'Serious flaws' in workforce plan for seven-day NHS, MPs say

The government has failed to assess whether there will be enough clinical staff to provide its manifesto pledge of a seven-day NHS, MPs have said.

A damning report by the House of Commons public accounts committee (PAC) called on health ministers to find out and report back on the workforce implications of the policy.

PAC chairwoman Meg Hillier MP (Lab,  Hackney South and Shoreditch) said it ‘beggars belief’ that seven-day NHS policy should be advanced ‘with so flimsy a notion of how it will be funded’. 

‘Namely from money earmarked to cover all additional spending in the NHS to the end of the decade,’ she said.

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The DH said the report failed properly to take account of workforce increases and plans to deliver further capacity expansion in future.

The committee criticised the department for failing to adequately assess the impact on the workforce of rolling out seven-day services, a criticism which has been made by clinicians’ organisations since the policy was developed under the coalition government.

The report said that the DH ‘does not know if there will be enough clinical staff with the right skills’.

While the government had committed an additional £10bn funding for the NHS in England by 2020, the DH claimed this money would cover the expansion of seven-day services, the PAC report said. But it warned: ‘However, the £10bn is a pot that the department seems to expect will cover everything - despite not having separately costed seven-day services and other initiatives.’

MPs on the committee recommended that the DH report back to them by December 2016 with a summary of the workforce implications of implementing the seven-day NHS policy.

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The report also criticised NHS bodies for failing to retain existing clinical staff. It warned that ‘national bodies need to get a better grip on the supply of clinical staff in order to address current and future workforce pressures’.

The committee said the DH and national NHS bodies had ‘provided ineffective leadership and support, giving trusts conflicting messages about how to balance safe staffing with the need to make efficiency savings’.

Ms Hillier said: ‘There are serious flaws in the government’s approach to staffing the NHS and without urgent action the public will pay for it on multiple fronts.

‘Frontline staff such as doctors and nurses are the lifeblood of the service, yet the supply of these staff in England is not keeping pace with demand.

‘This poor workforce planning means patients face the possibility of longer waiting times and a greater cost to the public purse.'

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She added: ‘Taxpayers are being asked to accept uncosted plans for a seven-day NHS – plans which therefore present a further serious risk to public money. It beggars belief that such a major policy should be advanced with so flimsy a notion of how it will be funded – namely from money earmarked to cover all additional spending in the NHS to the end of the decade.

‘Taxpayers are entitled to ask questions about the financial security of the NHS and the level of service it is able to provide both now and in the future.

‘If the government hopes to reassure the public it has credible plans for staffing and service delivery we urge it to demonstrate leadership in addressing the pressing concerns detailed in our Report.’

A DH spokeswoman said: ‘This report doesn't properly take account of the dramatic workforce increases we have delivered, or our clear plans to increase capacity in the future in order to deliver a safer, seven-day NHS. We've got more than 25,300 extra clinical staff caring for patients already since 2010, and because we've increased nurse training places by 15% there are currently 50,000 nurses in training. By 2020, we expect to have 11,420 more doctors working in the NHS, coupled with 10,000 nursing, midwife and allied health professional training places through our reforms.

‘By March next year, we will provide a quarter of the population with seven-day care.’

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