'No coherent attempt' to prepare workforce for seven day NHS, say MPs

The report by the Commons public accounts committee comes as negotiations continue between the British Medical Association and government over controversial changes to the junior doctors’ contract, which the government says will support a seven day NHS.

The committee accused the DH of not adequately assessing the impact of seven day services on clinical staff, and claimed the department was not able to provide an indication of the workforce required to implement seven day services. Neither could it give an approximate answer.

The MPs also raised concerns that funding for seven day services may not be sufficient and said there had been no attempt to separately cost the policy against the £10bn additional funding promised by the government in the 2015 spending review.

The report said: “We are therefore far from convinced that the department has any assurance that the increase in funding will be sufficient to meet all of its policy objectives.”

HSJ reported last month on concerns raised by NHS providers over the costs of implementing the new junior doctors’ contract.

The report also called efficiency targets set by national bodies “unrealistic” and the cause of “staffing shortfalls”, leading to increased use of agency staff.

The committee suggested that increased use of agency staff was a result of pressure on trusts to balance efficiency targets and ensuring they have enough staff. It cited February’s National Audit Office report, which said trusts’ workforce plans were largely determined by financial considerations.

NHS Improvement admitted to the committee that the 2014-15 efficiency target of 4 per cent was “unrealistic”, but said trust boards “needed to exercise more judgement in setting staffing levels”.

The report said the DH and NHS Improvement “have not addressed the underlying causes of the increased demand for agency staff”.

Committee chair Meg Hillier said: “It is unacceptable for the government to blame staffing agencies for the growth in spending in this area when its own mismanagement is a major contributor to the size of the bills.

“At the same time, taxpayers are being asked to accept uncosted plans for a seven day NHS – plans which therefore present a further serious risk to public money.

“It beggars belief that such a major policy should be advanced with so flimsy a notion of how it will be funded – namely from money earmarked to cover all additional spending in the NHS to the end of the decade.”

A DH spokesperson said: “This report doesn’t properly take account of the dramatic workforce increases we have delivered, or our clear plans to increase capacity in the future in order to deliver a safer, 7 day NHS. We’ve got more than 25,300 extra clinical staff caring for patients already since 2010, and because we’ve increased nurse training places by 15 per cent there are currently 50,000 nurses in training.

“By 2020, we expect to have 11,420 more doctors working in the NHS, coupled with 10,000 nursing, midwife and allied health professional training places through our reforms.

“By March next year, we will provide a quarter of the population with seven day care.”