Legal duties of the Secretary of State for Health and Social Care for NHS workforce planning and supply in England

Ahead of this debate the Library has produced the following background information and list of further reading on NHS workforce planning and supply:

Background

Alongside other measures to address workforce pressures, the Royal College of Nursing (RCN) are calling for legislation to provide clearer accountability for workforce planning and supply within the NHS. In particular, they have called for the Secretary of State for Health and Social Care to be explicitly accountable for workforce provision. See for example:

• RCN, Lack of accountability on staffing in England has put the NHS back years, RCN chief tells MPs, 1 May 2019
• RCN, Response to NHS England and NHS Improvement on Implementing The NHS Long Term Plan Proposals for possible changes to legislation, April 2019
• RCN, Fund our Future Nurses, November 2018

Currently the Health and Social Care Act 2012 gives the Secretary of State for Health and Social Care a number of broad duties, including an overarching duty to promote a comprehensive health service (Section 1). There is also statutory a duty on the Secretary of State to ensure there is an effective system in place for the delivery of education and training in the NHS and the public health system in England (Section 7). Since 1 April 2013, this latter duty has been largely delegated to Health Education England (HEE). The key purpose of HEE is to ensure that the healthcare workforce has the right skills, behaviours and training, and is available in the right numbers to support the delivery of healthcare and health improvement.

NHS England’s Next Steps on the NHS Five Year Forward View (March 2017) set out what had been achieved on workforce numbers over the three years since the publication of the NHS Five Year Forward View in 2014. Health Education England’s draft Workforce Strategy, Facing the Facts, (December 2017) noted some further actions beyond the Five Year Forward View. More recently, chapter 4 of the NHS Long Term Plan (January 2019) set out how the NHS will build on this existing work to recruit, train and retain more staff. It included plans to address workforce pressure through improved working conditions and support for staff. Baroness Dido Harding, Chair of NHS Improvement, is leading a programme to develop a ‘workforce implementation plan’, which is expected to produce a final report later this year. The Interim NHS People Plan was published on 3 June 2019.

The King’s Fund, The NHS long-term plan explained (23 January 2019) gave the following verdict on the workforce provisions in the Long Term Plan:

The plan correctly diagnoses the problem and the actions it proposes are the right ones. Most of these actions will take time to deliver and much is left to the new national workforce group and forthcoming workforce implementation plan to address. Some action will depend on other government decisions, for example, on the training budget, and the UK’s future immigration policy. In the meantime, however, workforce shortages remain a key risk and the plan is a missed opportunity to have taken urgent action to address this – for example on international recruitment of nurses.

On 12 February 2019 the Health Foundation published a report highlighting that NHS staff numbers are “failing to keep pace with demand and that there is ongoing deterioration in workforce numbers in critical areas such as primary and community care, nursing and mental health.”

Further reading:

The Library has published the following relevant briefings:

• NHS Key Statistics: England (CBP07281, 30 May 2019)
• NHS staff from overseas: statistics (CBP07783, 7 July 2019)
• Commons Library reading list for general debate on the effect of leaving the European Union on the UK’s health and social care sector (CDP-2019-0066, 15 March 2019)

See also:

Health and Social Care Committee (2019), NHS Long-term Plan: legislative proposals (HC2000, 2017- 19)

Health Select Committee (2018), Nursing Workforce (HC353, 2017-19)

Health Foundation, King's Fund and Nuffield Trust Joint briefing (2018), The health care workforce in England: Make or break?

Health Education England (2017), Cancer Workforce Plan

Health Education England (2017), Stepping forward to 2020/21: The mental health workforce plan for England

Nuffield Trust, Palmer W and Imison C (2018) "Lesson 3: Don’t treat the workforce as an afterthought"

House of Lords Select Committee on the Long-term Sustainability of the NHS (2017), The long-term sustainability of the NHS and adult social care (HL Paper 151, 2016–17)

Public Accounts Committee (2016), Managing the supply of NHS clinical staff in England (HC 731, 2015-16)

Nuffield Trust (2016) Reshaping the workforce to deliver the care patients need

NHS Confederation (2014), Not more of the same: ensuring we have the right workforce for future models of care

The King's Fund (2013), NHS and social care workforce: meeting our needs now and in the future?

Centre for Workforce Intelligence (2013), Big picture challenges for health and social care: implications for workforce planning, education, training and development

Health Select Committee (2012), Education, training and workforce planning (HC6, 2012–13)