Poor NHS workforce planning a few years ago by the government has led to the current climate of staff cutbacks and redundancies, say workforce experts.
The government should have warned the NHS to start trimming its growing staff back in 2004, the parliamentary health select committee was told at a meeting on 13 December, in the latest evidence session of its inquiry into workforce planning.
John Sargent, a workforce development consultant and former chief executive of the Greater Manchester Workforce Development Confederation, told the MPs that warnings could and should have come sooner.
He said, “The [health] department has an important role—a key leadership role—but all of us knew back in 2004 that a comprehensive spending review was coming, and most people can guess roughly what it might be like. It certainly won't be the growth in money terms of 7.3% that we've seen.
“Now when you bear in mind there is a four year lead-in time to get more nurses registered, or more for doctors, then there's a very strong argument that, back in 2004, the department should have been anticipating the most likely scenarios within the next spending review.
“The commissioning changes should have been flagged up in 2004, and reductions should have been occurring from 2005 onwards in anticipation of the next spending review.”
Anne Rainsberry, director of people and organisational development at NHS London, the strategic health authority for London, who also gave evidence, said that some areas of the country had been under pressure to meet the health department's national targets, which individual authorities felt were not always affordable.
“My view would be that the department could strengthen its expertise in the area of strategic workforce planning, and that would be most welcome,” she said.
The effect of government policies was also a problem, said Trish Knight, director of workforce development and commissioning at the Leicestershire, Northamptonshire and Rutland Healthcare Workforce Deanery, who also gave evidence.
“In some of their [the health department's] policies they haven't really considered the financial implications of the workforce,” said Ms Knight. “If you take the example of [the white paper] Our Health, Our Care, Our Say, it is an excellent policy document, but what does that mean, not just in workforce terms, but in the finances of the workforce?”
Ms Rainsberry also argued that planning for medical workforce needs should be merged with the separate system for other groups of NHS staff.
“The way in which planning for the medical workforce and the rest of the workforce is done in two different silos—one being done by the department with HEFCE [the Higher Education Funding Council for England] and the other with the health authorities—is very divisive and actually militates against us being able to think more flexibly about redesigning the workforce.
“We have to have the ability to plan the total workforce, not parts of the workforce. The way MPET [multiprofessional education and training] is currently managed needs to be looked at. Then we could integrate workforce planning at a strategic level.”
The inquiry continues.