The government plans to more than halve the number of NHS staff being recruited from abroad in the next 15 years, according to its long term workforce plan.
On Thursday, a preview of the plan announced the intention to funnel £2.4bn into solving the severe staffing crisis in NHS England.
The full document, which was published this morning, said the service aims to train more NHS staff domestically to “reduce reliance on international recruitment and agency staff”.
“In 15 years’ time, we expect around 9-10.5% of our workforce to be recruited from overseas, compared to nearly a quarter now,” the NHS plan said.
The report also says:
• Half a million trainees will begin clinical training over the next six years • The NHS hopes to recruit 300,000 new staff and retain 130,000 extra healthcare workers • Training places will be expanded across the sector including: GPs (50%), adult nurses (92%), pharmacists (29%), dentists (40%), dental therapy and hygiene professionals (28%), healthcare scientists (13%) • From autumn, recently retired consultant doctors will be given the option to return to work across England through the NHS Emeritus Doctor Scheme • Almost a quarter of NHS staff (22%) will be trained via apprenticeship by 2031/32 • New medical degree apprenticeships will train 2,000 doctors by 2031/32 • Staff will be supported to access the new childcare measures announced in the recent budget • The shortfall in mental health nursing is of “particular concern”, with plans to boost this by 73%
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The NHS, the report said, is “particularly reliant on international recruitment” to fill workforce gaps. The total proportion of NHS workers with non-UK nationalities – across all professions – has grown to more than 17%.
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Since 2017, there has been a 2% increase in UK-trained medical graduates joining the workforce. By comparison, in the same time period, there has been a 121% rise in international medical graduates.
Of the doctors who joined the UK workforce in 2023, 50% were international medical graduates.
And, in 2022/23, about half of new nursing registrants in England were trained overseas.
“This leaves the NHS exposed to high marginal labour costs and risks the sustainability of services in the longer term given the growing global demand for skilled healthcare staff,” the report said.
But achieving the productivity improvements outlined in the plan is depending on ” a sustained increase in capital investment in the ageing NHS estate” and investing in digital infrastructure to allow the NHS to make the most of new technologies.
This includes replacing equipment that has passed its recommended lifespan and expanding “capacity to accommodate the increased demand for healthcare from an ageing population”.
“This would enable staff to function more efficiently, and shorten diagnosis and treatment times in areas such as cancer,” the report said.
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New roles will be ‘trained and regulated properly’
Vacancies currently stand at 112,000, and there are fears shortfalls could grow to 360,000 by 2037.
Shorter medical degrees, apprenticeships so staff can “earn while they learn” and more medical school places in the areas of greatest need were among the previous headline announcements.
The Prime Minister has insisted people being brought into new roles in the NHS will be “trained properly and they’ll be regulated properly”.
Rishi Sunak said the General Medical Council (GMC) will bring new roles like physician associates into its remit as regulator.
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PM: ‘We’re improving culture, leadership and wellbeing’ in NHS
As the Conservatives have now been in power for 13 years, critics – including Labour’s shadow health secretary Wes Streeting – have been asking why the party hasn’t acted sooner.
He said governments from all parties had “ducked” the workforce challenge for decades but said “overcoming this won’t be quick or easy”.
He added: “It’s only possible because of the difficult decisions we’re taking elsewhere to cut the debt and by prioritising the NHS there will be other things that we can’t afford.
“But the NHS is too important. So we’re making the tough calls, and doing things differently, to protect the long term future of the NHS and this country.”
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And while the plan focuses on retention and training, as waves of strikes continue across the health service, the preview contained no mention of pay other than to say: “Everyone working in the NHS should be recognised and rewarded fairly to help ensure we attract and retain the staff we need to provide the best possible care for patients.”
In response to questions about this, the prime minister said everyone would like to be paid more, but the government’s job is to “make sure that we reward people fairly and well for the work they are doing” but also bring down inflation.
He said he is “really pleased” the NHS staff council, which represents over a million NHS workers, voted to accept the government’s pay offer, adding: “I think they did recognise that it was fair and reasonable and rewarded their members for their hard work.
“”And I’m very grateful to all them for doing that because I know that fundamentally what they care about is working really hard, to deliver excellent healthcare.”
Unite General Secretary Sharon Graham said: “This looks like a bold plan to transform the training of new staff in the NHS. But the devil is in the detail as usual. There is a promise of funding for training for three years, but nothing about money for current staff.
