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Call for Growth in NHS Funding to Meet Staffing Ambitions

The NHS workforce will have to grow at a quicker rate than recent years if it is to reach its ambitions on future staffing levels, according to a new report.

NHS England's long-term workforce plan was published earlier this year and set out how the service intends to deal with severe staffing shortages. Around 260,000 extra doctors and nurses are expected to join the service's ranks over the coming years, the document states, along with boosts to other staff groups.

Under the plans, the NHS total workforce would grow by around 2.6-2.9% a year.

It is expected that the number of staff employed permanently by the NHS will grow from 1.4 million in 2021/22 to between 2.2-2.3 million in 2036/37.

Real-terms Funding Growth of 3.6% "Not Outlandish"

But the Institute for Fiscal Studies (IFS) has said that NHS staffing numbers grew by around 1.1% per year between 2009/10 and 2019/20. If the NHS achieves its workforce goals, then one in 11 workers will be employed by the health service by 2036, according to fresh analysis of the plan conducted by the IFS. And one in two public sector workers could be employed by the health service, it added.

The IFS also concluded that funding for the service will need to increase if the plan is implemented in full.

Experts said that the plan implies real-terms funding growth of around 3.6% per year for the NHS in England, which is "not outlandish by historical standards" but could require "difficult fiscal decisions". This growth is in line with long-term growth rates but higher than real-terms growth seen in recent years, according to the research.

The IFS suggested that the plan does not consider the large increase to the NHS's pay bill, though it does include £2.4 billion in additional funding for the training of new staff.

"We estimate that the plan might imply average real-terms funding growth of around 3.6% per year for the NHS in England," said Max Warner, research economist at IFS and an author of the paper. "That is by no means outlandish by historical standards, but would nonetheless require difficult fiscal decisions in the current climate of sluggish growth. NHS modelling suggests that even these large staffing increases will only be 'enough' to meet future demand if staff productivity can be increased by a highly ambitious 1.5% to 2% per year.

"The risk of having a workforce plan but no similarly high-profile plan for capital, technology or management is that higher spending on staffing squeezes out other vital inputs and makes those productivity gains all but impossible to achieve."

Keeping Pace with Ever-growing Demand

Commenting on the paper, Danny Mortimer, deputy chief executive of the NHS Confederation, said: "We know that the workforce plan will require long term funding if it's to be rolled out successfully, and health leaders will agree that NHS funding should revert to the long run average growth rate to be in line with the ever-growing demand the NHS faces. This investment needs to not just expand numbers but also improve working conditions and reward and accelerate access to careers.

"It also needs to be matched by investment in technology and working environments to support healthcare staff to work effectively and efficiently. We have an ageing and growing population, with increasingly complex needs, so it's vital that funding grows in line with demand.

A spokesperson for NHS England said: "The first-ever NHS Long Term Workforce Plan provides a once in a generation opportunity to put staffing on sustainable footing and ensure the NHS can embrace the latest technologies and meet the changing and future needs of patients. The number of people aged over 85 is estimated to grow 55% by 2037, as part of a continuing trend of population change which outstrips comparable countries, and without the action set out in the plan the vacancy gap could grow to up to 360,000 by 2037."

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