The NHS is proposing to slash recruitment to avoid ‘financial ruin’ and instead use AI to help doctors treat patients.
A leaked workforce plan, being finalised by health officials, says the NHS in England will have to rely on technology to get by with hundreds of thousands fewer staff than the previous Conservative government had planned.
The controversial amendments were drawn up while Labour leadership hopeful Wes Streeting was health secretary.
He quit last week with an attack on Sir Keir Starmer, saying he had lost confidence in the prime minister and warned ‘where we need vision, we have a vacuum’.
James Murray, Mr Streeting’s successor and previously chancellor Rachel Reeves’ deputy at the Treasury, will now have to decide whether to press ahead with the proposals, which are due to be published within weeks.
A draft of the plan seen by the FT says using technology and treating more patients in local clinics or at home rather than in hospital will mean the NHS ‘does not need anything like the growth rate [in staff numbers]’ set out in its 2023 workforce plan.
It warns the existing recruitment plan would lead to ‘a vast increase in the NHS pay bill as a proportion of GDP’ and adds: ‘This is a path to financial ruin and would bankrupt both the health service and the country.’
In 2023, NHS bosses set out a ten-year staffing plan that it said would put the workforce on a ‘sustainable footing’ after years of chronic shortages.
The controversial amendments were drawn up while Labour leadership hopeful Wes Streeting was health secretary.
The plan would have seen staffing levels grow from 1.4million to 2.3million by the mid-2030s, with annual increases of 2.6 to 2.9 per cent.
However, the draft drawn up by the current government promises a ‘fundamentally different approach’, arguing that a 50 per cent increase in doctors in the NHS over the past decade ‘has not led to better access, experience or outcomes for citizens’ and instead has seen productivity fall.
The new measures would cut annual staffing increases to 1.1 to 2 per cent, suggesting that up to 380,000 fewer people will be working in the NHS in the mid-2030s than previously forecast.
To manage this, the draft envisages far wider use of AI, including ‘instances where technology can completely substitute for a role’.
AI capable of making autonomous decisions should be used in treatment, ‘for example, by using patient data to frame a consultation, highlight risk level [and] identify key patient information’, it says.
It proposes that staff who deliver sustained productivity improvements through technology should be given ‘a share of the benefit’ through bonuses or extra time off, the FT reports.
Alan Lofthouse, deputy head of health at the Unison union, warned that ‘cutting skilled, trained health staff for unproven tech would be reckless’.
The new document says the NHS is ‘likely to have enough doctors to meet forecast demand by 2034/35’ and it sets out plans to stop them leaving, including allowing staff to exchange some of their pension contributions for higher pay.
The new measures would cut annual staffing increases to 1.1 to 2 per cent, suggesting that up to 380,000 fewer people will be working in the NHS in the mid-2030s than previously forecast.
However, it notes that up to 49,000 more GPs might be needed by 2035 to deliver more care closer to home, which is 23 per cent more than in the 2023 plan.
This would be at the expense of those working in hospitals.
The proposals also envisage an increase of about 50,000 nurses over the next decade, down from 170,000 to 190,000 in 2023.
The Institute for Fiscal Studies estimated that the previous plan would see the NHS employing 9 per cent of all workers in England by 2036/37, up from 6 per cent, adding about £50billion in costs.
Paul Johnson, former head of the think-tank, said the 2023 plan ‘would have meant a big increase in spending’ but he cautioned that the new one is unlikely to allow a reduction in spending, suggesting NHS budgets would continue to rise in line with previous trends.
Mr Johnson criticised the ‘chopping and changing’ of strategies and added that hopes of transforming the NHS through AI had to be met with ‘a degree of scepticism about the capacity of an organisation that struggles to use 2005 technology, let alone anything more recent’.
The Department of Health said: ‘We don’t comment on leaks.’