“If there is not enough money to pay NHS staff a decent wage now, and transform current wage structures, then all the aspirations for more staffing in the training plan will fail to address the current crisis in the recruitment and retention of staff. That is what is at the heart of the current staff exodus”.
Analysis: No benefits in the short term
England will not see the benefits of the NHS workforce plan in the short term.
Essentially what this plan does is to grow the workforce, to retrain the workforce where it needs to with the addition of extra technology, and essentially to retain that workforce.
The government wants to work towards a plan over the next five, 10 and 15 years where it is less dependent on overseas-trained health professionals.
Essentially what this means is that we won’t see the benefits of this long-term workforce plan in the short term and it won’t do anything to address things like social care or NHS estates.
Three people have been taken to hospital after a double-decker bus carrying sixth form students left the road and ended up in a river in Hampshire.
Emergency services were called to Bishopstoke Road, Eastleigh, at 10.07am on Thursday after the Bluestar bus left the road.
Three “high-priority” patients were taken to hospital – and 14 people were treated at the scene with less serious injuries.
The bus was carrying students from Barton Peveril Sixth Form College in Eastleigh.
A South Central Ambulance Service spokesman said it scrambled two helicopters and five ambulances to the scene.
The spokesman said: “We have sent multiple units to the incident including five ambulances, two helicopters, and specialist response units.
“We’re continuing to support and assess patients on scene. All patients have been removed from the bus. Three high priority patients are being taken to hospital. Around 14 with less serious injuries are being treated on scene.”
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The college posted on Facebook that an incident centre had been set up for parents and it was “working closely” with police.
It continued: “We ask that people do not attend the actual scene. For concerned parents, an incident centre has been established at The Hub at Bishopstoke.
“An officer and college staff will be available at The Hub to provide updates and address any questions you may have.”
A Hampshire Constabulary spokesman said: “We are currently dealing with an incident on Bishopstoke Road in Eastleigh, after College Bus 607 for Barton Peveril students left the carriageway into a river.
“Emergency services are in attendance and the road has been closed so please avoid the area.
“It is anticipated the road may be closed for up to 12 hours for investigation and recovery work.
“Everyone on the bus has been accounted for and all injured persons are being treated by the ambulance service.”
A Hampshire and Isle of Wight Fire and Rescue Service spokesman said: “We are on scene of an RTC involving one double decker bus that went off the road in Bishopstoke, Eastleigh.
“Fire crews from Eastleigh, St Mary’s, Redbridge, Hightown and Portchester are in attendance alongside emergency service colleagues.
“People are asked to avoid the area to help emergency services deal with this incident.”
Richard Tyldsley, Bluestar general manager, said: “One of our buses, carrying students to Barton Peveril College, was involved in an incident earlier this morning in Bishopstoke Road, Eastleigh.
“Reports suggest the bus left the highway and came to rest in a shallow river.
“There were 19 passengers on-board at the time. Our driver and at least two of the passengers have confirmed injuries, and we are awaiting further updates on the status of others on-board.
“We do not currently have full details of their injuries and are following their progress closely.
“Our thoughts are with everybody involved, and we wish those who were injured a full and speedy recovery.
“At this time, we do not know the circumstances behind this incident and are carrying out an immediate investigation. We are also assisting the police as they carry out their own inquiries.”
Hours after giving birth, with her son rushed away to a high dependency unit, as she lay broken and bleeding, Morgan Joines overheard a midwife blaming her.
Her son had been born with wet lung after an emergency and traumatic caesarean section.
“I overheard [the midwife] tell a student nurse I was the reason my son was ill, because I was too lazy to push,” she told Sky News.
“I was broken. I genuinely believed for ages afterwards that I had failed my son.
“I thought I was the reason he was ill.”
Her son was born at John Radcliffe Hospital in Oxford, part of the Oxford University’s Hospital Trust. Morgan is one of more than 500 families who say they have been harmed by maternity care at the Trust.
A taskforce, chaired by Mr Streeting and made up of experts and bereaved families, will first investigate up to ten of the most concerning maternity and neonatal units.
And campaigners – calling themselves the Families Failed by OUH Maternity Services – are calling for Oxford to be on that initial list.
‘I thought I was going to die’
The unit was rated “requires improvement” in its last inspection by the government’s watchdog, the Care Quality Commission, in April 2023.
