NHS Long-Term Workforce Plan Summary: 2026

Introduction

NHS Long Term Plan vs Long Term Workforce Plan vs 10 Year Health Plan

Students lose marks in interviews by mixing these up, so here is the clear distinction. The NHS Long Term Plan was published in January 2019 as a 10-year roadmap for NHS services in England, prioritising prevention, primary and community care, mental health and early cancer diagnosis. The NHS Long Term Workforce Plan, published in June 2023 by NHS England, was the first comprehensive plan for staff, built on three pillars: train, retain and reform. Its flagship pledge was to roughly double medical school places to 15,000 a year by 2031/32.

The current overarching strategy, however, is the 10 Year Health Plan for England, Fit for the Future, published on 3 July 2025 by the Labour government. It supersedes the 2019 Long Term Plan and reframes NHS reform around three shifts: from hospital to community, from analogue to digital, and from sickness to prevention. It also commits to a brand new 10 Year Workforce Plan to replace the 2023 document. In my experience as a GP, interviewers in the 2026 cycle are far more interested in whether you understand these three shifts than whether you can recite old shortfall statistics.

A practical tip: if a question simply says the NHS Long Term Plan, ask the panel to clarify, or briefly state which document you mean. Showing that you know the 2025 plan now leads, while the 2023 workforce plan is being refreshed, instantly signals that you are up to date.

Before we begin, it is worth clearing up a common confusion, because three different documents share similar names. The NHS Long Term Plan (January 2019) was a 10-year strategy for NHS services. The NHS Long Term Workforce Plan (June 2023) was a separate plan focused on staff: training, retaining and reforming the workforce. Crucially, both have now been overtaken by the 10 Year Health Plan for England, Fit for the Future, published on 3 July 2025, which is the current overarching NHS strategy. This guide explains each one, what changed, and how to use it in your medicine interview.

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: Why the NHS Needed a 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.

👉🏻 Read More: Nursing Strikes in the UK

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 lagged behind the average OECD country for nurses and doctors per head of population. NHS vacancies have since fallen from that peak as recruitment caught up, but workforce pressure has shifted: by 2026 the bigger debate is about funding enough substantive posts (especially for newly qualified doctors and GPs) and reducing reliance on overseas recruitment.

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.

👉🏻 Read more: Ultimate Medicine Interview Preparation Guide

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: NHS Long Term Workforce Plan (2023) Summary: Train, Retain, Reform

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:

Doubling Medical School Places to 15,000

The headline ambition of the 2023 plan was to roughly double medical school places, from around 7,500 to 15,000 a year by 2031/32, with an interim target of about 10,000 places by 2028/29. This was to be achieved by expanding existing medical schools, opening new ones, and piloting medical degree apprenticeships. Important update: the July 2025 10 Year Health Plan signalled that the new 10 Year Workforce Plan will set out fewer staff overall by 2035 than the 2023 plan projected, arguing that better skill mix, technology and AI will let a smaller workforce achieve more. The government has also pledged to expand or reallocate medical school places towards areas with poorer health outcomes, and to increase by 50% the proportion of students on free school meals entering medical school in England by 2035. Treat the 15,000 figure as the 2023 ambition, now under review.

GP Specialty Training

To meet demand for GPs, the 2023 plan aimed to increase GP speciality training places by 45 to 60% by 2033/34, raising numbers by around 50% to about 6,000 places a year by 2031/32, with roughly 5,000 places by 2028/29. As of 2026, GP recruitment has improved but paradoxically many newly qualified GPs report struggling to find substantive posts, so the forthcoming 10 Year Workforce Plan is expected to focus as much on creating GP jobs and shifting funding into general practice as on training numbers.

👉🏻 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

NHS England began piloting a medical degree apprenticeship in 2024 to widen access and recruit from local communities, funding an initial cohort of around 200 places and aiming for up to 400 by 2026/27, with a longer-term ambition of about 2,000 medical apprentices a year by 2031/32. As of 2026 this route remains small and at an early stage, and its future scale depends on the new 10 Year Workforce Plan and on the abolition of NHS England, the body that designed it.

👉🏻 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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.

