The eagerly awaited 10 Year Health Plan brought much to welcome, with headlines directed at measures to prevent sickness, increase local health services and the aspiration to make the NHS the most AI-enabled health system in the world.
As ever, the success of a plan like this depends on a workforce that is engaged and productive, sufficient funding, and, of course implementation and momentum. These details often, but not always, lurk behind the headlines.
The workforce point is key – particularly retention. As the government rightly acknowledges, without its staff the NHS would be little more than a collection of machines, buildings and beds.
We particularly welcome the recognition that specialty, associate specialist and specialist (SAS) doctors can play a crucial role, and the pledge to improve pathways for experienced specialty doctors to develop and operate at a specialist level. Better supporting SAS and locally employed doctors could help to retain and get the very best out of this important cohort.
The plan also includes promises to give UK doctors priority for training places and significantly reduce the NHS’s reliance on overseas qualified doctors. It should be remembered, however, that the NHS has long relied on the dedication and expertise of these doctors, and countless patients have benefited from their contribution. The need to retain, support and develop our international colleagues will continue, and the government must set out how it will do this.
A key workforce challenge that is not sufficiently addressed in the plan is how to support the many skilled, passionate healthcare workers who have a long career ahead of them, but are burnt out or struggling with their mental wellbeing. This is not only damaging for them but can jeopardise patient care. We know that many are also on the verge of quitting and long-term absence rates due to mental wellbeing issues remain high.
The plan acknowledges the mental wellbeing crisis – recognising that healthcare workers feel demoralised, like rota-fodder, and are traumatised by Covid-19 – but does not go far enough in attempting to manage it. The occupational health service the government has committed to rolling out for all NHS staff does include support for mental health issues, but can this provide the specialist, confidential support healthcare staff really need?
Those working in the NHS should at least have counselling and peer support networks available to them when they need it, to tackle issues early on and enable them to continue to care for patients safely. Access to specialist help outside of their place of work – without fear of repercussion from employers – is also important. We know national services like NHS Practitioner Health, which only has funding until Spring 2026, provide a vital lifeline for many who are struggling to cope. Their future must be secured.
More than a year ago, NHS England initiated a review into the provision of mental wellbeing support for NHS staff. The outcome of this review is notably absent from the 10 Year Health Plan. Sustained investment in comprehensive mental wellbeing support can play a critical role in retaining the medical workforce. This requires greater attention and long-term thinking, and it should be prioritised in the 10 Year Workforce Plan promised later this year.
Funding the plethora of promises made in the plan is another key point. We all know transformation comes with a price tag. The confirmation within the spending review of an additional £29 billion funding for the Department of Health and Social Care offers some reassurance, but clearly significant additional savings will need to be made. One area that springs to mind is the spiraling cost of clinical negligence claims to the NHS. Last year alone, the government paid out £2.8 billion on claims, with £536 million of this being on legal costs. An estimated £58.2 billion will be needed for future costs for claims arising from incidents that have already occurred, a sum which the Public Accounts Committee recently identified as being the government’s second largest liability after nuclear decommissioning.
While it is disappointing that the government has not set out, as part of the 10 Year Health Plan, how it will tackle this, the news that David Lock KC will provide expert advice on this issue ahead of a government review in the autumn is welcome. At a time when the NHS finances are in such a parlous state, and there is much to be done to transform patient care and services, sums like these are unsustainable. A comprehensive strategy, which balances fair compensation for patients and affordability for the NHS, is long overdue.
Of course, the high cost of clinical negligence claims also impacts on healthcare professionals not protected through a state-backed indemnity scheme, such as dentists and private practitioners, who bear the cost of protecting themselves against claims.
Finally, to AI and the aspiration to make it every doctor and nurse’s trusted assistant, saving time and supporting decision making. The healthcare sector is one of the biggest areas of AI investment globally and is at the heart of many nations’ public policies for more efficient and responsive healthcare systems. The UK government’s desire to “turbocharge” AI in healthcare has been clear from the outset, and it comes as no surprise that it forms a key pillar of the 10 Year Health Plan.
We are at a turning point with AI and it is an exciting time to be part of the medical profession. To really unlock the potential benefits of AI technologies to patients, however, more could be done to generate confidence in AI tools among the clinicians using them, so they are reassured that they are usable, useful, and safe – both for themselves and their patients.
If frontline clinicians see the technology as burdensome, unfit for purpose or are wary about how it will impact upon their decision-making, their patients and their licenses, they may be less likely to embrace and interact with it. This point was crystalized in a White Paper published earlier this year – a collaboration between the MPS Foundation, the Centre for Assuring Autonomy at the University of York and the Improvement Academy hosted at the Bradford Institute for Health Research.
What is clear is that we need a thoughtful approach to integrating AI into healthcare, ensuring the tools genuinely support the clinicians using them, while preserving the important human touch in patient care.
Dr. Rob Hendry is Medical Director and Chief Member Officer at Medical Protection Society.
