The must-read stories and debate in health policy and leadership.

Worth waiting for?

The eagerly-awaited interim NHS workforce plan has arrived and many will be disappointed with it.

The most pressing issues facing the NHS workforce are the level of nursing vacancies, staff shortages in other professions, the lack of continuing professional development training and the ongoing pensions crisis. On all these issues, the interim plan offers no definitive solution (although the Department of Health and Social Care made a subsequent announcement on pensions – see below). Instead, we will have to wait for the spending review before we are offered any tangible routes out of the mess the NHS has got itself into after decades of poor workforce planning and policy.

But there is much to commend in the plan. It does sensibly outline changes to the way the NHS manages its people and how individual providers are regulated by national bodies. This welcome recognition of the need to improve management culture is long overdue and shows Baroness Dido Harding starting to deliver on her words.

There are also sensible suggestions around staff passporting between organisations, multidisciplinary working and integrated care systems taking on more workforce policy.

The question of regulation for managers is, however, parked until the full five-year interim plan is published after the spending review.

As Baroness Harding told HSJ in an exclusive interview, this document is meant to be a stepping stone. We can start to see the destination, but there are plenty of potential roadblocks and a failure to secure substantial support from the Treasury could hold the plan below the water line.

Baroness Harding argues the NHS can do a lot now to improve the working conditions of its staff. That is true, but, while there are 40,000 nursing vacancies alone, there is no pretending that this interim plan is more than a promise of jam tomorrow rather than delivering today, even if that is what we had been advised to expect.

Pension pot half empty

The government’s announcement of a consultation on more flexible pensions arrangements has prompted many questions and provided little relief.

The 50:50 contributions arrangement the DHSC has said it is consulting on has already been widely criticised. “More work for half the pension. Why would anyone opt for that?” said one disgruntled HSJ reader.

The devil may well be in the detail but the consultation documents are not yet available online. The government has, however, confirmed it will run for 12 weeks.

Questions have been raised about what will happen to the employer contributions under the 50:50 option. Will they be used to pay for the funding gap left by the flexible scheme? (The DHSC said it would cover the cost of this rather than the Exchequer but it is unclear how much this will be.)

Others pointed out that, for those in a fully-tapered plan, a 50 per cent contribution would still result in a huge tax bill. And yet more in the comments section said the government had missed the point.

The language around this announcement has also perhaps alienated non-clinician pension scheme members who are not immune to the tax problems, as it is unclear whether these new solutions would apply to them as well as doctors.