Key takeaways
NHS roles are changing with new care models
More care will happen in communities, meaning new contracts and ways of working.
Hiring plans must follow new legal rules
Reducing overseas recruitment and using ‘positive action’ needs careful handling.
Tech and pay changes will affect staff
AI tools and performance-based pay will need fair training and clear policies.
Workforce Implications: the NHS 10 Year Health Plan
The NHS 10-year Health Plan, ‘Fit for the Future’, sets out a vision for transforming healthcare services in England. The core vision being an NHS that is digitally enabled, preventive, community-based, equitable and financially stable. At the centre of this reform is the NHS workforce, and how it is recruited, trained and managed.
Whilst the Plan promises a more efficient NHS, with increased opportunities for staff, it also introduces significant legal risks for NHS employers. This article outlines some of the key workforce implications and employment challenges that we can expect to arise.
Contractual Reform
The Plan proposes to move away from hospital-centric care to a community-based model. This transformation involves training thousands of additional GPs, offering same-day appointments through the NHS App, and establishing neighbourhood Health Centres in every community, each operating for at least 12 hours a day, six days a week.
Contractual reform is required to facilitate the community-based move, in line with the implications for working time, pay and geographic mobility. The UK Government has promised a “big conversation on significant contractual changes,” although the detail remains unclear. NHS employers should prepare for consultation and the renegotiation of terms with both staff and Unions alike.
Local Recruitment and Workforce Planning
The Plan aims to make the NHS the largest employer in the country, ushering in a host of new recruitment and retention challenges. This is coupled with a target to reduce international recruitment to under 10% by 2035. Employers must tread carefully with targeted recruitment, and positive action must not be misapplied, in order to avoid claims of discrimination.
A brand-new set of ‘minimum employment standards’ has also been promised by the UK Government. As is common with much of the Plan, the detail and scope of these standards is currently unclear. However, auditing of HR policies, contracts, and working conditions to ensure an NHS employer’s compliance with the new standards should be expected.
AI is also set to become a trusted assistant to Clinicians, incorporated within their training. This places a new burden on NHS employers to ensure that staff are adequately trained to adapt to these advancements, and, that they have the necessary equipment to access this. Increased reliance on AI also presents potential role changes and possible risk of redundancies, as certain roles are reduced in function, or replaced altogether.
Performance-Linked Pay
Managers will be granted powers to reward high performers and address underperformance. Modern incentives aligned with high-quality, productive care are also being introduced. NHS employers will have to ensure that performance reviews do not provoke claims of less favourable treatment and/or discrimination. Equally, it would be wise to audit appraisal systems to support this shift and consider implementing fair and lawful adjustments to assist performance-linked pay reviews.
For NHS employers, the 10-year Health Plan promises to be a pivotal moment to modernise workforce practices. By anticipating the workforce implications of the 10-year Health Plan, NHS employers can prepare for the legal risks; prioritise retention and recruitment of its workforce; and ensure efficient delivery of health care services moving forwards.
This article was co-authored by Sandy Ibbotson, Alice Webb and Amy Millson.
