Workforce optimisation maturity

"Workforce planning has been woeful for a very, very long period of time,” Secretary of State for Health Jeremy Hunt admitted at the Conservative Party conference in Manchester in October 2017, adding, “we’ve got to do a lot better."


Over the coming years, the already beleaguered NHS workforce will have to respond to rising demand, and changing population demographics and healthcare needs. Already the subject of reforms, resource challenges, and unrelenting scrutiny, if the NHS workforce is to be ready for the future, resource pressures will need to be addressed so that the health service has the ability to deliver high quality patient care.





As of July 2017:

The NHS in England employs 1.2 million staff which is 21,706 more than in July 2016

There are


nurses and health visitors, which is 1,240 less than June 2017 and 933 less than July 2016

There are


doctors which is 1,461 more than June 2017 and 3,129 more than July 2016

As of June 2017, there were 165,896 bank staff in NHS trusts and clinical commissioning groups, which includes:




nurses and health visitors



classified as support to doctors, nurses and midwives

From 1 April to 30 June 2017:


NHS staff retired

National Audit Office figures show trusts spent £3.3 billion

on agency staff in 2014-15 up from £2.2 billion in 2009-10.

Since the introduction of agency price caps in October 2015 the NHS has saved
£1 billion

In 2014-15, 61% of temporary staffing requests by trusts were to cover unfilled substantive vacancies


Winter pressures are a thing of the past – pressure is now all year round.


Bed occupancy rates exceeding 90% are now an everyday fact.




There were 30,613 full-time vacancies advertised by NHS England in March 2017, up from 26,424 in 2016 and 26,406 in 2015.


It is estimated that one in three nurses will reach retirement age by 2026, meaning that the need for longer term workforce management is more urgent than at any other time in the NHS’s history.



Shifts in policy

In the UK, policy makers looking to address the recruitment and retention challenges facing the British healthcare system advocate the use of rostering software as part of the solution. Secretary of State for Health Jeremy Hunt has celebrated the progress rostering software has made on retention and resourcing:


“Look at what trusts in Plymouth, East and North Hertfordshire, Salisbury, and Leeds are achieving by following the

e-rostering model used by airlines.


“Look at the combined regional or city-wide nursing banks in Cheshire, Devon, or Northumbria that mean that for the first time in living memory trusts are spending more on bank staff than agencies."


“Last year the NHS reduced agency spend by £700m—that’s £700m more for frontline care—but that was only possible because so many trusts are starting to make a reality of flexible working.”


The widespread adoption of the technology, combined with national guidance, in the UK has made such platforms a key tool for better shaping patient care.


However last year, NHS Improvement advised healthcare providers across England to produce workforce rosters four to six weeks ahead of when the roster is due to be worked. The guidance stemmed from Lord Carter’s review into hospital productivity, which stated: “While most hospitals use e-rostering, we found that few trusts were using its full functionality and benefiting fully from what it can do.


“A firmer grip of e-rostering will reduce dependency on bank and agency staff and it will improve predictability and consistency of deployment for staff even where recruitment is still a challenge.”


Paul Scandrett, Allocate Software director of healthcare, says this development marks a sea change in how UK’s healthcare leadership view e-rostering.


“A decade ago, no one wanted to talk to me or the company about rostering. Now, the health secretary talks about it and Lord Carter’s review has led to the NHS issuing guidance on how to carry out rostering. This makes the UK a leader.”

Policy Timeline

February 2013

November 2013

March 2014

July 2014

October 2014

February 2015

October 2015

February 2016

March 2016

June 2016

November 2016

April 2017

November 2017

Robert Francis presents The Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry to Parliament  Read more.

NICE begin safe staffing review Read more.

The Northern Ireland Department of Health, Social Services and Public Safety published Delivering Care: Nurse Staffing in Northern Ireland to determine nurse staffing Read more.

NICE publishes Safe staffing for nursing in adult inpatient wards in acute hospitals Read more.

NHS England publishes NHS Five Year Forward View, calling for better use of technology to improve services Read more.

NICE publishes Safe staffing for midwifery settings Read more.

NHS England, Care Quality Commission, NICE, and NHSI announce that the one nurse to eight or more patients ratio is a guideline and not a requirement Read more.

Department of Health publishes Lord Carter's review, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations showing how the NHS can make large savings through efficiency Read more.

The Nurse Staffing Levels (Wales) Act 2016 becomes law in Wales Read more.

The Scottish government announces its intention to make the use of nursing and midwifery workforce planning tools a legal requirement for all NHS organisations Read more


NHS Improvement publishes Rostering: good practice, a guide to help trusts deliver the Carter Report recommendations by easily identifying areas of improvement within their current rostering practices Read more.

Jeremy Hunt, Secretary of State for Health, announces at NHS Providers conference that, by the end of 2017, all trusts must meet best practice on e-rostering, as outlined in NHSI’s, Rostering: good practice’ Read more.

The Scottish government opens a consultation on the Safe and Effective Staffing in Health and Social Care proposal to enshrine minimum NHS staffing levels in law Read more.

The Welsh government and NHS Wales publishes statutory guidance for the Nurse Staffing Levels (Wales) Act 2016 Read more.

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As of June 2017, there were bank staff in NHS trusts and clinical commissioning groups, which includes:

figures show trusts spent