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NHS workforce plan fails to answer key questions on pay and future consultant supply

After the release of the long-awaited NHS England Long Term Plan for Workforce, HCSA – the hospital doctors’ union has issued the following comment.

HCSA President Dr Naru Narayanan said:

Amid all the congratulatory responses today it might seem churlish to put a dampener on this long-term plan. But despite welcome news on the expansion of medical school places, alarm bells will be ringing among hospital doctors over the reality gap between aspirations and the current situation on the ground. There’s not a lot of point simply pouring more doctors into the NHS without fixing training blockages or issues which mean we are haemorrhaging staff of all grades. The elephant in the room is pay.

“Huge practical questions also remain unanswered. Who will train these thousands of extra doctors and associate professionals? The plan predicts a 4-8 percent shortfall of consultants by 2036/7, yet they will be vital to the success of training.

“It lacks detail on the specialty placements required for the future pipeline of consultants. This is currently a disastrous bottleneck meaning hundreds each year cannot progress, storing up future shortages, and here the plan is worryingly vague. You can’t expect to retain staff and run top-quality services if you rely on lower-paid locally employed doctors and frustrated trainees with insufficient opportunity to progress.

“There are also very real fears of mission creep if non-doctors such as associate professionals and practitioners are to be deployed to conduct work currently carried out by doctors. If mismanaged this could leave patients at higher risk, because when procedures inevitably go wrong these clinicians won’t have the wider training needed to respond.

“An over-reliance on non-medical professionals in these areas will also see competition with doctors for on-the-job training. This is a significant concern. Associate professionals and advanced practitioners are an asset to the NHS, but they are not a replacement for doctors and must not be seen as a shortcut or silver bullet for patient care.”