On Friday 30 June, NHS England published their much-anticipated Long-Term Workforce Plan. The plan has been described as a “once-in-a-generation opportunity to put staffing on a sustainable footing and improve patient care“.
The NHS Long-Term Workforce Plan, covering the next 15 years, focuses on training and retaining staff and reforming the ways the NHS works to free up staff capacity. Government have backed this plan and committed an additional £2.4 billion over the next 5 five years.
The NHS has a current workforce gap of 112,000 and waiting lists of seven million. The COVID-19 pandemic played a part to escalate these numbers, but workforce capacity was already stretched before the pandemic. Staff have been working at capacity for so long to catch up on this backlog. Unfortunately, the impact has been felt by both patients and staff.
Care for people with a brain tumour has not improved in decades. While current NHS staff are working tirelessly, we know that these acute shortages are the lynchpin for poorer patient experience. There just isn’t enough staff to ensure every patient with a brain tumour receives a diagnosis quickly, has access to a Clinical Nurse Specialists (CNS) and Health Needs Assessment (HNA), and are given choice through accessing the latest clinical trials.
Last year we joined together with over 100 organisations to call for the government to address the endemic staff shortages and increase supply.
We welcome the Plan and the emphasis it places on:
- speciality training in cancer
- investing in CNS, retaining staff by improving culture and wellbeing
- embracing innovations in technology.
But there’s more to unpick if we’re to truly address the workforce crisis for people with brain tumours right now.
What does the NHS Long-Term Workforce Plan mean for the brain tumour community?
Having a fully staffed, effective and sustainable workforce is crucial for people with brain tumours. Across the whole pathway of care the NHS workforce are key to ensuring patients receive the best possible care. Every person with a suspected brain tumour should be diagnosed as fast as possible. Once diagnosed, they should have access to a HNA and care plan (NHS Long Term Plan). They should also have a named healthcare professional to help put that personalised plan in place (NICE Quality Standard) and support to access potentially life-prolonging clinical trials.
However, we know that this is not the case for all people with brain tumours despite NHS staff working around the clock to meet the increasing demand.
Our Improving Brain Tumour Care surveys found that just 40% of respondents said they were offered a HNA. It also found that nearly one in six were not given access to a CNS or key worker.
The Plan set out how it aims to double the number of medical school training places, increase GP training places, particularly in specialist areas, and invest in the adult nursing training. We welcome this predicted expansion of staff capacity, particularly the commitment to invest in training opportunities for nurses who wish to become a CNS in oncology. The Plan also highlights where training opportunities will be focused, including areas with the greatest shortages, such as cancer and diagnostic services. While there are many contributing factors to the unmet need in brain tumours, the impact from the workforce crisis is clear and this proposed increase in capacity could make a huge difference in people’s care.
It is also promising to hear that there are plans in place for increased capacity for allied health professionals, including radiographers, and research nurses. However, greater attention is also needed for all aspects of patient pathways, including rehabilitation and in palliative care.
We do need to make sure, however, that the proposed increase in apprenticeship and shortening the curriculum for medical students still guarantees high-quality training is provided. Medical oncologists already do not receive mandatory training in neuro-oncology and the proposed shortening of training could be concerning if we want to ensure that every health and care professional is equipped with the knowledge of the signs and symptoms of brain tumours to get people a faster diagnosis.
Reforming the ways of working in the NHS is a key part of delivering the Workforce Plan. It has outlined how they will work going forward so staff can spend more time with patients. This includes working closely as part of multidisciplinary teams and harnessing digital and technological innovations. Working in a more integrated and innovated way is very much welcome. This is something that the brain tumour community have previously faced challenges with. There is much innovation within diagnosis and potential treatment, including liquid biopsy and DCVax-L. Unfortunately, this has previously not been widely embraced in the field of brain tumours. We look forward to working with the NHS to roll out some of these innovations that will specifically support patients with brain tumours.
If you’d like to learn more, the NHS Long-Term Workforce Plan is available here.
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