A leaked internal document from NHS England warns that the health service could face a shortage of 571,000 full-time staff by 2036 if current trends continue. The 107-page workforce plan, seen by the Guardian, states that the NHS is already operating with 154,000 fewer staff than needed, far exceeding the official figure of 124,000.
The blueprint, which is under review by ministers, proposes radical action to address chronic understaffing. It warns that without intervention, the NHS will have 28,000 fewer GPs, 44,000 fewer community nurses, and a significant shortfall of paramedics within 15 years. The growing and ageing population will increase demand for care, particularly in rural areas already struggling to recruit staff.
NHS England urges the government to reduce reliance on overseas recruitment and expensive temporary staff. The plan calls for doubling medical school places from 7,500 to 15,000, increasing GP trainee numbers from 4,000 to 6,000, and boosting annual nurse training from 29,865 to 52,722—a 77% rise. It also recommends a 40% increase in dentists and a 20% rise in physiotherapists and allied health professionals.
However, the Treasury, led by Chancellor Jeremy Hunt, is reportedly resisting the plan due to its multi-billion-pound cost. Hunt is said to prefer tax cuts or increased military spending over training more health staff. Health Secretary Steve Barclay supports the plan, arguing it is a realistic assessment of the scale needed to tackle shortages that compromise patient safety and waiting time targets.
A senior NHS leader described a standoff between Hunt and Barclay, with the Treasury seeking less precise and less expensive projections. The plan is expected to be published soon, once the disagreement is resolved.
