Interim NHS People Plan – a vision for the workforce?

Following the publication of the Interim NHS People Plan, RCP’s president Professor Andrew Goddard, sets out how the vision will help people working in the NHS to deliver the NHS Long Term Plan.

Following her speech on workforce plans at RCP’s Medicine 2019 conference, Baroness Dido Harding, chair of NHS Improvement, has now launched the Interim NHS People Plan. It sets out a vision for those working in the NHS to enable them to deliver the Long Term Plan (LTP).

We all know that the ability to deliver the ambitions laid out in the LTP relies on the NHS and the government getting to grips with the workforce shortages we experience every day.

The interim plan focuses on the actions that must be taken now to begin to turn the tide. It also covers the groundwork required for improved recruitment and retention in the years ahead.

Now the NHS is prepared to start taking action, the next challenge is convincing the Treasury to fund a step change in the training of the future health and care workforce. But will the plan make a difference?

Making the NHS a better place to work

The plan places a focus on the here and now, recognising that if we don’t look after the current workforce the challenges will only multiply. This is particularly true as demand for care continues to grow, placing ever-increasing pressures on already overstretched staff.

It is essential that staff feel valued and supported so that they can continue to deliver excellent care. This means creating a new deal which explicitly outlines what staff can expect from the NHS as an employer.

The deal will include:

  • a commitment to creating a compassionate culture, with employee-centred practices and opportunities for career development
  • a review of policies and the approach around bullying and harassment, work-life balance, physical and mental wellbeing, and equality and inclusion
  • increasing the flexibility of training through a ‘step out - step in’ model

NHS England has already appointed a national Chief People Officer who will have responsibility for delivering the change.

Leadership can be a bit of a buzzword, but it has a very real impact on how we feel about our work.

Professor Andrew Goddard, RCP president

Improving leadership culture

Leadership can be a bit of a buzzword, but it has a very real impact on how we feel about our work. The plan sets out a range of actions to develop leadership capacity across the workforce, from embedding leadership training in all undergraduate programmes to creating a new ‘NHS leadership compact’, that will establish the cultural values and leadership behaviours expected from leaders.

We need leaders who are focused on quality improvement and creating the space for us to deliver improved care for our patients. We know it can be done, and our chief registrars are a great example of doctors balancing clinical and leadership responsibilities.

Professor Andrew Goddard, RCP president

We need leaders who are focused on quality improvement and creating the space for us to deliver improved care for our patients. We know it can be done, and our chief registrars are a great example of doctors balancing clinical and leadership responsibilities.

Delivering 21st century care

While we must ramp up the number of people training to become clinicians, we also need to be honest with ourselves that how we deliver care is changing. The plan acknowledges this and looks at how we transform the workforce by developing a greater skills mix, embedding new roles and scaling up new ways of working.

The plan also pledges to develop an increasingly flexible and adaptive workforce, removing practical barriers to the movement of staff across organisations. The NHS workforce of the future will deliver care in multi-disciplinary and multi-professional ways across different healthcare settings.

At the RCP we know that physician associates (PA) are a highly valuable growing profession ready to work alongside multi-disciplinary teams to deliver high-quality patient care. The interim plan commits to:

  • a consultation to identify what the NHS and patients require from medical graduates which in turn will support the development of a new curriculum by the GMC
  • working with the government on the regulation of PAs and scoping out prescribing rights
  • establishing a system-wide Programme Board to address geographical and specialty shortage issues.

I’ve not been shy in shining a spotlight on the need to double the number of medical students. While there are no firm commitments in the plan, the door has been left open for further discussions but we mustn’t underestimate the size of the expansion needed to meet the challenges ahead. 1500 more places just won’t be enough. Importantly, the plan is open about the critical shortages across professions, but particularly in nursing and outlines the initial plans for how the NHS will tackle them.

The plan comes on the back of the recent recommendations by the migration advisory committee to add ‘medical practitioners’ to the shortage occupation list, which will support the ambition to increase international recruitment through the use of ‘national lead recruiters agencies’. Alongside this, we wait to hear whether the government will support the expansion of the Medical Training Initiative.

On both research and digital health elements of the plan, the RCP is ahead of the curve. With our recent call for every clinician working in the NHS to become research active. We’ve also recently appointed our first clinical director for digital health who will lead on developing a digital health strategy for the RCP.

Professor Andrew Goddard, RCP president

On both research and digital health elements of the plan, the RCP is ahead of the curve. With our recent call for every clinician working in the NHS to become research active. We’ve also recently appointed our first clinical director for digital health who will lead on developing a digital health strategy for the RCP. 

Although the interim plan lacks detail on how it intends to achieve its goals, it bodes well for the full People Plan. The Treasury must now support its commitments to NHS staff.

In particular, we need urgent action to stop longstanding doctors being driven out of the workforce due to pension challenges. While it is welcome that the government has recognised the need to address this, any solution must have the support of the profession.