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Landmark £2.4bn NHS workforce plan prioritises training, retention and reform

Medical school training places will be doubled to 15,000 by 2031, the landmark NHS Long Term Workforce Plan has revealed, alongside a host of other measures focusing on ‘clear priorities’ of training, retention and reform.

The much-anticipated and long-overdue plan, published today, sets out long-term staffing projections, warning that without action a current shortfall of 112,000 NHS staff could grow to 360,000 by 2037 due the ‘growing and ageing population, coupled with new treatments and therapies’.

The plan details a programme of incremental growth for education and training places for doctors, which will see an initial rise of a third in 2028/29 to 10,000, before reaching the +50% target of 15,000 by 2031.

The first new medical school places will be available from September 2025, and new medical schools could open in areas of the country where there are the greatest staffing shortages. This will allow the NHS ‘to level up training and help address geographical inequity’. Similar plans are also in place for postgraduate medical training places.

Training routes expanded

Other measures of note outlined in the plan include the GMC preparing to consult on four-year medical degree courses that would allow medical students to join the NHS workforce six months earlier, as well as the expansion of apprenticeship routes to qualify for NHS clinical roles.

The introduction of medical degree apprenticeships, with pilots running in 2024/25, will mean that 2,000 medical students will train via this route by 2031/32, ensuring the NHS can draw on the widest pool of talent.

Apprentice staff will ‘earn while they learn’ and gain a full degree while ensuring they meet the high clinical standards required by the relevant professional regulators. One in six (16%) of all training for clinical staff will be offered through apprenticeships by 2028 – including more than 850 medical students.

A new apprenticeship funding approach that ‘better supports employers with the cost of employing an apprentice’ will be developed.

Training places will also be increased across the NHS, with GP training places rising by 50% to 6,000 by 2031, and the number of adult nurse and midwife training places available each year doubling to 24,000 during the same period.

The 15-year workforce plan will be backed by a £2.4bn investment from the Government ‘to fund additional education and training places over five years on top of existing funding commitments’, NHS England said.

With full implementation of the plan over the longer term, NHS England said there could be 60,000-74,000 more doctors, 170,000-190,000 more nurses and 71,000-76,000 more allied health professionals in place by 2036/37.

Culture, leadership and wellbeing

NHS England aims to improve culture, leadership and wellbeing to ensure up to 130,000 fewer staff leave the NHS over the next 15 years.

Flexible working, access to health and wellbeing support, modernisation of the NHS pension scheme and continuing professional development are just some of the ways in which this will be achieved, the plan explains.

In addition, from the autumn, recently retired consultant doctors will have a new option to offer their availability to trusts across England by supporting the delivery of outpatient care through the NHS Emeritus Doctor Scheme.

Advances in technology and treatments mean that staff numbers and roles will change over time so the NHS will refresh the Long Term Workforce Plan at least every two years to help meet future requirements.

‘Lacks substance on retention’

While the plan has been widely welcomed by medical organisations, patient groups and other stakeholders, particularly in terms of the training and reform elements, concerns have been raised over the apparent ‘lack of substance on retention’.

Dr Latifa Patel, BMA representative body chair and workforce lead, said: ‘Doubled medical school places means more doctors entering the system, which is no doubt a good thing, but we need guarantees that the initial expansion will be followed with the infrastructure needed to support doctors throughout their training and into their future careers. There’s no point having more students if there are no academics to teach them, no spaces to learn in and no consultants and GPs to supervise them once they graduate.

‘This is why retention is key, and where today’s announcement feels particularly light. It’s all well and good training new doctors, but pointless if they don’t stay in the workforce. Investing in medical school places while refusing to reverse years of pay erosion for doctors and fixing the broken pay review system, is completely illogical and uneconomical. Doctors will leave for better paid jobs abroad and we won’t see the benefits of increased recruitment.’

The plan does not cover the issue of pay, which has been the source of previous and upcoming strike action among junior doctors and consultants.

Stakeholders welcome workforce plan

Professor Dame Helen Stokes-Lampard, chair of the Academy of Medical Royal Colleges, said: ‘The fact that there now is a plan is thanks to the consistent lobbying of more than a hundred health and care organisations, including the NHS itself, and a Government that has seen the value in planning for a future beyond just one political cycle.

‘It is also important that this plan is seen as the first of many and will be evolving over time, so where people feel it is not providing the detail or nuance they were seeking now, they have the assurance of influencing future versions.

‘We know things are very tough for patients and the hard-pressed, health and care staff right across the UK, so I for one sincerely hope this plan brings hope with glimpses of a more positive future to all who work in the NHS and the millions of people who rely on it every day.’

Professor Neil Mortensen, president of the Royal College of Surgeons of England, said: ‘It is my hope that [the workforce plan] will guide us in building a flexible and adaptable NHS workforce, equipped to meet the evolving needs of our patients.

‘I am particularly pleased to see proposals to expand medical school and training places across all areas. It signals a renewed commitment from the Government to investing in healthcare professionals. Embedding a culture that truly values staff and their wellbeing, making them want to stay working in the NHS, will also be vital. If we can get this right, I am in no doubt the plan will pave the way for a brighter and more resilient health service.’

Additional measures outlined in the workforce plan include:

  • Investment in new technology to ‘free up staff to focus on using their expertise to help patients’
  • An expert group will be set to ‘harness advances in AI’
  • Trainees ‘will be 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’
  • More student nurses will be able 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 of around 150 additional advanced paramedics annually, including to support the delivery of same day emergency care
  • Expand 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.