Government plan to tackle NHS staff shortages shelved amid Treasury row

Exclusive: ‘HMT now says we have the money. If [the plan] is out before Christmas I’ll eat Santa’s hat,’ says one senior NHS figure

A flagship government plan to tackle NHS staff shortages has been shelved amid government “uncertainty” and a row with the Treasury over funding.

Senior NHS sources have said the 15-year workforce strategy, announced by Sajid Javid when he was health secretary, and slated for publication this October, is now unlikely to be finalised or published before Christmas.

The concern among senior NHS figures is that the new health secretary, Therese Coffey, and the Treasury are reluctant to consider ways of paying to retain or recruit staff.

Healthcare leaders have raised concerns about the delay, warning that it will “compound” the already severe staffing shortages. They have called for Ms Coffey to include workforce announcements within her speech tomorrow.

NHS Employers chief executive Danny Mortimer said: “One of the single most important actions the health secretary can announce this week is the immediate investment in a national minimum wage for care workers, which will help maintain desperately needed capacity in social care.”

Medical royal college leaders released a report on Wednesday arguing that failure to invest in workforce planning had led to the current crisis in the NHS.

It said: “Open discussion and a full debate about the state of the NHS and social care are currently being avoided.”

One source said the Treasury was a “massive hurdle” but that Mr Javid was “up for a fight”.

Another senior NHS source said: “We’ve not had a functioning Department for Health and Social Care system to even get things off the ground. We don’t know what the new priorities are for the government. [But] we are hearing they may change track… a view [that] we have enough money, so get on.”

They added: “We need to have an honest conversation about affordability or some sense of ‘what the NHS can do’ with the resources it has. Neither is a place where politicians want to be.”

“HMT now says we have the money. If [the plan] is out before Christmas I’ll eat Santa’s hat.”

A third source said: “I imagine there are some things that are just going to go by the wayside with the new government. The workforce [plan] being delayed is [about] whether they want to sign up to long-term workforce planning overall.”

Ms Coffey is set to make announcements on Thursday about an “emergency” NHS plan. On Saturday The Independent revealed that the DHSC was in discussions with No 10 regarding signing off new A&E targets.

Some fear that delays to the workforce plan mean that the NHS will miss key points in doctors’ and nurses’ academic cycles. Under existing training schedules for clinicians, planning for the 2024 intake will need to happen in early 2023.

Miriam Deakin, interim deputy chief executive for NHS Providers, warned: “A delay in producing a workforce plan will only compound existing severe staff shortages and lead to more ‘burnout’ as the NHS works flat out to reduce care backlogs. Trusts need the government to commit to tackling this serious problem.

“Support from the secretary of state to develop a long-term workforce plan for the NHS is vital. With more than 132,000 vacant NHS jobs, the need to plan further ahead to train, recruit and retain staff in the right numbers is critical.

“That is why we have called consistently for a national, fully costed and fully funded workforce plan. Trust leaders are doing everything they can to recruit and retain staff in a challenging context and as the cost of living rises.”

Danny Mortimer of NHS Employers, part of the NHS Confederation, said: “NHS leaders have welcomed the engagement, led by NHS England and Health Education England, in the development of a comprehensive workforce plan.

“However, they will be concerned to hear that the government has extended its deadline for this vital work. The government must act now to invest in the health and social care workforce. We know where the risks lie. There are steps the government can take now to support training pipelines for increasing staff numbers in community services, mental health and learning disability services in healthcare as a starting point.”

In 2021, Mr Javid announced that the NHS and education authority Health Education England would create a 15-year strategy for the health and care workforce.

The 15-year plan has been developed in two parts: one was set to be published over the summer and the second published by autumn.

A leaked copy of part one, created by Health Education England, the DHSC and social care body Skills for Health, seen by The Independent, said: “Historic supply trends and our analysis of key drivers of change suggest that we will need to continue to grow the workforce. It is a matter for the government by how much, balanced against competing calls on the public purse.”

The document warns that investment in NHS workforce budgets has not kept up with increases in spending on services.

According to the document, 16 per cent of the NHS workforce is made up from international recruitment.

A Department of Health and Social Care spokesperson said: “We are boosting NHS recruitment with almost 4,100 more doctors and more than 9,600 more nurses working across the NHS compared with last year, and we are on track to meet our manifesto commitment to recruit 50,000 nurses by 2024.

“We have also commissioned NHS England to develop a long-term workforce plan to recruit and retain more NHS staff. We have launched a taskforce to drive up the recruitment of international staff into critical roles across the system this winter.”