NHS workforce planning: Limitations and possibilities

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Workforce planning for the NHS is a large undertaking. The NHS in England employs approximately 1.3 million staff, 70 per cent of recurrent NHS costs relate to staffing, and more than £4 billion is spent annually on staff training.

Securing a sufficient number of staff with the appropriate skills and deploying them effectively is a highly complex challenge, and one that is all the more important now that the NHS is about to enter one of the most financially constrained periods in its history. If it is to thrive and survive, productivity will need to make a step-change, and much of the scope for improvement lies in the workforce.

This report considers the degree to which NHS workforce planning in England is likely to support the delivery of a workforce that is fit for the future. To inform this assessment, we examine current developments at national and regional level, highlight relevant international experience, and propose ways in which planning could be made more effective.

Some of the key conclusions are:

  • Workforce planning capacity.The workforce plans of different strategic health authorities (SHAs) vary in approach and scope.

  • Integration of workforce planning. The different dimensions of planning are still not adequately co-ordinated. Given the prospect of much tighter funding, there are particular risks in the failure to link financial and workforce planning at both local and national level.

  • Workforce productivity and flexibility. We found a variable pattern of investment and attention within strategic health authorities (SHAs). Seven out of ten SHAs were investing less than 5 per cent of their budget on general workforce and leadership development.


The report recommends that the emphasis of workforce planning should not be solely on 'new' recruits but on how the system can develop new skills for those who are already employed in the service. It concludes that the focus should be on developing a flexible approach to workforce planning that doesn't seek long-term precision but can enable the current workforce to evolve and adapt to the inherently unpredictable health care environment.

Other key recommendations include:

  • There should be greater clarity of roles and responsibilities. Roles within workforce, service and financial planning need clarity, and current overlaps and gaps should be identified and resolved.

  • The multi professional approach to workforce planning should be strengthened. The impact of the recently established professional advisory machinery should be reviewed after one year to assess whether it is successfully supporting an effective multidisciplinary approach to workforce planning.

  • There should be better co-ordination between policy levers. The annual assessment of priorities needs to look at workforce in the round – not just the different professional groups. In particular, consideration of pay policy needs to be better linked to broader workforce goals.