Poor workforce planning is biggest internal threat to future of NHS, parliamentary inquiry finds

Authors: Abi Rimmer 

Publication date:  05 Apr 2017

Poor workforce planning is the biggest internal threat to the sustainability of the NHS, a major parliamentary inquiry has concluded.

The report, from the House of Lords committee on the long term sustainability of the NHS, highlighted concern at the absence of any comprehensive, national, long term NHS workforce strategy.[1] “Much of the work being carried out to reshape the workforce is fragmented across different bodies with little strategic direction from the Department of Health,” it said.

The inquiry report, published on Wednesday 5 April, said that Health Education England (HEE) was “unable to deliver” and recommended that the organisation should be “transformed into a new single, integrated strategic workforce planning body for health and social care.”

“This will enable it to produce and implement a joined-up place-based national strategy for the health and social care workforce, and it should always look 10 years ahead, on a rolling basis,” said the report. It added that HEE’s budget should be guaranteed and protected and that consideration should be given to its name “to better reflect its revised function.”

Ian Cumming, chief executive of HEE, said that the organisation welcomed the report and was particularly interested to see “proposals for an enhanced future role for Health Education England that reflect a need for more longer term, strategic workforce planning.”

HEE has started some work in this area and will announce further work in its workforce plan at the end of the month, said Cumming. But he added, “We accept, however, that much more needs to be done and look forward to examining the report and its 34 recommendations in detail over the coming days and weeks and working with partners to help support a better system to provide higher quality education and training for students and trainees and better quality, safer care for patients.”

In addition to its poor workforce planning the NHS had relied too heavily on overseas recruitment, the report said. “The government should outline its strategy for ensuring that a greater proportion of the health and care workforce comes from the domestic labour market and should report on progress against this target,” it advised.

The committee called on the government to takes steps to reassure and retain overseas trained staff working in the NHS and adult social care “who are now understandably concerned about their future.”

It highlighted the “indisputable link” between “a prolonged period of pay restraint, over-burdensome regulation and unnecessary bureaucracy” and low levels of morale and workforce retention. The government should commission an independent review of the current pay policy “with a particular regard to its impact on the morale and retention of health and care staff,” it recommended.

The committee also urged the government to bring forward legislation to modernise the system of regulation of health and social care professionals and to place them under a single legal framework, as envisaged by the 2014 draft Law Commission Bill.

Commenting on the report, Mark Porter, BMA council chair, said, “The committee is right to identify the serious and ongoing problems in recruiting and retaining NHS staff, and the morale damage from years of ongoing pay restraint. Only last week, doctors got yet another real terms cut in pay despite working harder than ever before.

“At a time when GPs are unable to keep up with the number of patients coming through the surgery door and hospital doctors are working under impossible conditions, our government should heed the committee’s recommendation and allocate the investment needed to match the promises made.”

Liam Brennan, president of the Royal College of Anaesthetists, said, “This report starkly highlights the significant workforce issues facing the NHS.” He added, “We know that without proper long term planning, we won’t have enough doctors, including anaesthetists, to treat the ever increasing number of patients in the NHS.

“We need the government to take responsibility not just for the short term but for the long term future of the NHS.”


  1. House of Lords Select Committee on the Long Term Sustainability of the NHS. Report of Session 2016-17: the long-term sustainability of the NHS and adult social care. 5 Apr 2017. [Link] .

Abi Rimmer BMJ Careers


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