After months of waiting, the NHS Long Term Workforce Plan has finally been published. Nursing Times takes a look at what it means for nursing.
Released ahead of the 75th anniversary of the health service, NHS England’s plan aims to tackle the biggest problems it faces: recruitment and retention.
The 151-page document details the current shortfall of health staff in the NHS, as well as the targets for the coming 15 years.
Without intervention, it warned that the shortfall of NHS staff was predicted to rise from the current 150,000 full-time equivalents (FTEs) to between 260,000-360,000 by 2036-37.
For some professional groups, such as community nursing, the gap is set to grow significantly.
The plan said that, by 2036-37, there could be a shortage of 37,000 community nurses, compared to 6,500 in 2021-22.
Meanwhile, the mental health nursing and learning disability nursing shortfall would rise to more than 17,000 FTEs, it added.
Here is a breakdown of the key pledges in the plan in relation to nursing, as well as some of the other promises.
Recruitment and training
According to the plan, there is a current shortfall of around 20,000-24,000 nurses-in-training.
In 2022, the student nursing in-take was 29,860, but to meet demand there needs to be between 49,225-53,858.
The situation is similar across other areas of the nursing workforce, with 5,000 nursing associates being trained, compared to 10,000-10,500 needed; and 1,811 health visitors, district nurses and school nurses training, compared to a need of 3,066-3,788.
The document highlighted the gaps in mental health and learning disability nursing as being of “particular concern”.
To address these shortfalls, the plan pledges:
- An additional £2.4bn for education and training until 2028-29 for all NHS roles, not just nursing
- Increase the number of nursing training places by 34% to 40,000 by 2028-29 and 53,858 (80%) by 2031-32
- The proportion of student nurses training through apprenticeships will increase from the current 9% to 28% by 2031-32
- As part of the overall nursing increase, adult nursing training places will rise to 27,901 by 2028-29 and 37,959 by 2031-32 (92%)
- Increase nursing associate training places to 7,000 by 2028-29 (40%) and to 10,500 by 2031-32 (110%)
- Increase mental health nursing places by 38% by 2028-29 and 93% by 2031-32
- Increase primary care nurses by more than 5,000 by 2036-37
- Expanding the number of training places for health visitors by 17% by 2028-29 and by 74% by 2031-32 to reach 1,300 annually
- District nursing training places to increase by 41% by 2028-29 and 150% by 2031-32 to nearly 1,800
- Extension of dual registration courses for nurses in the fields of child nursing and learning disability nursing
- Allowing student nurses to join the register – and the workforce – up to four months earlier following qualification. Some universities already do this, the plan noted
Further increases for doctors, allied health professionals and other areas of the clinical workforce were also pledged.
The plan also laid out an intention to increase the number of four-year (as opposed to the standard five-year) medical degrees, and introduce doctor apprenticeships.
This training plan, NHS England said, would mean the health service could rely less on international recruitment.
The report stated that the plan aimed to reduce the number of adult nurses who need to be recruited from overseas from 57% in 2022-23 to around 15-17% in 2036-37.
Significantly, in terms of nurse education, NHS England has also used the plan to state its apparent support for a reduction in clinical placement hours for student nurses.
The plan stated: “We encourage the NMC to consider how graduate nurses can join its register after fewer practice hours, mirroring the approach in many other countries, and enabling the increase in training capacity set out in this plan.
“A reduction in placement hours from 2,300 to 1,800 over the course of a nursing degree would reduce pressure on our learners while significantly increasing placement capacity across the NHS to give pre-registration students the high-quality learner experience they need to prepare to work in the NHS.”
In 2022, the equivalent of 9.1% of the NHS workforce left their jobs.
The NHS workforce plan has promised a “renewed focus” on retention, including improvements to continued professional development (CPD) and wellbeing support, in order to reduce the leaver rate to between 7.4% and 8.2%.
These are the headline promises NHS England is making for retention across the workforce, as well as specifically for nurses:
- Increasing staff numbers
- Reviewing in-work support for newly-qualified staff, including supporting all NHS trusts to adopt the National Preceptorship Framework
- Embed a “compassionate culture built on civility, respect and equal opportunity” and tackle race, gender, and sexual discrimination in the NHS
- Enable regular conversations with staff about their wellbeing
- Ensure all NHS organisations have clear and regularly communicated Freedom to Speak Up frameworks
- Support NHS organisations to invest in occupational health and wellbeing services for staff
- Work to “fully embed a culture of flexible working” beyond what is required under statute, and recognising that nursing and midwifery – primarily female workforces – are likely to have parental or caring responsibilities
- A “commitment” to continuing national CPD funding for nurses, midwives and allied health professionals
- Reducing attrition rate for student nurses by investigating the key reasons for people leaving
NHS England has promised to revisit and continue “refreshing” the workforce plan at least every two years.
The plan featured input from nursing organisations including the Royal College of Nursing, Queen’s Nursing Institute, the Royal College of Midwifery and the Nursing and Midwifery Council.