The National Audit Office has found ‘significant weaknesses’ in the modelling that underpins NHS England’s much-anticipated Long Term Workforce Plan, published last summer.
The NAO said it could not replicate numbers that feature in the NHS Long Term Workforce Plan and that some of the modelling assumptions may be optimistic, including the notion that a planned doubling of medical school places can be achieved by 2031-32.
Weaknesses also included complex modelling design, the use of manual adjustments, and limited public communication of uncertainties.
Gareth Davies, head of the NAO, said: “The creation of the modelling that underpins the Long Term Workforce Plan has been a significant undertaking. However, NHS England must strengthen its workforce modelling next time around to make better-informed decisions about the NHS’s future workforce.”
HM Treasury, the Department of Health & Social Care and NHS England requested that the NAO independently assess the modelling underpinning the NHS workforce plan. The NAO said that creating the modelling is a significant achievement and provides a foundation on which to build.
Meg Hillier, chair of the Public Accounts Committee, said: “It is good to see that NHS England has for the first time produced this modelling, but it now needs to build on this and address the weaknesses the NAO report identified so its long-term decisions about the NHS’s future workforce are better informed and we know what money will need to be spent on it.”
Dr Navina Evans, NHS England’s chief workforce officer said: “The NHS Long Term Workforce Plan is based on credible and robust modelling, developed by experts and independently assessed by The Health Foundation, and we are pleased that the NAO has recognised that the plan is a significant achievement which provides a good foundation for our strategic workforce planning.
NHS workforce planning
NHS more diverse than ever, but leadership representation lacking
“We have always committed to updating the modelling regularly and will implement any necessary changes, considering the NAO’s recommendations, as we develop future iterations.”
The NAO found that the rapid expansion in medical school capacity presents challenges, which the modellers did not factor in. These include the impact of rapid expansion of student numbers on training quality, and whether existing staff have capacity to provide on-the-job training to that number of students.
NHS England intends that increased domestic education will reverse the growing reliance on recruitment of professionals trained overseas. In broad terms, according to the NAO, it expects the number of international recruits to fall as domestic training grows.
“NHSE’s modelling projects that there will be no international recruitment of doctors at all from the mid-2030s,” said the NAO. “In our view, this is not a reasonable modelling assumption and, if the rest of the plan is implemented in full, risks too many medical students being trained from the early 2030s onwards.”
Evans added: “Expanding domestic education, training and recruitment to ensure we have more healthcare professionals in the NHS to meet the changing needs of the population remains the right course of action for patients and staff. We have already made significant progress with a 25% increase in medical places and record numbers of staff working in the NHS, and we are fully committed and remain on track to delivering the vital actions set out in the plan.”
Danny Mortimer, chief executive of NHS Employers, said: “We have always known that meeting the ambitions of the NHS Long Term Workforce Plan will be no easy feat due to the scale of the challenge in filling existing gaps and boosting staff numbers to meet future demand, and the significant delay in commissioning the plan.
“We have always maintained that one of the most important aspects of the eventual publication of the plan was the commitment to regularly refresh it. It is helpful therefore that the NAO has given advice to how future iterations can be improved, building on the huge expertise and practical understanding already held in the NHS England team.”
Sign up to our weekly round-up of HR news and guidance
Receive the Personnel Today Direct e-newsletter every Wednesday
HR opportunities in Healthcare on Personnel Today
Browse more HR opportunities in healthcare
