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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”.

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“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%

NHS ‘reliant on overseas staff’

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%.

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.

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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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.”

No mention of pay

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.

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Woman cancer-free after UK’s first liver transplant for advanced bowel cancer

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Woman cancer-free after UK's first liver transplant for advanced bowel cancer

A 32-year-old woman is cancer-free after undergoing the UK’s first liver transplant for advanced bowel cancer.

Bianca Perea, a trainee lawyer from Manchester, was diagnosed with the most advanced kind of bowel cancer in November 2021, with doctors telling her they aimed to prolong her life rather than find a cure.

But, alongside other treatments including targeted drug therapy, chemotherapy and surgery, the transplant has been a huge success and Ms Perea now has no signs of cancer anywhere in her body.

Ms Perea first visited her GP in Wigan after feeling constipated and bloated. After tests, a colonoscopy and a biopsy, she was diagnosed with stage four bowel cancer, which had spread to all eight segments of her liver.

Ms Perea accepted the diagnosis, but said she refused to believe the outlook was so bleak.

“I don’t want to sound kind of ignorant or arrogant or anything like that but I just didn’t feel in my gut that that was going to be it,” she said.

Her mother asked about a possible transplant at that stage but was told it was not a feasible treatment.

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Ms Perea had 37 rounds of a targeted drug called panitumumab plus chemotherapy for two and a half years.

She had an excellent response to the treatment, which meant she was able to have an operation in May 2023 to remove the bowel tumour.

But scans showed she still had tumours in her liver, which could not be operated on.

EMBARGOED TO 0001 MONDAY JANUARY 6 Undated handout photo issued by The Christie NHS Foundation Trust of Bianca Perea who is cancer-free after undergoing the UK's first liver transplant for advanced bowel cancer. Bianca, a 32-year-old trainee lawyer from Manchester, was given the surgery in the hope it could offer a potential cure for her deadly disease. Issue date: Monday January 6, 2025.
Image:
Bianca with her beloved dog. Pic: PA

Nevertheless, because her response to chemotherapy had been so good and her bowel cancer was seemingly gone, doctors began to look at liver transplants.

Ms Perea was added to the transplant list in February 2024 and was lucky enough to find a donor last summer.

File photo dated 30/11/17 of an NHS Blood and Transplant Small Human Organ in Transit box at St George's Hospital in Tooting, west London. Some 35 human organs were made available for transplant after being donated over Christmas Eve and Christmas Day, new figures have shown. The organs were provided by 11 donors across the UK after their death and included a heart, lungs, kidneys, livers, pancreas and bowel, NHS Blood and Transplant (NHSBT) said. Issue date: Friday December 27, 2024.
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An NHS Blood and Transplant Small Human Organ in Transit box at St George’s Hospital in Tooting, west London. File pic: PA

She said: “Within four weeks of going under the knife, I was able to drive and walk the family dogs, it was really quite incredible.

“To go from being told I’d only have a short time to live to now being cancer-free is the greatest gift.

“I’ve been given a second chance at life and I’m going to grab it with both hands. I am so grateful to the family who agreed to donate their loved one’s liver.

“I do believe this is a cure. They’re always hesitant to say that, obviously, but I am cancer-free right now.”

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Now, Ms Perea is looking forward to going on holiday this year and is working on improving her fitness.

“My liver is doing really well,” she said. “I get tests on that, and I’ve just had my second scan and that’s all clear, so it’s really good.”

Dr Kalena Marti, Ms Perea’s oncologist, said: “To see that Bianca has had such a positive outcome is wonderful.

“When we looked at the tumour cells in her liver after it had been removed, they weren’t active.

“This is excellent news, and we hope that this means that the cancer won’t come back.”

She added: “Advanced bowel cancer is complex and there are lots of different types of the disease, so what works for one person might not work for another. As a result, it’s important that we continue to develop new treatments.

“Thanks to the generosity of organ donors and their loved ones, we can now access liver transplants for some patients, which is fantastic.”

You can watch a full interview with Ms Perea at 8.30am this morning on Sky News Breakfast.

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Millions of commuters face more snow, ice and rain after weekend of travel disruption

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Millions of commuters face more snow, ice and rain after weekend of travel disruption

Millions of commuters returning to work and school this morning will face more snow, ice and rain, as several weather warnings remain in place across the UK.

More travel disruption is likely due to flooding from heavy rain and thawing snow, the Met Office said, with 97 flood warnings and 262 flood alerts in place.

It comes after most of the country saw heavy snow or icy rain fall over a wintry weekend.

Major airports closed their runways for several hours due to snow, while stranded vehicles and collisions blocked key roads across England.

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An amber weather warning remains in place until 6am this morning across parts of Lancashire, Cumbria and the Lake District.

