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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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Girl, 12, who died after being found unresponsive at psychiatric unit failed on multiple levels, inquest finds

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Girl, 12, who died after being found unresponsive at psychiatric unit failed on multiple levels, inquest finds

A 12-year-old girl who died after an incident of self-harm was failed on multiple levels, an inquest jury has found.

Warning: This story contains references to self-harm and suicide

Mia Lucas, who died in January 2024, was found unresponsive at an NHS children’s psychiatric unit after developing a rare neurological disorder that had been left undiagnosed.

The jury at Sheffield Coroner’s Court heard the girl was found at the Becton Centre, part of Sheffield Children’s NHS Foundation Trust.

She had been placed there after being sectioned while suffering an “acute psychotic episode” during an assessment at the Queen’s Medical Centre (QMC) in Nottingham.

On Thursday, the jury found that the failure to undertake a lumbar puncture at QMC before her transfer to the Becton Centre “possibly contributed to Mia’s death”.

A lumbar puncture involves a needle being inserted into your lower back to find out if symptoms are caused by a brain or spine condition.

Mia Lucas.
Pic: Family handout/PA
Image:
Mia Lucas.
Pic: Family handout/PA

The jury also said there was a failure at the Becton Centre to respond adequately to Mia’s risk of self-harm.

Professor Marta Cohen told the jury Mia’s cause of death was “compression of the neck” but she had now added that this was caused by “acute psychosis”, which was caused by “autoimmune encephalitis”, an inflammation of the brain that can cause extreme psychiatric symptoms and is treatable.

The autoimmune encephalitis diagnosis emerged during the nine-day inquest after a pathologist revealed she had received new post-mortem results.

The revelation prompted shock in the courtroom and tears from Mia’s family members in the public gallery.

The condition was described as “complex and rare”, according to consultant paediatric neurologist Mike Taylor.

He added that there was a low level of suspicion Mia had it, while being assessed at QMC, and told the court that experts had to consider the very severe treatment side effects, which included death.

Mia’s mother, Chloe Hayes, told Sky News she was unhappy at how the Becton Centre had supervised her daughter.

Mia Lucas (right), with her mother Chloe. Pic: Family handout/PA
Image:
Mia Lucas (right), with her mother Chloe. Pic: Family handout/PA

“All they had to do was watch her. I actually never got told the truth about the attempts that Mia made [to self-harm] until after she died,” she said.

“If I’d have known the truth I wouldn’t have left Mia there. And I think she had so much to live for. I don’t think she knew what she was doing.”

In a statement, Mrs Hayes added that she wanted people to know her daughter’s extreme behaviour was only evident in the final few weeks of her life.

“For the other 12 years, she was a beautiful soul who loved life and loved her family, and that’s how we want her to be remembered,” she said, describing Mia as a “happy, fun, friendly girl who had so much to live for.”

NHS Trusts apologise for Mia’s death

In a statement, Dr Manjeet Shehmar, medical director at Nottingham University Hospitals NHS Trust, offered “heartfelt condolences to Mia’s family for the loss of their daughter”.

She continued: “We accept the coroner’s outcome in court today and apologise to Mia’s family for not identifying autoimmune encephalitis while she was in our care. While this is an incredibly rare condition and initial tests were negative, we recognise that further testing may have had an impact on her future, for which we are truly sorry.”

Dr Shehmar said that in future cases of suspected possible autoimmune encephalitis, a lumbar puncture will be performed.

The trust will also “strengthen training and guidance for staff internally and review current published evidence of acute psychotic episodes in children and young people”.

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Pic: Family handout/PA
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Pic: Family handout/PA

Dr Jeff Perring, executive medical director at Sheffield Children’s NHS Foundation Trust, said: “Our thoughts are with Mia’s family and everyone who is grieving her loss in such tragic circumstances.

“We are deeply sorry for Mia’s death and recognise the profound impact this has had on those who loved her.”

The trust has carried out a thorough review of Mia’s care and made “significant changes” at the Becton Centre, he added.

“We will continue to work with children, young people, their families and carers to listen to, learn and take action from their experiences.

“The inquest has been important to understand fully the circumstances surrounding Mia’s death. We will now carefully reflect on the evidence heard and the coroner’s conclusions to ensure we continue to provide safe and compassionate care.”

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. Alternatively, you can call Mind’s support line on 0300 102 1234, or NHS on 111.

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Budget 2025 is a big risk for Labour’s election plans

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Budget 2025 is a big risk for Labour's election plans

Day two after a budget is always an important moment.

This is when the nerds and boffins of Britain’s fiscal thinktanks assemble to deliver their snap verdict on the chancellor’s decisions.

The moment is more important than ever when, as was certainly the case this time, the budget is a big one.

So what did the Institute for Fiscal Studies (IFS) and the Resolution Foundation make of this year’s budget?

