‘Weak’ NHS plans spark fears over Boris Johnson’s 50,000 nurses pledge

Boris Johnson’s pledge to deliver 50,000 more nurses to the NHS has been thrown into doubt after a leaked email revealed civil servants have concerns over the PM’s “weak” plans.

The Department of Health and Social Care (DHSC) has demanded more “robust” details from NHS England on how exactly it will keep nurses working in the NHS after civil servants expressed “concerns” about the current plans.

The leaked email, obtained by Health Service Journal, exposes the difficulty the NHS has in meeting the government’s key manifesto pledge of 50,000 more nurses by 2024-25.

The pledge is primarily based on improving working conditions so that 18,500 nurses who already work in the NHS do not leave.

In the email, seen by The Independent, from the DHSC’s director of workforce, Gavin Larner, to the NHS England chief people officer, Prerana Issar, Mr Larner said in relation to plans to deliver on the 50,000 nurses: “Unlike the other delivery plans received, this does not include either trajectories or milestones.”

He added: “We will be providing detailed feedback to workstream leads on all the plans today, but we do have particular concerns about the retention one, so wanted to flag this early.”

He described parts of the plans as “weak”, adding: “We need to see clearly that this workstream is addressing all the related work that needs to happen to support improved retention and deliver your 13,000 commitment – pay, pensions, leadership, health and wellbeing etc.”

He said ministers would “expect to see a much clearer model of change in the delivery plan and how you see the publication of a staff offer translating into national work that changes employer behaviour in a way that in turn ensures all staff feel noticeable differences progressively in their working lives which in turn improves retention”.

He said the “cause and effect is largely implied and unclear at the moment and this needs to be much clearer for the delivery plan to give confidence to ministers that national action over the next three or four years will in a sustained way deliver the improvements to culture and retention which will retain at least the 12,500 more nurses promised in the interim plan”.

The email, sent on Tuesday, also revealed that a meeting with health secretary Matt Hancock had taken place earlier this month where it was clear the “main lever” to deliver extra nurses would be international recruitment but Mr Larner added: “We would also like you to set out what you could do beyond this if additional measures, including legislation, or resources, not included in the interim plan, were taken into account.”

This suggests the government may be prepared to go further to ensure the 50,000 nurses pledge is delivered.

An NHS England spokesperson said: “Trusts’ retention rates have improved over the past year partly as a result of improved staff satisfaction with pay and working conditions as reported in the annual staff survey, and partly as a result of NHS Improvement’s retention collaboratives.

“Further gains are possible, and the people plan which will follow the budget will set out the path to 50,000 extra nurses, based on evidence of what is – and is not – feasible and practical, including on retention.”