A plan full of promise - the paediatric perspective on the NHS People Plan

RCPCH President applauds the Plan's ambition and vision - but says it must be backed by the appropriate resources.

The interim NHS Workforce Implementation Plan, or NHS People Plan, was published today, 3 June. This complements the NHS Long Term Plan (England) as it focuses on the challenges particular to the NHS workforce. These challenges limit the positive impact of medical professionals’ work and pose a significant risk to the health of children and young people.

A full People Plan will follow this interim Plan, translating this national vision into detailed, costed action plans, alongside a detailed implementation plan for the NHS Long Term Plan as a whole. The full plan will follow the government’s next Spending Review when the total investment available for education and training and for digital and capital transformation is due to be confirmed.

The Interim Plan focuses on three key areas:

  • Recruiting more staff
  • Making the NHS a great place to work
  • Equipping the NHS to meet the challenges of 21st century healthcare

The NHS Interim People Plan includes:

  1. How the NHS will rapidly increase the number of NHS staff, deliberately starting with the nursing workforce where the current vacancy pressure is greatest. The plan sets out how the NHS will:
    • Immediately increase the number of undergraduates studying nursing with an offer to universities of more than 5,700 extra hospital and community placements for student nurses this year
    • Rapidly expand the number of staff in recently created new roles including increasing the number of nursing associates to 7,500, offering a career route from healthcare support work to registered nursing
    • Launch a new campaign, in conjunction with Mumsnet, to inspire more nurses to return to the NHS
    • Quickly grow the number of nurses and doctors recruited from overseas via a new approach that will agree national “lead recruiter” agencies with the expertise to support the local NHS with international recruitment
  2. How to make the NHS “the best place to work”, addressing current concerns from frontline staff on the pressures they face, and improving retention rates. The plan sets out how the NHS will:
    • Rapidly address current pensions issues which are discouraging experienced doctors and nurses from doing extra work for patients and causing them to think hard about remaining in the NHS
    • Conduct a major staff engagement exercise this summer, led by new Chief People Officer, Prerana Issar, to create an explicit offer to staff covering issues they say matter to them for example, access to flexible working, career development and the best possible support from line managers
    • Ensure more support and development for frontline NHS managers, from ward to board, including the development of a new leadership compact covering the standards and behaviours leaders can expect of each other and a doubling of the size of the NHS Graduate Trainee scheme
  3. How to equip staff and NHS frontline organisations to provide 21st century healthcare including the need to join up health and care and take advantage of digital technology, genomics and other innovations. The plans sets out how the NHS will:
    • Devolve significant responsibilities for workforce planning to the emerging integrated care systems
    • Develop new models of multi-disciplinary working to support the Long Term Plan’s ambition to integrate primary and secondary care
    • Launch a national consultation exercise to establish what the NHS, patients and the public require from 21st century medical graduates
    • Expand the NHS Digital Academy, deliver intensive digital skills training for boards and senior leaders, and develop the pipeline of digital experts in the NHS to support the Long Term Plan’s drive to fully harness digital technology

Professor Russell Viner, RCPCH President, said:

This is a plan full of promise and we applaud the ambition and vision – the key now is for the aspiration to be translated into action and crucially backed by the appropriate resources.

Positively, the plan recognises the workforce pressures across the whole the health service. Importantly for training, it promises a range of initiatives to increase flexibility which is so important for retaining our junior doctors.  

The emphasis on recruitment and retention of nurses is welcome, and children’s nurses are a vital part of the child health workforce.

The Health Secretary announcement on lifting immigration restrictions for qualified doctors and nurses of any nationality who have a job in the NHS is also positive and recognises the scale of the workforce gaps. It’s also in line with the Migration Advisory Committee’s recommendation last week that all medical practitioners should be on the shortage occupation list.

However, the Plan lacks clarity on how the UK based medical workforce will be recruited and retained. There are serious gaps in paediatric rotas, and it is only a matter of time before the gaps begin to affect the level of care being delivered. 

We are heartened to hear that children and young people’s mental health services will employ nearly 6,500 more staff, including mental health support teams in schools and colleges. Young people are most at risk of developing mental health problems at times of transition, such as moving between schools and in adolescence generally. The proposal to increase the amount of mental health staff in schools and colleges is hugely welcome as it will help to widen access and prevent problems escalating.

The People Plan’s focus on the entire trajectory of workforce planning – from the undergraduate curriculum to leadership management – is vital, as is the aspiration to improve the culture within the NHS to eradicate blame and support staff subject to bullying and harassment. These measures will take time, but our members are clear they must be prioritised.

We look forward to working with NHS England and NHS Improvement to support the delivery of the Plan and contribute to discussions to ensure the needs of children and young people are met.

We hope there will be opportunities to embed the voices of children and young people a part of the national consultation that the Plan promises. Their ideas, insight and enthusiasm will be invaluable in shaping future education and training needs of medical graduates.

As we’ve said many times – if the nation’s children are healthy, and the child health workforce is properly supported to deliver the care that is needed – then the benefits are huge for the entire population. This was the message from the Long Term Plan and it must not be forgotten when the full People Plan is published later in the year.

Other information to note

The Department of Health and Social Care an the Cabinet Office have today issued a press release outlining plans to consult on proposals to offer senior clinicians a new pensions option, known as a 50:50 option.

The RCPCH will be putting together a summary of the Plan and its implications for paediatricians and the child health workforce shortly.