Key ask: Delivery of the NHS Long Term Workforce Plan, including greater national prioritisation and investment in growing and developing the workforce in community health services and primary care.

The supply of community staff has not kept pace with increased demand for services and strategic ambitions to boost out-of-hospital care. There are staff shortages across key community roles such as district nursing, podiatry, and speech and language therapy, many of which will play a central role in multi-disciplinary teams. This trend is replicated in the primary care sector where there were 2,164 fewer full-time equivalent GPs in May 2023 compared to September 2015 (29,364 down to 27,200), while demand for GP appointments continues to grow.

Community provider leaders are clear that without the right numbers and skills mix of community and primary care staff, there is limited capacity to take forward strategic goals around integration and scale up the important work being undertaken by multi-disciplinary teams.

Support is also needed to maximise the potential benefits that could be offered by the additional roles reimbursement scheme. While it is working well in some places, there are some challenges with implementing the scheme, particularly in relation to pay and terms and conditions, where the sectors do not always align.

The recently published NHS Long Term Workforce Plan is a significant moment in supporting the ambitions for greater integration between community and primary care. The commitment to grow the proportion of mental health, primary and community staff to deliver more preventative and proactive care across the NHS is significant, as is the focus on optimising multi-disciplinary teams and the development of an integrated community and primary career framework. However, this must be accompanied by a robust implementation plan and appropriate funding to break down the barriers to recruiting and retaining staff in the sector.