UK Prime Minister Rishi Sunak reaffirmed the government’s long-term workforce plan for the National Health Service (NHS) in a speech to the conservative conference.

Sunak said, “For decades, we have not trained enough doctors and nurses. The result: the NHS either hiring staff from abroad or paying temporary agency workers huge fees. And we are ending that with the first ever long-term workforce plan for our health service.”

“Our plan doubles the number of students training to be doctors and nurses,” Sunak said. “But it is also a reform plan for the NHS with new ways of training, new roles and new ways of working, all driving up productivity.”

Kate Shoesmith, Deputy Chief Executive at the Recruitment & Employment Confederation (REC), responded to the speech.

“Agencies provide dedicated and qualified staff around-the-clock to plug urgent gaps in the NHS, in large part because of the failure of successive governments to produce the right workforce plan to retain enough permanent staff and attract the next generation of NHS workers. We know from our data that there has been a sharp increase in demand for temporary healthcare workers in recent weeks which is likely to continue as we head into the winter.”

“Temporary healthcare workers care deeply about the NHS but only ask for a greater work/life balance – and so choose to work though agencies,” Shoesmith said. “Agency workers are still health workers and the cost of their shifts is mainly made up of the worker’s salary because an agency fee on framework is capped at around 10% of the hourly rate for a nurse.”

“Much of the increase in temporary workforce spend since the pandemic is down to NHS staffing banks and off-framework providers who are not restricted by pay caps,” Shoesmith said. “That is why we have asked the Public Accounts Committee to investigate value for money for all the different staffing arrangements in the NHS so we can move from blame to end game. We need to put patient care front and centre, where it belongs.”

Tania Bowers, Global Public Policy Director at the Association of Professional Staffing Companies, said, “The workforce crisis in the NHS isn’t easily resolved and while the NHS Workforce Plan has been designed to create a more sustainable access to resources, the impact of most tactics could take 15+ years to be truly felt. APSCo has previously highlighted that access to globally trained healthcare professionals needs to be more widely available, but conversations with our members have highlighted a number of additional changes needed in this strategy.”

Bowers said, “This includes a plan to ensure that there are not only sufficient, but also appropriate, flexible training pathways that enable new routes into careers in healthcare. We also believe that there needs to be an assessment of how the funding and contractual terms for the supply of clinical staff are affecting the ability to change the supply pipeline and skill-mix.”

“With strikes once again plaguing the sector, more immediate solutions are required beyond the Workforce Plan. In particular, the red tape many employers face when hiring agency workers needs to be cut,” Bowers said. “An example is the lack of conformity around pre-hiring compliance and safety checks of permanent and agency staff which is contributing to the increased costs and delays of getting nurses and doctors in front of patients.”

Sunak also addressed recent strikes by doctors over pay. “We have negotiated and reached pay deals with over a million NHS workers, including nurses and hospital porters. We have met the recommendations of the independent pay review bodies for junior doctors and consultants in full.”

“We have cut their taxes on their pensions as they requested,” Sunak continued. “But they continue to demand, massive unaffordable pay rises. And that they have chosen to walk out this week says it all. This strike is all about politics, not patients.”

British Medical Association (BMA) council chair Phil Banfield said on the strikes that central to restoring the long-term future of the NHS is incentivising doctors to work in the system. Doctors say the only way to do that is to pay competitive rates in what is a global market. The BMA says junior doctors' pay has fallen by 26% since 2008, once inflation is taken into account.

Meanwhile, Sunak also announced the cancellation of the High Speed 2 railway project.

In its place, Sunak said the government will reinvest £36 billion in hundreds of new transport projects in the North and the Midlands, and across the country.

Bowers said, “Given the investment that has already gone into the project, it is disappointing that the Manchester leg of the HS2 has been scrapped completely, without concrete timings for further investment in rail across the North.”

“While Sunak intends to still invest in improving the infrastructure in the North, the devil will be in the detail, particularly in regards to time frames. Given the election next year, a lot is left in the air, which is not great for inward investment,” Bowers added.

In the speech, Sunak also announced the creation of a new Advanced British Standard which will bring together A-Levels and T-Levels into a new, single qualification for school leavers.

“First, this will finally deliver on the promise of parity of esteem between academic and technical education,” Sunak said. “Because all students will sit the Advanced British Standard. Second, we will raise the floor, ensuring that our children leave school literate and numerate.”

Sunak continued, “Third, our 16- to 19-year-olds spend around a third less time in the classroom than some of our competitors. We must change this. So, with our Advanced British Standard, students will spend at least 195 hours more with a teacher. And fourth, A-Level students, generally, only do three subjects compared to the seven studied by our economic competitors.”

In the speech, Sunak added that in order to attract and retain more teachers, those who teach key subjects in schools and, for the first time, in UK further education colleges too, will receive special bonuses of up to £30,000 tax free over the first five years of their career.

Bowers responded, “The prime minister’s plans to shake up education with a new Advance British Standard reflects the general sentiment by our members and business leaders that the current curriculum needs to be overhauled to better equip emerging generations with the skills needed. T levels have not delivered the desired impact, partly due to a lack of publicity, but also because there is no incentivisation for businesses to commit limited time and energy to train youngsters on work schemes.”

“However, what is perhaps more pertinent is the fact that such a huge ‘once in a lifetime’ change will be intrusive for a labour force that is already in crisis,” Bowers added. “The skills deficit in education and the dissatisfaction of the current workforce will not serve to deliver this change.”

“There are simply not enough STEM teachers available so it is difficult to see how schools could actually teach more children science subjects,” Bowers continued. “Such plans require more clarity around how the teaching profession will be supported including additional training and the creation of a fulfilling, but also manageable lifetime career, which we haven’t yet seen.”