Well, as you’d probably expect, they both fell short of distilling it into a single soundbite, but in broad terms, they both sounded somewhat positive.

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Yes, there were plenty of big provisos. The head of the IFS, Helen Miller, said Labour have broken their manifesto pledge not to raise National Insurance.

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The Resolution Foundation argued that if only the chancellor had raised the basic rate of income tax instead of freezing personal allowances, it would have made the tax rise considerably fairer and more progressive.

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And that’s before one gets into the criticism of some of the other bits and pieces from the red book – the structure of the EV tax, for instance (why doesn’t it try to penalise congestion?), or of the mansion tax (why not just overhaul council tax altogether?).

But for the most part, these closely-followed institutions seemed pretty supportive of this year’s budget – more so, certainly, than they were last year.

Primarily, that’s because while the last budget left only a very thin bit of headroom against Rachel Reeves’s fiscal rules, this one was far more cautious, doubling that fiscal insurance policy to just over £21bn.

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Yet that headroom is dependent on a couple of important factors. First, that the government will hold to its promises to keep spending growth constrained towards the end of the decade. Second, that it will be able to raise all the tax revenues it’s promising in that year.

That, in turn, gets to a deeper issue with the budget. Most of the tough stuff has been put off to the final year of the forecast – namely 2029.

That year, the government will face a squeeze at the very same moment that Britons are all asked to pay more in taxes.

And, critically, that’s the very year Labour is due to face a general election. Does it really plan to fight an election off the back of a contracting economy?

Consider, too, that for all the government’s promises to get living standards growing this parliament, they are currently only forecast to rise at the slowest rate since the 1950s – save for the pandemic and energy price shock period. The economic backdrop, in other words, is hardly rosy.

Still, for the time being, the chancellor has managed to put together a budget that has bolstered her position both in her party and in her job.

Markets remain relatively sanguine – much more so than after Rachel Reeves’s first budget last year – with bond yields lower today than before the event (albeit a little higher than yesterday).

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However, this was a complex budget. And, as with all bits of complex engineering, there remains a distinct possibility of large chunks of the budget failing to work.

But since so much of it isn’t due to kick in for a few years, it may take quite a while before we find out which bits work and which, if any, don’t.

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Man arrested at Manchester airport in connection with attack at Heaton Park synagogue

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Man arrested at Manchester airport in connection with attack at Heaton Park synagogue

A man has been arrested at an airport as part of the investigation into the terrorist attack at a Manchester synagogue.

The 31-year-old was detained at Manchester Airport on suspicion of the commission, preparation and instigation of acts of terrorism after arriving on an inbound flight, police said.

It brings the total number of people arrested in connection with the incident at Heaton Park Hebrew Congregation Synagogue to seven.

Jihad al Shamie launched the attack at the synagogue in Crumpsall on 2 October, driving his car at worshippers gathering on the Jewish holy day of Yom Kippur, before attacking others with a knife and trying to storm inside.

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Manchester synagogue terrorist: what we know now

Armed police shot al Shamie after he ran towards officers “aggressively” while carrying a knife and what police feared was an explosive device – later identified as a fake.

Worshippers Melvin Cravitz, 66, and Adrian Daulby, 53, were killed, with Mr Daulby being described as a “quiet hero” who leapt from his seat to block the doors of the synagogue as it came under attack.

Adrian Daulby, left, and Melvin Cravitz. Pics: Family handout/Greater Manchester Police
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Adrian Daulby, left, and Melvin Cravitz. Pics: Family handout/Greater Manchester Police

He died from a single gunshot wound to the chest fired by an armed police officer, while father-of-three Mr Cravitz died from multiple knife wounds inflicted by al Shamie, an inquest at Manchester Coroner’s Court heard in October.

The inquests into the deaths of both men have been adjourned until February next year.

Three other men were treated in hospital for serious injuries. Two have since been released, police said on Thursday.

The deadly attack rocked the local community. Pic: PA
Image:
The deadly attack rocked the local community. Pic: PA

An inquest into the death of al Shamie, a Syrian-born UK citizen, heard he was identified by his fingerprints and evidence, including his car, phone and inquiries with his immediate family in the aftermath of the attack.

At the hearing in October, Judge Alexia Durran, the chief coroner of England and Wales, said her provisional findings were that al Shamie died of gunshot wounds.

The Independent Office for Police Conduct found no misconduct in the police response.

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Synagogue attacker died of gunshot wounds

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In a statement on Thursday, Assistant Chief Constable Rob Potts, from Counter Terrorism Policing North West, said: “The loved ones of Mr Daulby and Mr Cravitz have been updated on this development, as have those who were seriously injured in the attack.

“Our investigation is continuing, and I would once again appeal for anyone with information that they think could assist our enquiries to please come forward.”

Police also said a 30-year-old man arrested on 9 October on suspicion of failing to disclose information contrary to S38B of the Terrorism Act 2000 remains on bail.

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