Nuffield Trust: The next UK government must firmly commit to close stubborn gaps in NHS staffing

Challenge issued from the Nuffield Trust to political parties comes ahead of the upcoming general election and is the first set of a series of electoral policy ‘tests’ that the next UK government must meet to address some the longstanding issues facing health and care services in England.

Press release

Published: 08/03/2024

Bolder policies and specific goals to close gaps in NHS staffing levels are needed from the next UK government if it is to get a grip on stubborn staffing shortfalls that leave patients in some areas of the country struggling to access GP appointments and some NHS services plagued with severe shortages.

The challenge from the Nuffield Trust to political parties comes ahead of the upcoming general election this year and is the first set of electoral policy ‘tests’ that the next UK government must meet to address some the longstanding issues facing health and care services in England.

Data analysed by the Nuffield Trust illustrates an uphill struggle faced by patients in some regions of England to see GPs - even when accounting for the typical health needs of the local population. People in Gloucester have 45% more GPs per head than those in Kent and Medway (1,868 patients per GP vs 2,702). The government has failed to meet a pledge to deliver 6,000 more GPs by 2024-25 and incentives to attract GPs to underserved areas, including £20,000 golden hellos, are not well understood and little evidence exists on their attractiveness to doctors in training.

The government has met its manifesto pledge to grow the nursing workforce by 50,000 over the last four years but the benefits are not being felt equally. The headline figures mask a 19% fall in health visitors and an 8% fall in learning disability nurses, with the latter contributing to a 44% reduction in learning disability nurses since 2010.

The call for specific goals to close staffing gaps is one of five NHS workforce policy tests set out by the Nuffield Trust in the first of its general election briefing series funded by the Nuffield Foundation. To firmly address entrenched workforce challenges and to support the existing NHS long term workforce plan, the think tank is also urging the next government to:

  • Address unacceptably high dropout rates at every stage of clinical training and in early NHS careers to support the ambitious training goals of the long-term workforce plan. This includes the recommendation to gradually write-off the student debt of healthcare workers such as nurses over a period of 10 years, with the scope to expand to doctors and other groups.
  • Reform the NHS pay review body process which has failed to avoid sustained industrial action and has lost the confidence of all sides. Pay review bodies must publish recommendations which can address different financial realities of staffing groups more quickly.
  • Ensure that new roles which can support doctors and nurses are rolled out safely and effectively by boosting public understanding and providing clear regulation and oversight which accounts for staffing needs of local healthcare systems.
  • Support and develop the skills of NHS managers and leadership to create a culture which can reverse the declining experience of the NHS workforce.

Nuffield Trust Senior Fellow Dr Billy Palmer said:

“The public are all too aware of staff shortages, long waits and disruptive strikes creating real difficulties for health and care services and they deserve bold action from government to address these workforce challenges.

“Growing the NHS workforce is popular, and an ambitious workforce plan already exists, but to succeed it needs to be accompanied by robust policies or we risk wasting money, time and talented people too early in their NHS careers. This oversight will do nothing to reduce our reliance on overseas recruitment, nor will it stem severe shortages in some clinical professions and in regions of the country. The status quo of hoping some of these issues around retention and work experience will sort themselves out isn’t good enough.

“Solely boosting the number of staff nationally in the NHS is not enough alone – the next government should set a clear aim of reducing the uneven distribution of key staffing groups and shortfalls to tackle unfairness in access for patients. This could be in the form of minimum numbers of GPs compared to patients in local areas, and better incentives to attract GPs to under-doctored areas should be considered.”


Notes to editors

  • We have summarised the five policy tests on NHS staffing into an accompanying slide set here.
  • The first in our general election briefing series What health and care need from the next government? Focused on NHS staffing has been launched on the second day of the annual Nuffield Trust Summit. It has been published ahead of a panel discussion titled Shifting attitudes and expectations over work. The session is chaired by Professor David Oliver, Consultant in Geriatrics and General Internal Medicine at Royal Berkshire NHS Foundation Trust. Speakers include Dr Billy Palmer (Senior Fellow, Nuffield Trust), Dr Nish Manek (GP and Clinical Fellow, Granta Medical Practices and NHS England), Dr Crystal Oldman (CEO, Queen’s Nursing Institute) and Professor Oonagh Smyth (CEO, Skills for Care). You can sign up to our Summit live stream here.
  • Ahead of the expected UK general election this year, the Nuffield Trust will be publishing a series of election briefings which brings evidence to bear on what health and care services need from the next government. This series of briefings has been funded by the Nuffield Foundation. The briefing series will cover five topics, with NHS staffing being the first, followed by social care, primary care, quality, and timely access to care and NHS finances.