Javid: elective recovery plan due this month, but no workforce strategy until spring

Sajid Javid also used his appearance in front of the Commons health committee to offer an olive branch to GPs and warn that some trust leaders “could do a lot better”, although he said he had seen some “fantastic examples of NHS leadership”.

The evidence session was called so MPs could grill Mr Javid about ministers’ plans for addressing the elective care backlog, following the decision to allocate an additional £5.9bn to tackling the problem in last week’s spending review.

Commons health and social care committee chair Jeremy Hunt focused much of his attention on ministers’ plans for addressing the workforce crisis, which represents a major impediment to efforts by the NHS to recover the backlog.

Mr Javid faced strong criticism from Mr Hunt for the government’s failure to publish details of Health Education England’s budget in the spending review.

Mr Javid said he could not yet give the details on how many doctors, nurses or other clinical staff the government thought the NHS workforce required. He said his department had “internal estimates” but these required “fine tuning”.

Mr Hunt said: “The concern that a lot of people have is that there is absolutely no detail in terms of the extra doctors and nurses that you think are going to be necessary.” The former health secretary added this was worrying because the lack of clarity meant ministers could not be held to account. 

Mr Javid told the committee: “By end of November, there will be a delivery plan specifically around electives [which will set out the workforce needs both short and longer term]. But there’s a broader workforce need beyond electives…

“[Then we will publish] a 15 year-plan to set up a strategic framework for the long-term workforce needed [across health and social care]… Spring is roughly the time for that. HEE is consulting widely. It’s a big tent operation.”

The Department of Health and Social Care commissioned HEE to “review long-term strategic trends for the health and social care workforce” in July, as reported by HSJ.

The project represents the latest effort to estimate and plan for how to address the NHS’ workforce requirements. HEE published a draft workforce strategy Facing the Facts, Shaping the Future in 2017, which was intended to set the groundwork for the first major NHS workforce strategy in almost two decades.

However, the plan was delayed, and a new team was put in place, led by then NHS Improvement chair Dido Harding. The interim People Plan was then published in mid-2019, followed by the delayed People Plan and People Promise.

The latter said more details would follow around workforce numbers when the government “further clarifies the available budget to expand the workforce” in the autumn spending review.

As reported by HSJ last week, these details were omitted and discussions with the Treasury are ongoing.

NHS leadership

In reference to the NHS leadership review, being led by the retired vice chief of the defence staff, General Sir Gordon Messenger which was announced last month, the health secretary said: “I have seen some really fantastic examples of NHS leadership…

“But I have also seen that there are trusts that could do a lot better. Leadership is not the only answer but it’s an important ingredient. Without good leadership, you’re never going to get the best outcomes.

“In the NHS, we have some of the best leaders our country has. Really outstanding people. How can we replicate that in every part of the country?”

Primary care

Mr Javid struck a more conciliatory tone on GPs than ministers have in recent months. He said GPs were “really stepping up”.

He said he did not think it was right to target GPs on how many face-to-face appointments they carried out. He said it was an issue which should be decided based on clinical need and patient choice.

He also admitted the government was “not on track” to hit a 2019 Conservative manifesto pledge to get an extra 6,000 more GPs by 2024-25, but insisted the government was focusing on addressing this.  

The comments follow Mr Javid launching a drive to overhaul GP access earlier this month. The Daily Mail said the health secretary was pushing for more in-person appointments, and there would be “league tables and ‘hit squads’ for those that fail”.

However, Mr Javid insisted this was not the case. He said: “We never planned for league tables, we never have. That’s never come from the department, that’s never come from the NHS.”