Staff shortages and prospect of no deal Brexit threaten to undermine ambitious NHS plan - Nuffield Trust

Nigel Edwards responds to NHS England's Long Term Plan for the next 10 years.

Press release

Published: 07/01/2019

Commenting on the NHS Long Term Plan, Nuffield Trust Chief Executive Nigel Edwards said:

"The goals of this plan look right – carrying on with joining up care and improving services for older people, while pushing vital issues like heart attack survival and children’s health up the agenda. These are the most important issues for patients, and the level of ambition is good. What worries me is how difficult it will be to roll out such wide ranging changes. There are several big pitfalls ahead.

"The extra funding will actually be below the historic average and what experts thought was needed1. It’s enough to move forwards, but with little room for manoeuvre. If we face a no deal Brexit, the extra costs and tasks required would eat up the first instalments, stopping progress dead in its tracks2.

"The last few years have seen repeated cuts to public health and social care. The reforms we all know are needed to the way we pay for care have been kicked into the long grass again and again. If this goes on, the NHS will be stretched still further as it looks after more people who couldn't find the help they needed.

"In the NHS it is always difficult to take changes from the whiteboard to the ward. Success depends on extra effort and initiative from staff. But relations are frayed by shortages and increasing burnout, so some real leadership will be needed.

"The biggest obstacle of all is the lack of key staff. Our calculations with The King’s Fund and Health Foundation show a shortfall of 250,000 by 2030, which would make delivering even current services near impossible3.

"However, the biggest levers to resolve the workforce crisis are out of NHS England’s hands. Only bold policies on training, immigration and Brexit can deliver enough nurses, GPs and therapists for the next few years. The system of workforce planning has failed us, and needs deep reform."

Notes to editors

  1. Nuffield Trust Senior Policy Analyst Sally Gainsbury analysed the £20.5 billion a year by 2023/24 Theresa May announced in the summer - NHS funding boost: the need to manage expectations.
  2. Our calculations show that a no-deal Brexit would mean £2.3 billion in extra costs for the NHS by the end of 2019/20. Read Mark Dayan’s full briefing here and methodology here.
  3. Along with the Health Foundation and The King's Fund we have highlighted the scale of workforce challenges now facing the health service and the threat this poses to the delivery and quality of care over the next 10 years. Read the full briefing here.