NHS 10-year plan: Reforming the NHS workforce

The 10 Year Health Plan for England (the Plan) published on 3 July 2025 sets out an ambitious vision for the future NHS workforce. It recognises that the success of the “reinvention” of the NHS (summarised here) hinges on its people. The Plan’s goal is for the NHS to not only be the country’s biggest employer, but its best.

The Plan openly recognises the current challenges of unmotivated and burnt-out staff, bureaucracy and attrition. It proposes a strategy to build a more modern, motivated and sustainable workforce that will be capable of delivering the NHS of the future.

We'll have to wait until the 10 Year Workforce Plan is published later this year to get the full picture, but there are five areas of HR policy that stand out: agency staff, staff experience, training and development, recruitment, and the use of technology.

The end of agency staff

Perhaps one of the boldest aspects of the Plan is the pledge to eliminate agency staffing in the NHS by the end of this parliament (in other words, by 2029). There will be a transition from agency workers to staff banks, which, the Plan says, must become the primary route for temporary staffing in the future. The Government estimates this change could release £1 billion over the next 5 years.

There is no doubt that the cost of temporary staff is a challenge. Agency spending limits have been in place since November 2024 and these reforms have already decreased agency spend by nearly £1 billion over the past year (according to this Government press release). However, to eliminate agency staffing completely, even bigger steps will need to be taken to encourage workers back into bank and substantive roles.

Improving staff experience

There is a real focus on the need for the NHS to catch up with the private sector when it comes to the experience of NHS staff, and quickly. Private sector employers have been investing in wellbeing support and models for flexible working for years.

The latest NHS Staff Survey results paint a picture of a workforce that is demoralised and demotivated. Nationally, 30% of staff feel burnt out because of their work (although this number has been coming down).

The Plan hopes to improve the experience of NHS staff by introducing a new set of staff standards in April 2026. Employers will publish data on these standards every quarter. Poor performance on staff outcomes will act as an ‘early warning’ signal for CQC. The standards cover:

• Access to nutritious food and drink at work
• Reducing violence against staff, tackling racism and sexual harassment at work
• Standards of ‘healthy work’ and OH support
• Support for flexible working

The Plan hopes to incentivise and motivate NHS staff by changing the NHS appraisal system and providing incentives and rewards for high quality and productive care, including for senior managers.

Better training and development

The Plan promises better training and more scope for staff to develop their careers by:

• Completely reforming mandatory training (by April 2026)
• Introducing new ‘skills escalators’ to give staff a trajectory for clear career progression, with increasing autonomy
• Ensuring personalised career coaching and development plans
• Improving training and development for nurses, to tackle decreasing application and high attrition rate
• Increasing the number of nurse consultants (particularly in neighbourhood settings)
• Developing advanced practice models for nurses and other professionals
• Modernising postgraduate medical education (for which a review is underway)

As well as new freedoms, more support is also promised for NHS leaders, including a new Management and Leadership Framework in Autumn 2025.

Sustainable recruitment 

The Government hopes to embed a more sustainable recruitment strategy. The ambition is to reduce international recruitment to less than 10% by 2035. The NHS will look to local communities to recruit staff and prioritise UK medical graduates for foundation and speciality training.

There are specific plans to: 

• Create 2,000 more nursing apprenticeships over the next 3 years
• Create 1,000 new speciality training posts over the next 3 years
• Expand the number of medical school places, focusing on those from underprivileged backgrounds

These numbers look small, in the context of a vacancy rate of 6.7% (as at March 2025).  

There's also a plan to explore opportunities for UK-registered professionals working in other countries, to provide remote services to NHS patients.

Harnessing digital technology 

Almost every business in the world is thinking about how it can use AI to support it, and it is right that the NHS does that too. Workforce plans go hand in hand with wider plans to expand use of digital technology and automation. 

The Plan promises to incorporate training in the use of AI into the education and training curricula. The Plan asserts that “the NHS will have the most AI-enabled health workforce in the world”. 

HR services will also be digitalised, through a “digital first HR strategy”. An NHS staff app will allow staff to: 

• Access their records
• Manage flexible rostering
• Access digital HR services (including a virtual assistant)

The intention is for this to leave HR professionals more available to focus on complex issues. A new “state of the art” NHS payroll system is also going to be rolled out.

What to look out for next

The Government will publish a 10 Year Workforce Plan later this year, which will replace the Long-Term Workforce Plan published by the Conservative Government in 2023 (of which the 10 Year Health Plan is openly critical). We expect that to contain more detail as to how the commitments will be implemented in practice.

What is already clear is that the emphasis will no longer be on increasing headcount. The focus will be on efficiencies rather than growth. The Plan states that there will be fewer staff in 2035 than previously planned; but those staff will achieve more. The reason? They will have better treatment, better training, more exciting roles and “hope for the future”.

The key will be to ensure that staff are fully engaged in the implementation process. Only by doing that will the Government be able to bring about real and lasting change for a reinvented NHS.