewarding career in the NHS.
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