A radical expansion of nurse training as well as overseas recruitment and a tripling in the number of people training as postgraduates are among the urgent measures needed to prevent the health and care workforce crisis from worsening in the UK, according to a report from Nuffield Trust, The King’s Fund and the Health Foundation.

The report calculated that the solutions can only be fully implemented if there is a £900 million increase in the annual budget for training and developing healthcare workers in England by 2023-2024.

On nursing, the report concluded that, even with grants and expansion of postgraduate training, bringing 5,000 more students onto nursing courses each year and actions to stop nurses leaving the NHS, the gap cannot be entirely filled domestically by 2023-24.

The authors of the report say that to keep services functioning, 5,000 nurses a year must therefore also be ethically recruited from abroad, meaning the government will need to make wide exceptions to new salary restrictions in the Immigration White Paper and fund the visa costs incurred by NHS trusts.

Projections for the report show that without actions like these being embraced in the upcoming NHS workforce plan, GP shortages in England will almost triple to 7,000 and nurse shortages double to 70,000 by 2023-24.

On social care, the authors say the proposed migration system after Brexit is not appropriate, and the government will need to come up with a special new route into the UK for care workers. It called on a comprehensive overhaul of social care funding to stop poor pay and conditions continuing to drive staff away.

The report also calls for £250 million a year in additional funding for developing workforce skills, as part of the overall £900 million, so that staff can keep up with changing technology and illnesses.

Furthermore, it called on the government to legislate immediately to create a regulated profession of physician associates, so that these skilled staff can take on more tasks and reduce the pressure on doctors across England.

Other measures included were nationally backed initiatives to close gender and ethnic pay gaps in the NHS, a call on the NHS to become a better employer so that fewer people want to leave and NHS pay to keep rising in real terms and not return to cuts or fall behind pay in the rest of the economy.

The report follows the three organisations’ analysis last year assessing the scale of the problem, which warned that staffing shortages could top 250,000 without urgent action. It also comes ahead of the Workforce Implementation Plan expected next month, which will lay out how NHS leaders aim to address these issues.

Richard Murray, Chief Executive of the King’s Fund, said, “NHS workforce shortages are mirrored in social care where poor pay and conditions continue to drive away staff. Social care is heavily reliant on overseas recruitment, but the government’s post-Brexit migration proposals risk limiting this vital source of workers. The government should go back to the drawing board to devise a route for care workers to enter the UK and develop a more sustainable funding model for social care.”

Michael Johnson-Ellis, Managing Director at Healthier Recruitment, responded to the report, “With nearly a third of qualified nursing, midwifery and health visiting staff expected to retire in the next 10 years, and the proportion of GPs who have taken voluntary early retirement doubling since 2011, boosting retention is our first line of defence against a future skills crisis.”

“Overreliance on temporary workforces continues to have a negative impact on both the experiences of substantiate staff and continuity of care – and this is something which must be addressed aggressively,” Johnson-Ellis said. “Through proactively working to improve employee engagement, seeking permanent employees rather than relying on agency staff and deploying existing workforces in a more efficient way, Trusts can work to mitigate against the crisis situation that this report forecasts.”