Understanding the workforce implications in the ten-year health plan

The plan sets out how the government will reinvent the NHS in England through three shifts: 

1. hospital to community
2. analogue to digital
3. sickness to prevention.

It will be through the workforce that these three shifts are delivered. The government has stated that because healthcare work will look very different in ten years’ time, we will need a very different kind of workforce strategy.

The plan states that the government will:

• reorientate the focus of NHS recruitment away from its dependency on international recruitment and towards its own communities; supporting those unemployed or economically inactive into appropriate roles
• expand apprenticeships and accessible training so that people can earn while they learn
• allocate £5 million across ten integrated care systems (ICSs) to support 1000 young people and those from deprived backgrounds into pre-employment training, entry level roles or training posts
• continue to actively support care leavers, building on action the NHS has already taken as a signatory to the care leaver covenant

It also states that by 2035, every single member of NHS staff will have their own personalised career coaching and development plan, to help them acquire new skills and practice at the top of their professional capability. In addition, the intention is to:

• embed a culture of lifelong learning with a focus on skills and competencies. Introducing ‘skills escalators’ to give staff a trajectory for clear career progression
• create 2,000 more nursing apprenticeships over the next three years, prioritising areas with the greatest need
• development of advanced practice models for nurses, midwives, and allied health professionals, particularly in neighbourhood settings. And including increasing the number of nurse consultants.

The government also intends to:

• make AI every nurse’s and doctor’s trusted assistant, saving them time and supporting them in decision making
• work with the Social Partnership Forum to develop a new set of staff standards, which will outline minimum standards for modern employment. The government plan to introduce these standards in April 2026 and publish data on them at the employer level every quarter
• continue to work with trade unions and employers to maintain, update and reform employment contracts and start a big conversation on significant contractual changes that provide modern incentives and rewards for high-quality and productive care
• reduce the NHS’s sickness rates from its current rate of 5.1 per cent
• give leaders and managers new freedoms, including the power to undertake meaningful performance appraisals, to reward high-performing staff and to act decisively where they identify underperformance
• create 1,000 new specialty training posts with a focus on specialties where there is greatest need over the next three years
• accelerate delivery of the recommendations in General Sir Gordon Messenger’s review of health and care leadership and establish a new college of executive and clinical leadership to define and drive excellence
• introduce new arrangements for senior managers’ pay to reward high performance and to withhold pay increases from executive leadership teams who do not meet public, taxpayer and patient expectations on timeliness of care or effective financial management.

Next steps 

NHS Employers will play a key role in leading discussions to support the development of the upcoming ten-year workforce plan due later this year. We will share more detail in the coming months.

We will work with the government to develop guidance on the best use of existing terms and conditions to ensure that staff are deployed efficiently, job evaluation and job planning are conducted effectively and that standards for pay progression are properly met, based on good appraisal and excellent line management.

Further information
 

• Read the full detail in the government's Fit for the Future: 10 Year Health Plan for England.
• Read NHS Confederation's analysis of the government's key plan for the NHS and the takeaways healthcare leaders need to know.