Jeremy Hunt must deliver the NHS workforce plan in this budget

Julian Hartley profile picture

15 March 2023

Julian Hartley
Chief Executive


The NHS is grappling with unprecedented challenges. If we fail to tackle the vast workforce shortages urgently, the future of the health service will be at risk.

Chancellor of the Exchequer Jeremy Hunt himself rightly acknowledged this last year when he said that "persistent understaffing in the NHS poses a serious risk to staff and patient safety".

While chairing of the House of Commons' health and social care committee, he added: "We now face the greatest workforce crisis in history in the NHS and in social care with still no idea of the number of additional doctors, nurses and other professionals we actually need."

When he delivers the Spring Budget in the coming days, he and the government must honour the commitment in the Autumn Statement to deliver a long-term NHS workforce plan. And deliver they must.

There are 124,000 vacancies across the NHS at the last count – 13,000 more than at the same time last year.

Julian Hartley    Chief Executive

For years, severe workforce shortages across the hospitals, mental health, ambulance and community services have been trust leaders' number one concern with experienced staff leaving, those on lower pay lured to retail and hospitality jobs and senior staff feeling forced out by pension rules. There are 124,000 vacancies across the NHS at the last count – 13,000 more than at the same time last year. The government has pledged to publish a "comprehensive" plan this spring, which would include independently verified forecasts of the workforce the NHS needs over five, 10 and 15-year periods.

However, as The Times' Chris Smyth reports, there have been growing concerns that the Treasury is trying to water down plans to address these staffing gaps due to costs now involved.

This has, understandably, rung alarm bells for trust leaders. Indeed, only last November a coalition of over 100 health and care organisations including NHS Providers urged the chancellor to publish the NHS long-term workforce plan in full – including assessments of how many staff will be needed to keep pace with demand.

We want to see full implementation of the plan, not a 'shopping list'.  If it isn't properly funded, it won't succeed. To ensure clarity and accountability, it must also lay out specific projections and figures. Overstretched staff struggling with ever-growing demand and unsustainable workloads need to see the will and the way to ease their burden and shore up morale. Lack of certainty about the workforce supply in the coming years will only increase burnout, with a negative impact on patient care.

We also want to see a commitment to regularly update the plan, covering health and social care, along with the modelling behind it. Only a robust, long-term plan with more investment in expanding the workforce, and support for education and training, will properly address severe staff shortages. We need this plan to create national and local recruitment 'pipelines' for the NHS, reducing the reliance on temporary staff and overseas recruits to plug the gaps. Such a plan would help the NHS to focus on key strategic priorities that we all want to see, like reducing backlogs.

Trusts are doing everything they can to address the problems of vacancies.

Julian Hartley    Chief Executive

The ongoing strikes in the NHS, including this week's three-day walkout by junior doctors, are due to profound dissatisfaction among staff on a range of issues including pay. A long-term workforce plan would help address these structural challenges within the workforce, as would an agreed pay uplift for staff that doesn't come from existing budgets.

Trusts are doing everything they can to address the problems of vacancies, from partnerships with local education bodies encouraging students to follow NHS careers, to offering greater flexibility in working hours and patterns wherever possible to help retain staff they can ill afford to lose.

Expert report after expert report has set out the evidence for a fully costed and funded, long-term NHS workforce plan. It can't come soon enough and if the government fails to deliver after all this time, the frustration will be palpable.

As Hunt said last year: "NHS professionals know there is no silver bullet to solve this problem, but we should at least be giving them comfort that a plan is in place".

The Spring Budget will be a chance for him to do just that.

This opinion piece was first published by The Times Red Box.

About the author

Julian Hartley profile picture

Julian Hartley
Chief Executive

Sir Julian Hartley joined as chief executive in February 2023, having been chief executive of Leeds Teaching Hospitals since 2013, where he led a major programme of culture change and staff engagement to deliver improved quality, operational and financial performance.

Julian’s career in the NHS began as a general management trainee and he worked in a number of posts before progressing to a board director appointment at North Tees and Hartlepool NHS Trust.

In 2019 Julian was asked to be the executive lead for the interim NHS People Plan, having previously worked as managing director of NHS Improving Quality, and in 2022 he was awarded Knight Bachelor for services to healthcare in the Queen’s Birthday Honours.

Article tags: