Campaigning for transparent workforce planning in England

by Chaand Nagpaul

Amendments to the Health and Care Bill, debated in the House of Lords this week, are crucial to address the NHS staffing crisis

Location: England
Last reviewed: 28 January 2022
Chaand Nagpaul

Earlier this week, peers in the House of Lords debated a series of amendments to the Health and Care Bill, including an amendment on workforce planning across the NHS and social care which would legally require independently verified workforce assessments every two years.

This is something the BMA has repeatedly called for, particularly given the deepening staffing crisis in the NHS, with over 90,000 vacancies and record waiting lists already severely impacting patient care.

I find it incredulous that there is no central strategy that defines what workforce and skill mix is required to run the NHS – it should not have taken the BMA to calculate that we have the equivalent of 50,000 fewer doctors than similar OECD nations. It beggars belief that successive governments have been running a health service without knowing how many doctors and nurses are needed now and in the coming years, to serve the health needs of the nation.

The Government talks about tackling the backlog, with waiting lists likely to climb above 10 million, but continues to reject the need for workforce planning in favour of remaining in a state of ignorance.

The Health and Care Bill must address this most fundamental issue. Working alongside 90 other medical organisations as well as MPs and peers from across the political divide, we’re campaigning for this amendment, which would place a duty on the secretary of state to publish these independently verified assessments regularly. While this won’t solve the workforce crisis overnight, it will ensure there is openness about the scale of workforce deficit we have endured for far too long, and would enable a trajectory to put this right with finally some accountability.

The need for independent workforce assessment is clearly felt across the sector, and the amendment itself is supported by Lord Stevens, the former chief executive of NHS England. In the debate Lord Stevens accused the Government of ‘wilful blindness’ over the issue. He pointed out that since 2014 the Government had repeatedly broken several promises to produce a detailed workforce plan.

Jeremy Hunt, as chair of the health and social care select committee, has recommended independently verified workforce plans in almost all the committee’s reports over the last year, and is also backing this amendment. But he has concluded that it is being consistently blocked by the Treasury. This legislation would finally transcend short-term politically driven policies that tend to think only in terms of the five-year electoral cycle, but likely lead to higher workforce spend.

Fundamentally the public deserves honesty and transparency about the harsh reality of workforce shortages in the NHS, and why they may not receive the timeliness and level of care they deserve. They deserve to know that there is legislation in place to hold the Government to account to put this right moving forwards.

In response to the debate in the House of Lords, the government minister Lord Kamal could provide no real answer to why the Government does not support this amendment. Lord Stevens concluded that their opposition is solely down to wishing to maintain the status quo to avoid spending money. The minister did suggest more work and discussions would take place in the coming days and weeks.

The NHS is nothing without its workforce – it is imperative we do everything to ensure we have the doctors, nurses and healthcare staff we need to look after our population. It is therefore vital that the House of Lords shows leadership, and that peers do the right thing and vote for this amendment in the weeks ahead.