College statement on the NHS workforce plan

The College notes the publication of the much awaited NHS workforce plan. The plan is ambitious and emphasises the need to expand the number of medical training places, which should be welcomed.

We are very clear, however, that while the number of medical training places should increase, this must be matched by an increase in the number of postgraduate training posts in the NHS. 

As we have highlighted in our annual physicians’ census, the UK does not have enough doctors. Increasing the number of training posts is vital to ensuring that we have enough doctors to meet the needs of the health service in the future. Furthermore, we note the proposal to reduce the length of time doctors will be in training - we need to see more detail on this and would encourage clarity from the UK Government about how this would work in practice. 

It should also be noted that while the workforce plan is necessary, of course it does not address the immediate challenges. The UK Government must now redouble its efforts to make the NHS an attractive place to work. This includes valuing the workforce both in relation to terms and conditions, and practical support on areas like wellbeing, adequate rest facilities, and access to healthy hot food while on nightshift. The NHS is nothing without its current staff, nor is the care sector – and greater investment in the people currently working in health and social care is needed.

The College welcomes the plan to train around 1300 physician associates per year. The College is very supportive of physician associates - they are a key part of multidisciplinary teams across England. However, we are clear that an increase in physician associates should come with enough training posts for them to move into, and in addition to more junior doctors and more consultants (and placements) – not instead of. It is important to get the right balance of skills and experience to provide quality patient care. 

The workforce plan must be underpinned by a sustainable funding model and while we note the headline figure of £2.4bn, the mechanism for determining funding beyond that must be made clear. The College would also like to see a commitment to a model that can independently verify workforce numbers.

Commenting on the workforce plan, Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said:

The quality of care in our NHS is not determined simply by the numbers of staff but by the quality of their training.

Doctors are not made in lecture theatres. Medical students need access to supported clinical training placements, including contact with real patients and trainers with the time to train them. It is not clear how this will be realised. After graduation, trainees continue to need structured training, mentorship, and active assessment and feedback. Again, it is not clear how this can be realised.

As such, whilst we do welcome the expansion of the workforce proposed we must emphasise our concerns about the capacity of consultants and GPs to provide teaching and training – not only to medical students and medically qualified trainees, but also to the proposed increased numbers of physician associates, medical apprentices and colleagues from other healthcare professions. This is particularly the case when demand for direct patient care is so high and is absorbing the vast majority of trainers’ time.

The UK has, rightly, a long and proud reputation for the excellence of its medical training and the expertise of its trained medical staff. That reputation and excellence must not be undermined by a desire to increase the numbers of medical staff too quickly, without sufficent human resource to teach and train the staff of the future to the level our patients deserve.


1. The NHS workforce plan can be read here: NHS England » NHS Long Term Workforce Plan