Medical degrees could be shortened by a year and there will be thousands more university places for medical students, in a major plan to boost the NHS workforce in England.
The plan, which has been delayed for more than a year, has been called “historic” by NHS leaders.
But Health Secretary Steve Barclay admitted patients would not see some of the benefits for several years.
Critics say poor working conditions in the NHS could undermine the plan.
The NHS has been beset by strikes this year, and the dispute with doctors is still continuing.
Pay does not feature in the plan – instead, it focuses on increasing training places for medical and nursing students and a new apprenticeship scheme for doctors.
A consultation on whether five-year medical degrees could be shortened by a year will also be launched.
Currently, half of new doctors and nurses have to be recruited from abroad as the UK supply route has struggled to keep up with demand.
One out of every 10 posts remains unfilled – more than 110,000 vacancies.
And without action, this could rise to 360,000 by 2037, modelling for the plan suggests.
Prime Minister Rishi Sunak and NHS England chief executive Amanda Pritchard will officially unveil the plan on Friday.
To help achieve the goals, the government has promised £2.4bn over the next five years.
Ms Pritchard called it a “historic” moment for the NHS.
“It gives us a once-in-a-generation opportunity to put staffing on a sustainable footing for years to come,” she added.
Mr Sunak called it “one of the most significant commitments” he would make as prime minister.
The targets for 2031 include:
- doubling medical school places for student doctors, to 15,000 a year
- a 50% increase in GP trainee places for junior doctors
- 24,000 more nurse and midwife student places a year – close to double the number now
In the next five years, the proportion of NHS staff, including physios, podiatrists and maternity staff, trained through apprenticeships – combining paid work with study and no tuition fees – will double, to one out of every six.
And next year, an apprenticeship for doctors will launch, with a few hundred places.
NHS England medical director Stephen Powis told BBC Radio 4’s Today programme that making the plan a reality is “doable”, but would be “challenging” for the entire health system.
Pressed on whether he had confidence it would be backed financially by the government, he said it contained a “clear ambition over 15 years, laying out exactly what the NHS will need” beyond the initial £2.4bn.
Speaking to the same programme, Mr Barclay said senior NHS leaders had told him the plan “gives hope to the system” in the long-term.
He said patients will not see some of the benefits for several years, but added that reforms and measures to improve staff retention “will come through quite quickly”.
Gemma Peffers is one of thousands of people to have already started a nursing apprenticeship – in 2016, aged 30, at Royal Derby Hospital.
“I left school not knowing what to do,” she says. “I had lots of different jobs.”
Ms Peffers has now qualified as a nursing associate – a role that bridges the gap between healthcare assistant and nurse.
Her next step will be to start two years of training to become a nurse.
Learning on the job has been really beneficial, Ms Peffers says.
“We are learning the ethos of the NHS and getting to know how our patients want to be looked after,” she says.
And earning while she learns is important too.
“I’ve got children and a house to run,” Ms Peffers says. “The security is really important and has enabled me to pursue a career in the NHS.”
Being welcomed
There will also be a major drive on retention – including more flexible-working options and career development to provide clear routes to senior jobs. Last year, more than 40,000 nurses left the NHS.
The plan is being welcomed by many in the health service.
Matthew Taylor, of the NHS Confederation, which represents health trusts, called it “bold and ambitious”.
The same commitment was now needed for the social care workforce, he added.
Others have pointed out the drive to increase training places could be undermined by the lack of placements on the front line – half of a nurse student’s degree is spent working in the NHS.
It will also take years before this expansion starts to have an impact on current shortages – it takes five years to complete a medical degree and three a nurse degree.
Is it enough?
There are challenges making sure the expansion of training places are successful. The first one is making sure there are enough people interested in pursuing a career in health care.
That is less of a problem for doctors – medical degrees are heavily over-subscribed.
But the number of applications for nursing degrees is falling – with universities saying the cost of living crisis is putting people off.
However, perhaps the biggest challenge of all is ensuring existing staff are retained – nurses are leaving the NHS almost as quickly as new ones are joining.
There has been very little detail so far about how this will be addressed – and of course pay is not part of this plan and that is a key factor in keeping staff.
Pay awards going forward will be determined by two things – the size of the NHS budget and what is happening with inflation.
It is why the £2.4bn committed to boost training in this plan over the next five years is being welcomed, but on its own will not determine its success.
‘Dismal reality’
Dr Billy Palmer, of the Nuffield Trust think tank, said while it was good to see the plan published, there had been “years of drift”.
And he warned the “dismal reality” of working in the NHS at the moment could undermine the push to tackle shortages in the long term.
“There is a risk that we will feed more and more people into training only to burn them out ever faster,” Dr Palmer said.
Speaking to the BBC, shadow health secretary Wes Streeting said “congratulations to the government for listening to Labour”, claiming that ministers had “nicked” the opposition’s plan.
He continued: “There is a reason why the NHS is understaffed, and it’s the lack of a workforce plan for the last 13 years.”
Source – BBC News
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