Staff shortages mean good culture won’t make much headway: only way to stem the damage is immigration of trained staff

Nigel Edwards responds to the Interim NHS People Plan.

Press release

Published: 03/06/2019

Responding to the Interim NHS People Plan, Nuffield Trust Chief Executive Nigel Edwards said:

"This plan hits the right note in calling for a better, kinder culture in the NHS - and that will make a big difference as long as national leaders start with their own behaviour. Letting local areas plan their own workforces is a good idea given the relentless failure of national efforts, though we have to make sure they have people who know how to do it. This plan includes real steps to tackle the issue of new tax rules on pensions, which many senior staff see as fining them for spending time with patients.

"But a good culture won’t make much headway when staff are seeing unsafe shortages every day. The plan fully accepts the conclusions we reached with the King’s Fund and Health Foundation: the only way to stem the damage in the next few years is immigration of trained staff [1]. Yet the tough new rules suggested for the period after Brexit risk making it impossible to fill at least 40% of nursing roles from abroad, putting the entire plan into jeopardy [2].

"What’s more, many key measures here simply won’t happen unless they are backed up by funding in the upcoming Spending Review. We agree that staff skills need to keep up to date with new technologies and treatment. But this won’t happen without more money for training staff through their careers, a budget which has been slashed.

"A good plan is a good start, but for this to be more than a piece of paper, it needs to be backed up with money and people."

1. The Nuffield Trust, King’s Fund and Health Foundation report Closing the Gap provided a comprehensive set of measures to address the workforce crisis in the NHS, concluding that overseas recruitment was the only way to reduce the nursing gap by 2023/24. It can be read in full at

2. Our briefing on the Immigration and Social Security Co-ordination Bill includes analysis of how many nursing joiners to the English NHS would be blocked by the introduction of a blanket £30,000 threshold for skilled migrants without exemptions for the NHS as currently exist for non-EU migrants. It can be read in full at.

3. The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.

4. For any queries or to arrange an interview please contact Mark Dayan at / 07779227129