The Long Term Plan – how we educate, support and retain our workforce

11 Feb 2019

11 Feb 2019

Following the announcement of NHS England's Long Term Plan earlier this month, the RCP has engaged in a week-long discussion covering the plan's most important themes. Today, RCP vice president (education and training) Dr Emma Vaux discusses how we will train, educate, support and retain our workforce.

The dust has started to settle on the NHS Long Term Plan and we’ve now had time to consider what it really means for those of us on the frontline. The long and short of it is, for the plan to be a success, attention must now focus on how we train, educate, support and retain our workforce.

As part of our series of blogs on the plan, Professor Goddard has taken a look at the workforce supply aspects, asking ‘Are we a step closer to a workforce strategy?’ While increasing the NHS workforce is absolutely vital, we know there are no quick fixes. Looking after the workforce that we currently have and those that are in training should be at the forefront of everyone’s mind - from board to ward and everyone in between, clinical and non-clinical.

How does the plan help us create a more modern, flexible and welcoming environment that helps us all meet the needs of patients? One way is to value the diversity of the modern NHS team and recognise how it is possible to create opportunities to learn together, despite the busyness of our work places (as described in our recent publication Never too busy to learn). Another is how flexibility in training programmes may be enabled. Provided this is done well, the commitment to accelerating the implementation of ‘step out and step in’ training programmes may be one way of helping create the flexibility trainees have long been calling for.

The plan sets out the development of a fellowship programme for doctors and nurses entering general practice to support the development of portfolio – ie more diverse - roles. Our chief registrar scheme and, with Health Education England, the flexible portfolio training programme (recruiting its first cohort now), are both contributing to the flexible portfolio career landscape. We need to improve the experience of our medical registrar workforce today, so that they are inspired and prepared to be the consultants required for tomorrow. We’ll be working to make sure these programmes are recognised - and hopefully expanded - in the upcoming workforce implementation plan being led by Baroness Dido Harding.

The plan once again places a spotlight on the debate between generalist and specialist skills. As it highlights, a quarter of adults currently live with two or more long-term conditions and it’s vital that doctors are able to manage these more complex patients well. We, with our sister physician colleges,  are already leading the way on equipping trainees with the skills they need through the introduction of the new internal medicine curriculum in August 2019. The plan also draws upon our recent outpatient’s report highlighting the need to redesign services; this will require further considerations about the redesign of education and training in due course.

There has been a lot of talk about credentialing recently and the plan sets out to ‘accelerate the development of credentialing’. The GMC is currently consulting on it, as there isn’t yet a shared understanding of what ‘credentialing’ really means. Our developing experience of designing credentials on Gender Identity Healthcare Practice and Clinician Researchers, as two examples, demonstrates the potential which can be unlocked to up-skill clinicians whilst recognising their limitations.

The plan sets out some ambition on retention, taking it from a management buzzword to something that should be a core part of business as usual. The detail is lacking but the direction is positive. The same is true on the drive to place ‘respect, equality and diversity’ at the centre of the NHS. We all have a responsibility to role model behaviours and challenge inappropriate actions. The RCP code of conduct, published last year, very clearly sets out the expectations of all RCP members and fellows. This is the foundation to our developing physician wellbeing programme and the upcoming ’ThisDoctorCan’ series.

So the plan is here and now it’s time for meaningful implementation, keeping education and training at the heart of how we provide the best care for our patients. This will take effort, resource, commitment, perseverance, new and innovative thinking. We will be alongside you in support.

Dr Emma Vaux is the vice president (education and training) at the RCP and a consultant nephrologist and general physician at the Royal Berkshire NHS Foundation Trust. You can follow her on Twitter @VauxEmma