RCPCH welcomes workforce plan but concerns remain over lack of child health focus

Today NHS England and UK Government have published their ambitious long-term plan for the current and future NHS workforce.
Icon: Checklist with pen, in a dark blue circle on a bright blue background

The plan, which comes during record high demands across all health services and over 100,000 staff vacancies, sets out to train, retain and reform the workforce by:

  • doubling medical school training places to 15,000 by 2031, with more places in areas with the greatest shortages
  • increasing the number of GP training places by 50% to 6,000 by 2031
  • almost doubling the number of adult nurse training places by 2031, with 24,000 more nurse and midwife training places a year by 2031
  • placing trainees on wards and in practices sooner, with plans to work with the GMC and medical schools to consult on the introduction of four-year medical degrees and medical internships, allowing students to start work six months earlier
  • allowing more student nurses to take up jobs as soon as they graduate in May, rather than waiting until September, with more reaching the frontline and treating patients more quickly.
  • training around 150 additional advanced paramedics annually, including to support the delivery of same day emergency care
  • expanding training places for clinical psychology and child and adolescent psychotherapy, on a path to increasing by more than a quarter to over 1,300 by 2031

NHS England has committed to refreshing the Long-Term Workforce Plan at least every two years to ensure that the plan is adaptable and fit for purpose over the coming years. 

RCPCH stands ready to work with Government and NHS England to bolster the paediatric profession over the coming years. It is noted that paediatrics is not mentioned directly in the plan and RCPCH is keenly aware of the need for further investment and resourcing across the specialty and the wider child health workforce. We will continue to engage with Government to make paediatrics a priority. 

RCPCH President Dr Camilla Kingdon said:

RCPCH has long campaigned for a multi-year workforce plan that is evidence based, backed by funding, and that supports the growing demand in paediatrics and child health. We are delighted that the workforce plan has now been published – and we are truly hopeful that this initial document has the potential to grow and support our wider workforce for many years to come. We’re pleased to see a strong commitment to increasing medical school training places and a promise to action the NHS People Plan, ensuring that staff can work flexibly, have access to health and wellbeing support, and work in a team that is well led. We all know the morale is declining, and high rates of burnout across all areas of the workforce must be urgently addressed in order for these plans to succeed. 

However, my driving force and key focus is what this all actually means for child health services. While we welcome the broad aims of the plan, we must make sure that the key aims of recruitment, retention, and reform, fully apply to the child health workforce, and we want to see real commitments and assurances from government and the NHS as we take this forward. 

We are delighted to see the plan for expansion of training places for health visitors, school nurses and members of the child mental health workforce. However, RCPCH has a number of concerns as to how exactly the workforce plan will address the needs of children and young people and the workforce which supports them. Unfortunately, our experience is that all too often when children’s needs are not specifically addressed, they are forgotten altogether. There must be an ongoing focus on children and young people as a distinct group who require specific policy interventions, recognising that prevention and effective treatment of ill health starts in the earliest years. Children cannot be left behind again – the health of our nation depends on a healthy childhood. 

We know that this current workforce crisis will not be fixed overnight, and we do feel some relief that we now have way forward. However more detail will be needed on what this means for the child health workforce as there is scant reference to children in the plan. As the Royal College we have a duty to highlight some key shortcomings from this plan, nevertheless we stand ready to work with NHS England to get this right for children. We are committed to making this plan work and to advocating for the focus and inclusion of children and the child health workforce every step of the way. 

Dr Kay Tyerman, RCPCH workforce officer said:  

It’s heartening to see clear Government action on the current crisis in our health services, and we welcome the overarching themes of the plan, and can see the potential that this plan has to create a sustainable and strong health workforce for years to come. However, many questions for child health workforce remain. 

It’s welcome to see the long-needed commitments to increasing the health visiting and child mental health workforce. But serious concerns remain about the apparent lack of child health focus and planning within the report. We were shocked to see the plan notes a 92% increase in adult nursing training places, and inexplicably 0% for child nursing training places. Statistics show that child health needs are growing in number and complexity, and yet the plan makes no recommendations to support this workforce or children. We appreciate this is the starting point of a considerable long-term piece of work, but we are conscious of how children are all too often forgotten in health policy and planning. We cannot let this happen. 

In terms of next steps, the College will review the full plan with our committees including the Workforce Planning Board, and with our Ambassadors. There is a clear need for paediatrics and child health services to be reflected in the plan – and we once again stand ready to call for action.