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Workforce plan risks ‘collapse’ without suitable investment, warns RCN

The ‘Implications of the NHS workforce plan’ report, published today by the IFS warns that unprecedented increases in growth and productivity will be required to deliver on the plan’s staffing promises.

The RCN fear that without this guaranteed investment, the plan is in danger of collapse.

Difficult fiscal decisions lie ahead for the NHS, according to the IFS, who warn of the significant, and unprecedented growth required to meet the demands of the NHS workforce plan. The IFS’ ‘Implications of the NHS workforce plan’ report, published today, revealed the unaccounted for ‘medium-term’ financial consequences of a growing workforce.

To meet future demand, the plan pledges to increase the number of staff employed by NHS England from 1.5 million to 2.4 million by 2036/7. The report has found that by reaching this target, almost half (49%) of public sector workers in England will work for the NHS in 2036/7.

This increase will mean a much higher bill for the NHS, and will require wages to rise significantly to match or even exceed the growth in wages in the rest of the economy. Chief executive of the RCN, Pat Cullen expressed her concerns if these wage increases were to be neglected, she said:

‘These independent experts are laying down the challenge to the government and all parties over the significant boost needed - there are some difficult decisions and the service can ill-afford cans to be kicked further down the road.

‘It is vital that the government makes the NHS a good workplace that will attract the best people. And fair pay is a fundamental part of this - otherwise we’ll see nurses continue to leave in their droves.’

Under a central set of assumptions, the workforce plan implies annual NHS budget increases of around 3.6% per year in real terms. This increase is significant because it requires greater investment than the current 2% commitment by the government.

Economist and co-author of the report, Ben Zaranko stresses that this ‘real-terms NHS funding increases of 3.6% per year wouldn’t be outlandish.’ He continued to state that the ‘“glass half full” interpretation is that returning to the NHS’ long-run average funding growth rate of 3.6% per year could be enough to fund the workforce plan.’

However, two countervailing factors risk rupturing the plan. Firstly, ‘dire prospects for economic growth over the next decade’ means that continuing to deliver growth rates would mean harder trade-offs elsewhere, according to Mr Zaranko. Secondly, growth is only guaranteed if productivity in the service can be increased by between 1.5% and 2% per year, which would mean doubling our current rates.

Mr Zaranko wrote on twitter: ‘The NHS workforce plan is probably as close as any government is ever going to get to explicitly acknowledging the virtual inevitability of big increases in health spending over the medium term, given population ageing. It’s welcome for that reason alone.’

But Mrs Cullen warned that ‘failing to provide the investment that the Workforce Plan needs will put the entire plan in danger of collapse, add to the record backlog of care and put patient care at even greater risk.

She concluded, ‘the funding must not come at the expense of frontline services.’