RCR response to the publication of the NHS Long Term Workforce Plan

Today marks a significant milestone as we warmly welcome the long-awaited publication of the NHS’ long-term workforce plan. As someone who has dedicated nearly 40 years working in the NHS, I have witnessed first-hand the tireless efforts of healthcare professionals in providing quality care to patients. I know we will all be pleased to see the release of this much-needed strategy, which represents a significant step towards ensuring a sustainable and resilient NHS workforce.

At the RCR, we wholeheartedly support the ambition of the plan. It not only addresses the need for an increase in the number of doctors and healthcare professionals being trained but also recognises the importance of retaining their expertise.  

For years we’ve been calling for solutions to the workforce crisis, and this plan sets out a clear agenda.  

However, while acknowledging the positive ambition of the plan, the key to its success will be in the delivery. We still need further action including long-term funding, detail on specialty training posts, and basic NHS infrastructure and pay.
 

Funding of the workforce plan 

One of the most critical aspects of any sustainable healthcare system is adequate funding. New funding attached to the plan is hugely welcome and shows a positive commitment from the Prime Minister and Treasury towards supporting our workforce.  

However, to ensure stability and effective long-term planning within the NHS, we emphasise the need to go beyond short-term fixes and establish a long-term funding framework. We urge all political parties to commit to a fully funded 15-year programme in their manifestos, guaranteeing that we doctors can continue to deliver the care that the patients of the future deserve.  
 

Expansion of doctors working in the system

As we all know, the success of the NHS relies heavily on a well-trained and highly skilled workforce. While we welcome the ambitious expansion of medical school places, it is a shame not to see detailed capacity and demand projections spanning the full 15 years of the plan. Our own projections suggest a 40% shortfall of clinical radiologists within five years and a slightly lower, but no less devastating, shortfall of clinical oncologists, but even today, staff shortages are resulting in significant delays to diagnosis and treatment for cancer and other diseases.  

We must be honest about the scale of the challenge we’re facing and what will be needed to fix it. Expanding medical school places is undoubtedly a positive step, but we must also prioritise expanding capacity for specialty training. We’re calling for more specific details regarding specialty training opportunities, and support for (and commitment from) Trusts to take on new trainees. In the coming months, we are committed to playing an important role in developing these proposals further to ensure their effectiveness.  
 

Retention of existing staff

While the workforce plan’s focus on retention is welcome, expanding training places today will not result in the immediate growth of the workforce. All of us are well aware of how important it is to ensure that experienced doctors are not leaving the workforce early due to poor working conditions. Our census data tells us that over 75% of clinical oncologists and clinical radiologists who recently left the NHS were under the age of 60. This is not sustainable and we need to understand how our experienced doctors can be supported to stay in work. We’ve advocated for flexible job plans and additional support for doctors nearing retirement, and we’re pleased to see their inclusion within the plan. But Trusts need to look at all the factors that are contributing to early retirement – from on call policy to car parking spaces – and ensure that senior doctors feel valued. 

Equally, we all know how frustrating it is to try and do our jobs with systems and infrastructure that simply aren’t fit for purpose. When Tom Roques, Vice President for Clinical Oncology, talked on The Today Programme about needing to use seven passwords for seven separate systems in order to provide information to one patient, the entire profession groaned with recognition. The Government must ensure that healthcare professionals have access to the necessary tools and facilities to deliver care efficiently and effectively, and this means the fundamentals of IT infrastructure as well as more innovative new equipment. 

This ambitious plan comes at a time of huge challenges across the workforce. While the plan's focus on retention is commendable, it’s important to understand how devastated and burnt-out doctors are feeling, especially as these are the very doctors who will need to give even more of their time to train new recruits. Our trainees, meanwhile, face a unique set of challenges: debts from expensive university tuition fees, high accommodation costs, lack of control over annual leave dates, and intensely challenging childcare issues, to name but a few.  Unless and until doctors are listened to and supported properly, the situation is simply not going to improve, as evidenced by the recent BMA consultant ballot and the ongoing junior doctor strikes. We urge the government to come to the table with the BMA and resolve the current pay dispute. Our thoughts are with our Fellows and members facing very hard decisions, and also with patients who will be worried about what this means for them. 
 

Looking ahead

Today’s workforce plan is a clear step in the right direction. However, its success ultimately depends on the next stages and effective implementation. We eagerly anticipate working closely with NHS England on the details of delivering this boost in medical student numbers, as well as how this boost in medical students will translate into more senior doctors, so that we as clinical radiologists and clinical oncologists can effectively deliver world-class diagnostics and cancer treatment.  

We urge our Fellows and members to recognise the significance of this comprehensive workforce plan. By prioritising the needs of our doctors, we now have a unique opportunity to build a sustainable and resilient NHS that meets the needs of our ever-changing society. The RCR community and I remain dedicated to representing our members and working collaboratively to make this vision a reality.