'NHS Long Term Plan provides sustainability but we need more doctors' according to RCP

The RCP has welcomed the NHS Long Term Plan's focus on changing models of working, but called for the government to dramatically increase medical school places, and the supply of doctors, to alleviate burnout rate among health professionals. 

NHS England has today launched the NHS Long Term Plan setting out the vision for the next 10 years following the £20.5 billion funding boost agreed last year.

We are grateful for the support of more than 900 of our members and fellows who helped shape the RCP’s response to the consultation process to ensure that the voice of our profession was heard. While there is a lot to welcome in the plan we remain concerned about the lack of detail on workforce, and how the plan will sit alongside the long-anticipated green paper on social care.   

In response to the publication of the plan Professor Donal O'Donoghue, RCP registrar, said:

The Long Term Plan provides a step change in health, providing specific areas of improvement that will provide much needed sustainability to the NHS. It is particularly good to see a focus on changing models of working with greater integration, changes to outdated systems such as outpatient care and fundamentally making sure care is person-centred.

[...] if we are to see a real reduction in burnout rate, the only way to achieve this in the medium to long term is by dramatically increasing medical school places.

Professor Donal O’Donoghue, RCP registrar

We know that frontline staff today will be working out what the plan means for them and their interactions with patients. The plan sets out some small but important changes that should help improve doctors’ morale, from changes to training programmes permitting ‘step in step out’ training and an increasing focus on the health and wellbeing of staff. 

However, if we are to see a real reduction in the rising ‘burn out’ rate doctors report to us, the only way to achieve this in the medium to long term is by dramatically increasing medical school places. We encourage ministers to move beyond considering the expansion of the Medical Training Initiative, and to commit to the expansion this week.

Over the weekend the RCP welcomed the commitment laid out in the Long Term Plan to begin building on the recommendations on smoking cessation in hospitals in the seminal RCP report, Hiding in plain sight. The plan commits to providing all people admitted to hospital by 2023/24 with NHS-funded tobacco treatment services. The NHS paper also sets out the establishment of alcohol care teams (ACTs) in hospitals with the highest rate of alcohol dependence-related admissions, which is a welcome new focus. The plan is clear that the NHS must do more through its contacts with patients to support people to live healthier lives.

The plan is clear that the NHS must do more through its contacts with patients to support people to live healthier lives.

The Long Term Plan highlights key RCP publications and guidance, such as Outpatients: the future - adding value through sustainability, and calls for a redesign of outpatient services to give patients a choice of when and where to have their appointment, including limiting unnecessary travel, and provide greater flexibility for care. It also highlights the RCP and Society of Acute Medicine guidance on same day emergency care models and the future expansion of the model.

New ways of working and greater integration are central to the Long Term Plan, with proposals to bring together primary, secondary, physical, mental health and social care. Crucial to this will be the health and social care green paper, expected later this year, and implementation plans at a local level. This looks to provide a greater focus on person-centred care and improve experience, choice and outcomes for patients. 

The importance of our national audit programmes has again been highlighted with the National Asthma and COPD Audit Programme findings underpinning NHS England’s ambition to increase the number of patients with COPD who are referred for pulmonary rehabilitation. 

On workforce the plan sets out the beginnings of what will hopefully become a much anticipated new national workforce strategy. With a focus on retaining current staff, changing working and training practices, and increasing the wellbeing support available for staff. However, the Long Term Plan doesn’t offer enough at the moment on the critical step change we need. It’s disappointing the government is yet to commit to expanding the Medical Training Initiative but we hope this will follow soon. 

Over the next few weeks the RCP will spotlight areas of the plan in a series of articles to explore the issues more fully.