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The health care workforce in England: Make or break?

NHS leaders will shortly publish a long-term plan, which will set out their ambitions for the health service in the context of the recent funding settlement. We also await the outcome from the consultation on the draft national workforce strategy published by Health Education England in December 2017, as well as the green paper on the future of social care, which should contain important detail on the equally critical and fundamentally connected issue of the social care workforce.

This briefing highlights the scale of the NHS workforce challenges and the threat this poses to the delivery and quality of care. It sets out the reasons why the long-term plan and a supporting workforce strategy must address the urgent and mounting challenges facing the health care workforce. We believe these challenges now present a greater threat to NHS services than the funding challenges.

It is important to note that our commentary in this briefing is directed towards action needed by the NHS, as our focus here is on the workforce requirements linked to the NHS’s long-term plan. But this should not in any way detract from the message that urgent action is required in social care: the two systems are critically interdependent.

Indeed, our work suggests that there needs to be a more coherent national system to develop and oversee workforce strategy and ensure its alignment with the changing models of delivery of health and social care. We cannot continue with siloed working between hospitals, primary care and social care, and an effective approach to the workforce needs to look at the requirements of all these sectors holistically.

A coherent and holistic strategy will not only look at the training of the future workforce, but will also consider how to mobilise the talents of the current workforce – using the full range of policy options, including financial and non-financial incentives. Moreover, as many health and care staff work for non-NHS providers, a credible workforce strategy must look beyond those employed by the NHS: the failure to consider the workforce needs of health and care services as a whole is one factor that has contributed to shortages.

This briefing will be followed in the coming weeks by a more in-depth report that explores five key levers available nationally and locally that could help ameliorate the workforce crisis. These levers are: training; international recruitment; better employment practice; pay and conditions; and maximising the potential of staff through better use of existing skills, enhancing those skills and redesigning roles.

We will explore the opportunities offered by each of these levers and will recommend a number of high-impact interventions. The report will also explore the issues in social care in more depth than we are able to here.