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Health Secretary sets out plans for NHS workforce

Scheme pledges a review on pension flexibility

Jo Carlowe

Monday, 03 June 2019

The secretary of state for health and social care has today launched an Interim NHS People Plan which sets out proposals for the NHS workforce.

Included in the plan is a commitment to make general practice a “better place to work” by providing “more opportunities for mentoring and coaching, widening the availability of portfolio roles to offer GPs greater variety in their careers, and addressing burnout through the Practitioner Health Service”.


In addition, under “Actions in 2019/20” in the People Plan, is a proposal to roll out a voluntary two-year Primary Care Fellowship programme for newly qualified GPs and nurses entering general practice.

The plan also pledges to bring forward a consultation on a new pension flexibility for senior clinicians.

Responding to today’s publication, the British Medical Association (BMA) chair of council, Dr Chaand Nagpaul said: ”For many months, the BMA has been expressing concerns about the current pension taxation system, the unintended but serious consequences this is having on patient care and the wider NHS and so we welcome the fact that the DHSC [Department of Health and Social Care] and NHE England have today acknowledged the problem.

“We welcome that in his announcement the secretary of state has stated that in addition to the 50:50 proposal in the interim Peoples Plan, he is willing to discuss with the BMA other models for pension flexibility in order [to] mitigate the current disincentives for doctors to provide NHS services.

“The BMA has already outlined a number of temporary mitigations which, if swiftly applied, would stop experienced doctors leaving the NHS or reducing the hours of patient care they provide and we are giving a cautious welcome to the fact this is a step in the right direction for reform. We have modelled the proposed 50:50 scheme and it is clear that by itself this proposal will not remove the disincentive for doctors to reduce their working hours. It needs to be part of wider reform.”

He added: “Given the complexities of the NHS pension scheme and the fact that individual circumstances vary, it is essential that any flexibility offers far more than simply paying half of the employee’s contribution in order for half the accrual of pension. In addition, there needs to be the ability to recycle the employer’s pension contribution on the percentage of pay that is no longer pensionable. This is commonplace in other sectors with the chancellor describing such payments as ‘regular’.

“In addition, given the unintended consequences that have arisen as a result of separate changes to the NHS pension scheme and the introduction of the tapered annual allowance, it is essential that these options are no more than a short-term mitigation whilst the much needed reform of the pensions taxation system is undertaken”.

Niall Dickson, chief executive of the NHS Confederation, welcomed the Interim NHS People Plan, but called for it to be underpinned by investment.

“This is welcome but an effective workforce strategy will need investment. This will need to be delivered in the next spending review,” he said.

He added: “We are delighted the plan responds so positively to our call for a much greater role for local leaders in workforce development.

“We are also pleased that there is the promise of pension scheme reform for doctors. It may not be enough but it looks like a start and everyone in government needs to acknowledge and address the mounting problems NHS trusts are facing as senior doctors begin to restrict their clinical work.

“There is though a need for a much greater alignment with social care. We have to concede that any steps the NHS takes to strengthen its workforce position may unintentionally risk further weakening the social care workforce. We do not need two plans – we need one.

“The Confederation is leading a coalition of 15 health organisations calling for a sustainable social care system and we will continue to campaign for this to be addressed in the forthcoming spending review.”

Danny Mortimer, chief executive of NHS Employers, which is part of the NHS Confederation, said: “This is a further step forward following last year’s significant investment in pay for our teams, and brings greater focus to the issues that must be addressed in relation to our workforce.  However investment is required to incentivise more people to train to be nurses either through undergraduate or apprenticeship routes: employers look forward to this investment for the final plan later this year.

“Whilst medical colleagues will be disappointed that changes to the tax regime have not been possible, allowing greater flexibility in the pension scheme is a positive response to the concerns we have been raising on behalf of employers.  At the same time, we believe that the flexibility proposed should be available to support the retention of all the members of our team, and will continue to make that case.”

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