The long term workforce plan relies on ‘optimistic assumptions’ about improving NHS productivity and has significant weaknesses, according to a National Audit Office (NAO) report.
The plan, which was published in June 2023, promised to boost the number of GP training places by 50% and almost double adult nursing training places.
The NAO carried out an independent assessment of the modelling underpinning the plan to see if NHS England constructed the models effectively and if they were a ‘reasonable’ basis for strategic workforce planning.
The report concluded that while the workforce plan is a ‘foundation on which to build’, that it has weaknesses. It recommended that NHS England address these issues for the modelling to be used for regular strategic workforce planning.
It suggested that in future modelling, NHS England should include different scenarios, such as varying amounts of funding and demands facing the service, and that it should have more ‘realistic’ assumptions of the minimum level of international recruitment of doctors.
It said: ‘This first version of the modelling pipeline as a whole has significant weaknesses, including the lack of integration between different parts of the pipeline and the manual adjustments to balance supply and demand gaps in the triangulation models.
‘We found that limitations in documentation and the use of manual processing meant we were not able to fully replicate the results of the modelling as an independent reviewer. Some of the assumptions used in the modelling may be optimistic and the model outputs were weakened by the limited extent to which future uncertainties were communicated.’
Saffron Cordery, deputy chief executive at NHS Providers said that leaders ‘need’ the workforce plan to be a success.
‘It is therefore deeply concerning that ‘significant weaknesses’ in its modelling have been identified. Realising the plan in full will also depend on additional funding.
‘The report recognises the challenging productivity ask of trust leaders and their teams, who are already are doing everything they can to boost productivity. Overstretched staff are working flat out to treat patients with increasingly complex conditions within existing resources and in the face of relentless demand.
‘We need to see more capital investment in NHS infrastructure to support productivity efforts.’
Anita Charlesworth, director of the REAL Centre at the Health Foundation, said: ‘As noted by the NAO and our independent assessment, the modelling approach relies on optimistic assumptions about improving NHS productivity.
‘But, as we have previously stated, this will be a pipedream without significant investment in capital and technology, which has lagged behind comparable countries for decades. The additional £3.4 billion for digital transformation announced in the March 2024 budget is a welcome and significant start, if the money is actually spent as intended; capital and technology budgets have frequently been raided to cope with day-to-day spending pressures.’
Both the Health Foundation and NHS Providers also noted the need for an equivalent workforce plan for social care.
Ms Cordery added: ‘More widely, trust leaders know that for the NHS long-term workforce plan to succeed – and help ensure the sustainability of the health service – there must be more support for social care. Social care needs a fully funded long-term workforce plan, too.’
