Workforce plan will challenge status quo 4 July 2023 Delivering the NHS workforce plan depends on implementing major reforms which will challenge professional and organisational power. The NHS Long Term Workforce Plan for England1 makes bold assumptions about productivity improvements, moving care out of hospital, getting better at prevention and early intervention, and breaking down clinical hierarchies and boundaries. The plan estimates that the number of people aged over 85 will grow 55% by 2037 as part of a continuing trend of significant population growth. It is inconceivable that the healthcare needs of this cohort could be met by continuing the NHS’s hospital- centric, sickness-based operating model. Moving care from hospitals to homes, exploiting artificial intelligence (AI) and robotic process automation (using software robots to emulate human actions such as putting together a patient discharge summary) and removing barriers that prevent clinicians innovating or working differently are just three of the changes on which the success of the workforce plan depends. The shape of the workforce is projected to change markedly, with the total nursing staff working outside acute settings increasing from 30% to 37%, and the total community workforce nearly doubling. The demand for mental health and learning disability staff is growing at 4.4%, more than double the growth in acute demand. Alongside this are ambitious plans to increase the number of nursing associates—who sit between healthcare support workers and registered nurses—from 4 600 to 64 000. This will give them a greatly increased role in care delivery, while registered nurses will focus more on care planning and assessment. If successful this will provide a career development pipeline from support worker to nurse. Read the full article at BMJ __________________________________________________ Starmer’s promises set Labour up to fail 26 May 2023 Keir Starmer is making big, conflicting, and unrealistic promises on health, without a clear plan for delivering them, which is setting Labour up to fail. In a speech at a Braintree ambulance station on Monday 22 May 2023, Starmer, leader of the Labour party, committed a Labour government to meeting a raft of targets that haven’t been hit for years, saying, “Ambulances – seven minutes for cardiac arrest. A&E – back to the four hour target. GPs – the highest satisfaction levels on record. Waiting lists – down. Planned treatment within 18 weeks. No backsliding, no excuses – we will meet these standards again.” As if that isn’t enough to keep a new government busy, he also committed Labour to improving healthy life expectancy and halving the inequality gap between English regions. He claimed this would be achieved by diagnosing 75% of all cancers at stage 1 or 2 – which would require a huge performance leap – and cutting heart attacks and strokes by a quarter within a decade. He also committed to cutting the number of deaths by suicide. All this will be achieved while Labour shifts services from hospitals to communities with a big expansion of local health services. Read the full article at BMJ __________________________________________________ Labour’s health plan has a serious flaw 25 April 2023 Labour may have got the basic idea right in prioritising primary care over hospitals if they come to power, but they risk deluding themselves about the scale of the task. In a major speech at the King’s Fund last week fleshing out the opposition’s plans for the NHS, shadow health secretary Wes Streeting touted New Labour’s achievements in slashing waiting lists and waiting times as proof that his party could turn around the fortunes of the health service. He said the plans would be delivered by a mixture of investment and reform, but “the state of the public finances means reform will have to do more of the heavy lifting.” Keir Starmer’s team have been keen to learn lessons from New Labour’s time in power, and it shows. There is more than a hint of former health secretary Alan Milburn in Streeting’s approach—positioning himself on the side of patients to challenge the system rather than being a cheerleader for the health service. But the scale of change Labour is proposing is massive, going far beyond recruiting more primary care staff. They are promising a fundamental shift of care from hospitals to communities and homes. “Healthcare on your doorstep” is now one of Labour’s three principles for healthcare, alongside “there when you need it” and “patients in control.” Read the full article at BMJ __________________________________________________