The long-awaited 10 Year Workforce Plan is expected to be published soon, setting out what staff and skills are needed to fulfil the government’s reform ambitions. The 10-Year Health Plan says that by 2035 staff will be staff will be better treated, more motivated, have better training and more scope to develop their careers. It also pledges that the NHS will be not only the country’s biggest employer but its best.
With the workforce plan expected in Spring 2026, Healthcare Leader asked policy experts from key health think tanks and organisations across England about what they hope to see in the strategy.
Retention should be ‘at the heart’ of plan
Supporting staff and improving retention was a priority for all the organisations, with Hiba Sameen, lead economist at the Health Foundation, saying that ‘retention must be at the heart of the plan’.
Analysis by The King’s Fund from November 2025 found that the rate of staff leaving the NHS each year has averaged 11% since 2011.
Findings also showed that more than half (54%) of NHS leavers are recorded as voluntary resignations, with common reasons including work-life balance (9%) and the employee’s health (3%). And that the number of staff leaving for these reasons has more than doubled since 2012.
The 10-Year Health Plan said the workforce plan will set out how action will be taken on retention, productivity, training and attrition. It also stated the ambition to reduce international recruitment to less than 10% by 2035.
Ms Sameen added: ‘It is the fastest and most cost-effective way to grow effective workforce supply, but improving it will require action on flexible working, career development, safe staffing levels and working conditions.’
Nuffield Trust senior fellow, Kathryn Marszalek, highlighted the need for the plan to provide a ‘credible route to building a sustainable, domestically trained workforce,’ but said this will not help build a sustainable workforce unless the issue of staff retention is directly addressed.
Ms Marszalek added: ‘NHS staff are earning less in real terms than they did 15 years ago, and the recent staff survey results show declining motivation and engagement across the workforce,’ she said.
Results from the 2025 NHS Staff Survey showed that 35% of health service staff found their work emotionally exhausting, with about 31% saying they felt burnt out.
Sarah Woolnough, chief executive of The King’s Fund highlighted the importance of workforce planning and knowing how many and which types of staff are needed. But she also said that ‘improving retention is at least as important as recruiting new staff’.
Director of policy at The NHS Alliance, Dr Layla McCay, underlined the need for a plan to cover all parts of the service, including with consideration to primary care, ‘so that training capacity can grow in line with future demand’.
But she also said: ‘Progress on recruitment and retention also requires renewed momentum.
‘The commitment to work with trade unions and employers on contract reform must be backed by a realistic timeline, particularly for Agenda for Change (AfC) staff, where movement has been slow.’
A mandate was issued last month which means that Agenda for Change pay structure reform negotiations can start.
And Chris McCann, acting chief executive of Healthwatch England noted the need to improve the workforce culture for both staff and patients.
‘Recent NHS staff survey results are concerning, including declining confidence that organisations act on patient concerns,’ he said.
Mr McCann added: ‘The workforce plan should prioritise a culture of openness, where staff feel supported to raise issues and patients’ feedback consistently leads to visible improvements.’
Dr McCay from The NHS Alliance also said that embedding equality, diversity and inclusion throughout the plan was key.
‘This includes a clear pathway for inclusive talent management and a renewed commitment to NHS England’s EDI Improvement Plan. It should clearly set out how organisations will be held accountable and how progress will be measured,’ she said.
Helping healthcare staff get tech savvy
Health experts also highlighted the importance of getting the workforce ready for the shift from analogue to digital, which is one of the key ambitions in the government’s 10-Year Health Plan.
Ms Woolnough and Ms Sameen both stressed the need for the workforce plan to look realistically at the growth in digital and changes in technology.
Ms Woolnough said: ‘The plan must engage realistically with expected changes in technology, treatments and service models, for current and future staff. That means being clear about how staff roles and training will be supported towards the shifts from sickness to prevention, from hospital to community and from analogue to digital.’
Ms Sameen added that the plan needed ‘to be realistic about digital technology and AI [artificial intelligence]’.
Meanwhile, Ms Marszalek and Mr McCann both highlighted the importance of a plan which supports staff to keep pace with the growth in use of AI through up-to-date training to ensure they can use it ‘safely, effectively, and ethically’.
‘Realising the benefits of new technologies will require sustained investment in training and thoughtful integration of technology into existing workflows to avoid duplicating processes and creating additional work,’ Ms Marszalek said, adding that the plan offers an ‘opportunity’ to change the way staff feel at work.
Achieving the shift from hospitals to communities
Mr McCann stressed the importance of strengthening the primary and community care workforce. He said that achieving the shift from hospital to community requires ‘clear plans to expand and use the full skill mix of staff’.
‘This includes ensuring GP workforce planning aligns with the new funding formula, maximising the role of newly prescribing pharmacists and setting out how retention will be improved in key areas like dentistry,’ he said.
Ms Marszalek said staff play a key role in delivering the shift to the community, as highlighted in lessons from international comparisons.
She added: ‘This [shift] could be achieved by making more training placements available in community settings and by moving roles out of hospitals into the community.
‘In both cases, consideration will need to be given to the training needs of staff, the mix of skills that are needed, and the challenges of changing contracts and expectations.’
But Ms Sameen said that the plan must be grounded in ‘realistic projections’ of growing health care demand.
‘Our modelling suggests the number of people living with major illness will increase by 2.6 million by 2040, driving significant growth in conditions managed in both primary care and secondary care,’ she added.
‘Recruiting and retaining more GPs and other practice staff should be a priority, not only to meet rising demand but to deliver the government’s shift of care from hospital to community.’
Empowering NHS managers
Dr McCay from The NHS Alliance said that the plan should have a section dedicated to NHS management because ‘strong leadership is fundamental to the NHS’s long-term sustainability’.
‘The plan should include a dedicated section on NHS management, supported by a national approach to talent development and succession planning and underpinned by an independent leadership body,’ she added.
A focus on funding
Ms Marszalek said that the workforce plan must be backed by adequate funding for it ‘to have any teeth’.
She added: ‘The previous government allocated £2.4 billion to implementing the 2023 workforce plan; however, the money was exclusively for the expansion of training places.
‘No allowance was made for funding other aspects of the plan, including pay and progression, and there was little consideration of how other costs, for example capital and technology expenses, might change over time.’
Beyond the workforce plan
Ms Woolnough concluded that though the plan is significant, it can only do so much. She called for it to offer a foundation that staff can use to develop.
She said: ‘The plan is important, but only so much can be done from the centre. It should provide a framework which gives staff agency to develop health – broader than just delivering clinical services – and to innovate, based on the NHS becoming a great partner with other organisations involved in creating health and with local communities.’
