Intended for healthcare professionals

Observations Health Policy

The NHS workforce plan is an off-the-scale fantasy

BMJ 2019; 365 doi: (Published 06 June 2019) Cite this as: BMJ 2019;365:l4036
  1. Andy Cowper, editor, Health Policy Insight, London, UK
  1. andycowper{at}

The lack of quantifiable staffing targets means shortfalls and rota gaps will remain the new NHS normal

The Interim NHS People Plan is fantastic, not in the sense that it’s extremely good but that it is aligned to and derived from fantasy. What it sets out is simply not credible for tackling the NHS’s workforce challenges.

So negative a judgment is unavoidable, because the document is wholly unequal to the scale of the problem that is facing practically every NHS organisation. Hospitals and providers of mental health and community health services are reporting a shortage of more than 100 000 full time equivalent staff, and one in eight nurse posts are vacant.1 The latest data from the Nursing and Midwifery Council’s register show that more UK and EU nurses are leaving the register than are joining.2

The interim plan was launched with a promise of a consultation on the vexed issue of senior clinicians’ pension contributions and the “taper tax,”3 with the proposal of a halving of the rate of their later career pension growth in return for a halving of their contributions, with the effect being to avoid inadvertently hitting the relevant threshold.

But the issue of workforce, and …

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