The CQC flagged issues around maintaining patient dignity, and said medicines were not always safely stored and managed. The unit did not manage the control of infection consistently it said, and wards were not always kept clean.
One mum told the campaign group she thought she was going to die after being left alone while in labour and denied pain relief.
Another said she is reluctant to consider having another child and feels a “profound loss of trust in the NHS”.
Trust to meet campaign group
Yvonne Christley, Chief Nursing Officer at OUH, said she apologised “for not being able to respond in detail about individual patient cases”.
“We regret any instance where we fail to provide the service that women and their families should expect. When this happens, we make every effort to review individual cases to understand what went wrong and how we can improve.”
She said the trust “make every effort” to keep women and families informed of what action it has taken, and said it is committed to maintaining an open dialogue with community groups.
“The Trust has agreed to meet with the campaign group and is eager to collaborate with them to implement the necessary changes and restore confidence in our services. These meetings are currently being scheduled.”
Caesarean sections account for approximately 40% of all births at OUH.
A ‘degrading strip wash’
A few hours after Morgan’s son had been whisked away to another part of the hospital, a nurse tried to force her to take oramorph, a high strength painkiller, she said.
When she declined to take the drug, having previously had a bad reaction, she said staff “claimed I was being difficult”.
“[They said] to just take the meds and get it over and done with.”
Image: Morgan Joines overheard a midwife blaming her for her son’s condition when he was born
When Morgan was unable to get out of bed, she says the same nurse then gave her a “degrading” strip wash, without her consent.
The unit, she said, felt like it was against C-sections.
“Even though it was recommended by doctors that I had caesarean, it was medically necessary, I felt I should have done more to help him,” Morgan said.
Waiting eight hours for a C-section
When Kate* was 38 weeks pregnant with her third IVF baby, she was induced.
The doctors had tried to burst her waters, but realised her daughter was breech when the midwife felt her feet near the bottom of the birth canal, telling her: “I’m glad those didn’t break, I think I just felt a foot.”
At 11pm Kate reluctantly agreed to a C-section, but was told it was “safer to wait until the light of day” to go down to theatre.
She was sent away to an observation area experiencing intense contractions for more than six hours. In those hours, she said she was abandoned without pain relief and was bleeding.
“I felt so alone in the dead of night. My husband had been sent home, and I just wanted someone to talk to, someone to help me.
“I was in so much pain labouring but the midwife made me feel like a hypochondriac.”
She said the situation was escalating, she was becoming dehydrated, and her daughter’s heartrate was climbing, yet no one intervened.
A registrar who began his shift at 7am, examined her and rushed her immediately to theatre.
At this point she was 9cm dilated and the registrar was “shouting at me, telling me not to push.”
Kate’s daughter was her third IVF pregnancy, and she became emotional when she talked about what might have happened, had that registrar not examined her so quickly in the morning.
“They gambled with her life,” she said.
“If my waters had broken and that registrar wasn’t there, she would have started to come with her feet first. Both my boys had shot out, so I could be talking now as a mum who lost her child.
“It didn’t need to even get to that point.
“I should have had my C-section five hours earlier.”
After she had given birth, she was left “in a pool of my own blood, just covered in blood” and had to pull herself out of bed to clean up.
She said she joined the campaign in the hopes women will be listened to in the future and not have to endure what she did.
‘I can’t get my baby out’
Annika Weldon had three miscarriages before giving birth to her son.
“I remember lying on the ward, screaming in pain and none of the other ladies around me were screaming like I was,” she said.
“It didn’t feel right, obviously when you go into labour you expect you are going to be in pain, but I just knew there was something not right.”
The midwife who checked her when she was in active labour could not tell her if she was 1cm or 10cm dilated, she said.
“We spent 45 minutes trying to get my baby out but this midwife that I was with was just so uncaring, she didn’t really explain what I should be doing.”
Image: Annika Weldon miscarried three times before giving birth to her son
She had said early in the pregnancy she told doctors she wanted a C-section and “was told I couldn’t have one”.
“I kind of accepted that unless it was an emergency situation, I wouldn’t be able to have one but then in that moment I was like, I don’t know what else I can do here. I feel completely exhausted; I can’t get my baby out.
“I was just so tired and exhausted.”
Her son was born not breathing and she was haemorrhaging blood.
She was taken to emergency surgery and the last thing she remembers before waking up in the ward is throwing up in her hair.