Travel delays, stranded vehicles and power cuts are all likely under the warning – while rural communities could be cut off with up to an additional 15cm of snow falling during the period, the Met Office said.

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Leeds Bradford Airport warned passengers last night that disruption caused by the bad weather is likely to continue into Monday.

Several yellow weather warnings for snow, ice and rain will remain in place across Britain and Northern Ireland until this afternoon.

The Environment Agency said a combination of melting snow and rain could lead to “significant river flooding”, and advised people to stay away from swollen rivers and not drive through flood water.

This morning's weather warnings. Pic: Met Office
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This morning’s weather warnings. Pic: Met Office

Cold air will return and remain across the whole country from Monday onwards after a brief spell of milder conditions in southern areas, the Met Office said.

Deputy chief forecaster Mike Silverstone said: “The low pressure that brought the snow and heavy rain in the south will move out to the east by Monday. This will allow a cold northerly flow to become established again for much of next week.

“This will bring further sleet, snow and hail showers to northern Scotland in particular, but possibly to some other areas, especially near western coasts, with a fair amount of dry and bright weather elsewhere.”

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He added: “Temperatures will remain below average, with widespread frost and the threat of ice at times. Some areas, especially in the north, may struggle to get above freezing for several days.”

Further weather warnings could be issued with the potential for some snow to fall in southern and central England and Wales around the middle of the week, Mr Silverstone said.

You can stay up to date with the latest forecasts and warnings by clicking here.

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Sir Keir Starmer to launch plan for two million more NHS appointments

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Sir Keir Starmer to launch plan for two million more NHS appointments

Sir Keir Starmer will launch his plan to deliver millions more appointments across the NHS and to reduce waiting times to 18 weeks over the next five years.

The prime minister will lay out how greater access to community diagnostic centres (CDCs) will help deliver up to half a million more appointments, alongside 14 new surgical hubs and three expanded existing hubs.

Up to a million appointments could be freed up by giving patients the choice to forego follow-up appointments currently booked by default, the government says.

Overall, the plan will involve a drive to deliver two million extra appointments by the end of next year.

The aim of the reforms is that by the end of March 2026, an extra 450,000 patients will be treated within 18 weeks.

Figures published by NHS England last month showed an estimated 7.54 million treatments were waiting to be carried out at the end of October – the lowest figure since March 2024.

According to the Institute for Fiscal Studies (IFS), the last time the NHS met the target of 92% of patients receiving treatment within 18 weeks was in 2015.

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The reforms for England will also see an overhaul of the NHS app to give patients greater choice over where they choose to have their appointment and will also provide greater detail to the patient including their results and waiting times.

The first step in the digital overhaul will be completed by March 2025, when patients at over 85% of acute trusts will be able to view their appointment details via the NHS app, the government said.

They’ll also be able to contact their provider and receive updates, including how long they are likely to wait for treatment.

In the effort to free-up one million appointments, patients will be given more choice over non-essential follow up appointments, while GPs will also be given funding to receive specialist advice from doctors before they make any referrals.

Sir Keir is expected to say: “This government promised change and that is what I am fighting every day to deliver.

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“NHS backlogs have ballooned in recent years, leaving millions of patients languishing on waiting lists, often in pain or fear. Lives on hold. Potential unfulfilled.

“This elective reform plan will deliver on our promise to end the backlogs. Millions more appointments. Greater choice and convenience for patients. Staff once again able to give the standard of care they desperately want to.”

The CDCs will be open 12 hours a day and seven days a week wherever possible. Patients will be able to access a broader range of appointments in locations that are more convenient for them and which may speed up the pace of treatment.

The government believes its plan will help it to deliver the equivalent to 40,000 extra appointments a week in its first year – which was one of Sir Keir’s six key pledges.

Chancellor Rachel Reeve pledged £22bn over the next two years to cut NHS waiting times in her October budget, but some in the sector fear a workforce shortage means the prime minister’s ambitions will be hard to achieve.

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There have been some concerns that giving patients choice of the location of their treatment may see some hospitals in greater demand than others – but Health Secretary Wes Streeting said this was a “matter of principle”.

“When I was diagnosed with kidney cancer, I was inundated with colleagues in parliament who were asking who my surgeon was, whether I was going to the best place for treatment, whether I was exercising my right to choose in the NHS,” he said.

“Now, it turned out I had one of the best kidney cancer surgeons in the country assigned to me by the NHS, so I was lucky.

“But frankly, someone like my mum as a cleaner should have as much choice and power in the NHS as her son, the health secretary.”

NHS chief executive Amanda Pritchard said the government’s plan was an “ambitious blueprint”.

“The radical reforms in this plan will not only allow us to deliver millions more tests, appointments and operations, but do things differently too – boosting convenience and putting more power in the hands of patients, especially through the NHS app.”

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