• Tory manifesto makes significant pledges affecting NHS worforce
  • Key commitments to new consultant contract and legislation for safety
  • Manifesto fails to mention pay restraint or action to tackle nursing shortage

EU migrants working in the NHS and social care will be made a priority during the Brexit negotiations the Conservative Party manifesto has pledged.

The document, published today, has also revealed a raft of measures that could have widespread impact on the health service workforce with pledges to bring in a new consultant contract and reform professional regulation of doctors and nurses.

In a victory for Jeremy Hunt Tory party mandarins have also committed the party to legislating for the new Healthcare Safety Investigation Branch.This is likely to see it given statutory independence and new powers to protect information provided to it as part of safety investigations.

However, the document does not address NHS pay restraint policy or the worsening shortage of nurses in the NHS which has been described as the biggest single internal threat to the NHS’s sustainability. It also fails to offer any commitment around the roll out of a new independent medical examiner service.

The Conservative manifesto recognises the importance of EU staff to the NHS and social care system saying: “We will ensure that the NHS and social care system have the nurses, midwives, doctors, carers and other health professionals that it needs. We will make it a priority in our negotiations with the European Union that the 140,000 staff from EU countries can carry on making their vital contribution to our health and care system.”

But it also says employers who employ migrant workers will face an increased levy via an immigration skills charge of £2,000 a year. Health secretary Jeremy Hunt told HSJ it had yet to be decided whether the NHS would be exempt from this charge.

The manifesto recommits the party to training 1,5000 more doctors because “we cannot continue to rely on bringing in clinical staff instead of training sufficient numbers ourselves” but fails to mention nurse training. The nursing shortage has been estimated to be as high as 40,000.

Elsewhere the manifesto appears to put the government on collision course again with the British Medical Association saying: “We will reform the contract for hospital consultants to reflect the changed nature of hospital care over the past twenty years.”

The document stresses the need for seven day services, a controversial area of reform. It said: “In hospitals, we will make sure patients receive proper consultant supervision every day of the week with weekend access to the key diagnostic tests needed to support urgent care. We will also ensure hospitals can discharge emergency admissions at a similar rate at weekends as on weekdays, so that when someone is medically fit to leave hospital they can, whichever day of the week it is.”

Mr Hunt’s influence over the manifesto can be seen with an emphasis on safety and increased transparency over poor care. The document commits to legislation for HSIB saying: “We will continue to help the NHS on its journey to being the safest healthcare system in the world. We will legislate for an independent healthcare safety investigations body in the NHS. We will require the NHS to continue to reduce infant and maternal deaths, which remain too high.

“We will make clinical outcomes more transparent so that clinicians and frontline staff can learn more easily from the best units and practices, and where there is clear evidence of poor patient outcomes, we will take rapid corrective action.”

Other key proposals for the NHS workforce include:

  • Action to reduce bullying rates in the NHS and “vigorous and immediate action” against those who attack NHS staff.
  • New access to flexible working for NHS staff, quicker access to mental health and musculoskeletal services
  • Development of new roles and a “diverse set” of career pathways for some staff
  • Reforming “outdated” professional regulation by bodies such as the GMC – a pledge made by David Cameron following the Mid Staffs public inquiry.
  • Reforming medical education with closer working between universities and local authorities