👉🏻 Read more: Answering Medical Ethics Questions

Section 3: Analysis and Criticism of the NHS Workforce Plan

The 10 Year Health Plan 2025: Three Shifts and Neighbourhood Health

The 10 Year Health Plan for England, Fit for the Future, was published on 3 July 2025 and is the single most important NHS document to understand for 2026 interviews. It is built around three shifts. First, hospital to community: care moves out of hospitals into a new Neighbourhood Health Service, with teams of GPs, nurses, pharmacists and others working together closer to where people live. Second, analogue to digital: a greatly expanded NHS App is meant to become the digital front door to the entire NHS by 2028, with more remote monitoring and AI support. Third, sickness to prevention: a stronger focus on stopping illness before it starts, including a smoke-free generation, tackling obesity, and using genomics and data to predict and prevent disease.

Neighbourhood health is the idea that ties this together. Rather than patients bouncing between fragmented services, the plan envisages local, multidisciplinary teams holding responsibility for a defined population, including more services delivered in the community and even some on the high street. This is the same direction the 2023 Workforce Plan pointed in, shifting staff and care out of acute settings, but the 2025 plan makes it the central organising principle of the whole NHS.

For the workforce, the 10 Year Health Plan made a striking statement: there will be fewer staff in the NHS by 2035 than the 2023 Long Term Workforce Plan projected, because a better skill mix, technology and AI are expected to let a smaller workforce do more. The government also set goals to cut the share of new clinical recruits trained outside the UK from around 34% to 10% by 2035, and to widen access so more students from deprived backgrounds become doctors. A new 10 Year Workforce Plan to deliver all this was promised but repeatedly delayed; as of June 2026 it is still awaited, and bodies including the BMA and Royal College of Nursing have warned it may underestimate the staff the NHS actually needs.

What the Abolition of NHS England Means for the Workforce Plan

There is a major structural change you must mention to sound current. The 2023 Long Term Workforce Plan was an NHS England document, but on 13 March 2025 the government announced that NHS England would be abolished and its functions brought back into the Department of Health and Social Care, with the merger targeted for completion around late 2026 and headcount across the two bodies cut by roughly half. This is why the refreshed workforce plan has been delayed and rebranded as a government 10 Year Workforce Plan rather than an NHS England one.

In an interview, you can use this to show balanced thinking. Supporters argue that scrapping a large arms-length body reduces duplication, saves money and brings the NHS under clearer democratic control. Critics worry that a huge reorganisation, including big job cuts, risks distracting from frontline care and losing experienced planners at exactly the moment a new workforce plan is needed. A strong candidate acknowledges both sides and links it back to patients: whatever the structure, the test is whether the right staff are in the right place to deliver safe care.

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.

👉🏻 Read more: Junior Doctor Contract

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 2023 plan highlighted the need for digital, data and technology staff, and a separate digital workforce plan was promised. In the event, NHS England dropped the standalone digital workforce plan in 2025 and folded it into the wider workforce refresh, reflecting the government's decision to abolish NHS England and bring workforce planning back into the Department of Health and Social Care.

👉🏻 Read More: 7 Day NHS: A Guide

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.

👉🏻 Read more: Common NHS Hot Topics

Medicine Interview Questions on the NHS Long Term Plan and Workforce Plan

1. What is your understanding of the NHS long-term plan?
2. Have you ever noticed any issues in the NHS that are mentioned in the NHS Long Term plan?
3. How does the NHS Long Term Workforce Plan address healthcare workforce retention?

Harder questions, unlikely to come, but good for understanding:

1. How does the plan aim to increase productivity in the healthcare sector and meet the needs of an ageing population?
2. What measures are proposed in the plan to attract and retain healthcare professionals from diverse backgrounds?
3. How does the plan address the need for more staff in mental health, community care, and primary care roles?
4. What are the implications of the plan for the integration of social care and health services?

👉🏻 Read more: 280 Medical School Practice Interview Questions

Conclusion

Regardless of the path chosen, preparing well for medical school interviews is crucial. At The UKCAT People, we have created a comprehensive guide and 280 practice medical school interview questions to help applicants. Familiarising yourself with medical ethics interview questions is particularly useful, because so many NHS hot topics, including workforce and the 10 Year Health Plan, come down to fairness, resource allocation and prevention.

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.