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Maternity services investigated
She wasn’t told until much later the extent of her blood loss (2.5L) when she was struggling to pick up her own baby: “When I asked for help, I was made to feel like an inconvenience.”
‘OUH is particularly bad’
For Kim Thomas, co-founder of Families Failed by OUH Maternity Services and CEO of the Birth Trauma Association, these stories are nothing new.
But Oxford University Hospitals Trust is “particularly bad”, she says.
“They seem to have this incredibly arrogant attitude. They won’t take criticism.
Image: Kim Thomas, from the Birth Trauma Association
“Women who complain are routinely dismissed. There’s a failure to learn from mistakes.”
She says OUH also has “poor postnatal care”: “Dirty wards, blood on the floor, women left in their own blood, women not helped.”
Yvonne Christley, from OUH, said: “We are never complacent and welcome all feedback, whether positive or negative, as we learn from both.”
A Department of Health and Social Care spokesperson said: “Too many families have been devastated by serious failings in NHS maternity and neonatal care.
“They deserve swift answers, and urgent action is essential to prevent future tragedies.”
They said the government was “immensely grateful” to families for sharing their experiences.
“[We] will work closely with families on this journey to help ensure no parent or baby is ever let down again.”
The Oxford campaign group is growing daily, with more like Kate, Morgan and Annika joining the ranks of those calling for change.
And each day that passes without answers is a reminder of the trauma they endured.
“It still hurts to look back on. It’s taken a while for me to stop blaming myself, but it doesn’t get easier,” Morgan said.
Weight loss and diabetes jabs taken by more than a million people in the UK have been linked to a potential serious side effect, with some deaths, according to data from the UK medicines regulator.
New figures from the Medicines and Healthcare products Regulatory Agency (MHRA) show the group of drugs that includes Mounjaro, Wegovy, and Ozempic may be associated with inflammation of the pancreas.
According to the MHRA, there have been 181 reported cases of acute or chronic pancreatitis linked to Mounjaro, with five deaths.
Wegovy and Ozempic have been linked with 113 reports of pancreatitis and one death.
Other, less widely used versions of so-called GLP-1 drugs have also been linked to cases and deaths.
There is no evidence that the drugs directly caused the deaths. And the evidence isn’t strong enough for the MHRA to restrict access.
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Weight loss drugs compared
That’s because pancreatitis also occurs in people who aren’t taking the GLP-1 drugs, with about 560 cases for every one million people in the general population. Gallstones and alcohol are the biggest causes.
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But the MHRA and Genomics England are launching a new study to see whether some people have genes that put them at higher risk of developing pancreatitis if they take GLP-1 drugs.
People reported through the MHRA’s ‘yellow card’ alert system to have pancreatitis while using the jabs will be asked to provide a saliva sample and their genes tested.
Professor Matt Brown, chief scientific officer of Genomics England, said: “GLP-1 medicines like Ozempic and Wegovy have been making headlines, but like all medicines, there can be a risk of serious side effects.
“We believe there is real potential to minimise these, with many adverse reactions having a genetic cause.
“This next step in our partnership with the MHRA will generate data and evidence for safer and more effective treatment through more personalised approaches to prescription.”
Image: Assortment of weight loss and diabetic drugs. Pic: iStock
The main symptoms of pancreatitis are severe pain in the centre of the tummy area, fever and nausea. Acute cases are treated in hospital with fluids and oxygen, and generally make a recovery within a few days.
But there can be complications, and around 5% of acute cases are fatal.
With all medicines, there is a balance of risk and benefit.
For people with type 2 diabetes or obesity, there are clear benefits to using the jabs.
They lower blood sugar levels, lead to rapid weight loss and reduce deaths from cardiovascular disease by a fifth.
But for people who are a bit overweight and have sourced the jabs privately to lose a few pounds ahead of their summer holiday, the health benefits are far less clear.
This is a wake-up call for them.
These are powerful medications with effects not just on appetite, but on lots of body organs, including the brain.
And pancreatitis is just one of many possible side effects.
Lilly, the UK manufacturer of Mounjaro, has said patient safety is its “top priority”.
The drug’s patient information leaflet “warns that inflamed pancreas (acute pancreatitis) is an uncommon side effect (which may affect up to 1 in 100 people),” the statement continued.
Lily “also advises patients to talk to their doctor or other healthcare professional before using Mounjaro if they have ever had pancreatitis,” it added.