The lack of a “comprehensive long term workforce strategy” represents the biggest internal threat to the sustainability of the NHS, a new report says.

The report, published today by a House of Lords select committee to examine the long term sustainability of the NHS, warned of a “prevailing culture of short termism in the NHS and adult social care” – and claimed the “short sightedness of successive governments is reflected in a Department of Health that is unable or unwilling to think beyond the next few years”.

The committee, which was set up specifically to produce this report, also said necessary NHS transformation is happening, but “belatedly, and at an inadequate scale and pace”. 

Thirty-four recommendations were made, including setting up a new independent body named the Office for Health and Care Sustainability.

The report said the new body should look 15-20 years ahead on a rolling basis and focus on changing demographic trends, disease profiles, future service demand, workforce implications, and funding.

It said the reduction in health spending as a share of GDP seen over this decade “cannot continue beyond 2020 without seriously affecting the quality of and access to care”. 

The committee also recommended: 

  • Merging NHS Improvement and NHS England to create a new body with “streamlined and simplified regulatory functions”.
  • Strengthening and transforming Health Education England into a new integrated strategic workforce planning body.

On workforce, the report said Health Education England’s budget should be protected and that the government should outline a strategy for recruiting more staff from the UK.

And, the committee recommended that NHS England, with the help of Department of Health and GPs, should review alternative models to replace the “no longer fit for purpose” traditional small business model of general practice.

No recommendations were made for mental health.

The committee concluded that a tax funded, free at the point of use NHS remains the most efficient way of delivering healthcare. 

A spokesperson for the Department of Health said: ”We are totally committed to an NHS, free at the point of use, providing world-class care – and we agree that means taking decisions to ensure the sustainability of the service in future.

”We are already expanding the number of medical training places by 25 per cent to ensure we have all the doctors we need, investing in social care, working on a long-term funding solution in a green paper, and putting £325m into local transformation plans to improve services, with more to follow in the autumn.”

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