Ministers set out plan to train and keep more NHS staff

More doctors and nurses will be trained and thousands of new roles will be created to work alongside them, as part of a major NHS England workforce plan.

University places for medical students will double, a new apprenticeship scheme for doctors is planned and medical degrees could be shortened.

Prime Minister Rishi Sunak said the delayed workforce plan was "historic" and had taken time to get right.

Critics say poor working conditions in the NHS could undermine the plan.

There are more than 110,000 vacancies in the workforce at present, with one out of every 10 posts unfilled, which creates huge pressure on staff and affects the care patients receive.

The NHS has been beset by strikes this year, and the dispute with doctors is still continuing.

Pay for staff does not feature in the plan - instead, it focuses on increasing training places for medical and nursing students and a new scheme that allows trainee doctors to earn while they learn.

A consultation on whether five-year medical degrees could be shortened by a year will also be launched.

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Unveiling full details of the 15-year plan on Friday at Downing Street, Mr Sunak said it would "deliver the biggest ever expansion in the number of doctors and nurses that we train, and a plan to reform the NHS so we deliver better care in a changing world".

But he said overcoming the challenges of an overstretched workforce "won't be quick or easy".

"We're making the tough calls, and doing things differently, to protect the long-term future of the NHS and this country," Mr Sunak said.

NHS England chief executive Amanda Pritchard said the plan gave "a once-in-a-generation opportunity to put staffing on a sustainable footing for years to come".

'Dismal reality'

Shadow health secretary Wes Streeting said ministers had "nicked" the opposition's plan and he criticised the delay in publishing it.

"There is a reason why the NHS is understaffed, and it's the lack of a workforce plan for the last 13 years," he said.

The Liberal Democrats said the plan had come "too late" for the millions of people who had suffered in pain or died in hospital corridors waiting for treatment.

And the Nuffield Trust think tank warned that the "dismal reality" of working in the NHS at the moment could undermine the push to tackle staff shortages in the long term.

"There is a risk that we will feed more and more people into training, only to burn them out ever faster," Dr Billy Palmer said.

Currently, half of new doctors and nurses have to be recruited from abroad as the UK supply route has struggled to keep up with demand.

Without action, NHS vacancies could rise to 360,000 by 2037, modelling for the plan suggests.

To help achieve the goals, the government has promised £2.4bn over the next five years.

Mr Sunak called it "one of the most significant commitments" he would make as prime minister.

The targets for 2031 include:

• doubling medical school places for student doctors to 15,000 a year

• a 50% increase in GP trainee places for junior doctors from 4,000 to 6,000

• 24,000 more nurse and midwife student places a year - close to double the number now

• doubling training places for nursing associates to more than 10,000 by 2031

• increasing training places for physician associates to 10,000 by 2036

The role of nursing associate bridges the gap between healthcare assistant and nurse, while physician associates help doctors to diagnose and manage patients. They can work in GP surgeries or hospitals.

The new roles will mean more qualified staff can focus on spending time with their patients.

There is also a boost in training places for other roles, including pharmacists, psychologists and dental therapists.

In the next five years, the proportion of NHS staff, including physios, podiatrists and maternity staff, trained through apprenticeships - combining paid work with study and no tuition fees - will double, to one out of every six.

And next year, an apprenticeship for doctors will launch, with a few hundred places.

Speaking to BBC Radio 4's Today programme on Friday, Mr Barclay said senior NHS leaders had told him the plan "gives hope to the system" in the long term.

He said patients will not see some of the benefits for several years, but added that reforms and measures to improve staff retention "will come through quite quickly".

Gemma Peffers' role bridges the gap between healthcare assistant and nurse

Gemma Peffers is one of thousands of people to have already started a nursing apprenticeship - in 2016, aged 30, at Royal Derby Hospital.

"I left school not knowing what to do," she says. "I had lots of different jobs."

Ms Peffers has now qualified as a nursing associate and her next step will be to start two years of training to become a nurse.

Learning on the job has been really beneficial, Ms Peffers says.

"We are learning the ethos of the NHS and getting to know how our patients want to be looked after," she says.

And earning while she learns is important too.

"I've got children and a house to run," says Ms Peffers. "The security is really important and has enabled me to pursue a career in the NHS."

Being welcomed

There will also be a major drive on retention - including more flexible-working options and career development to provide clear routes to senior jobs. Last year, more than 40,000 nurses left the NHS.

The plan is being welcomed by many in the health service.

Matthew Taylor, of the NHS Confederation, which represents health trusts, called it "bold and ambitious".

But he said the same commitment was now needed for the social care workforce.

Others have pointed out the drive to increase training places could be undermined by the lack of placements on the front line - half of a student nurse's degree is spent working in the NHS.

It will also take years before this expansion starts to have an impact on current shortages - it takes five years to complete a medical degree and three a nursing degree.

Is it enough?

There are challenges making sure the expansion of training places is successful. The first one is making sure there are enough people interested in pursuing a career in healthcare.

That is less of a problem for doctors because medical degrees are heavily oversubscribed.

But the number of applications for nursing degrees is falling, with universities saying the cost of living crisis is putting people off.

However, perhaps the biggest challenge of all is ensuring existing staff are retained - nurses are leaving the NHS almost as quickly as new ones are joining.

There has been very little detail so far about how this will be addressed - and of course pay is not part of this plan, and that is a key factor in keeping staff.

Pay awards going forwards will be determined by two things - the size of the NHS budget and what is happening with inflation.

It is why the £2.4bn committed to boost training in this plan over the next five years is being welcomed, but on its own will not determine its success.