Last month, the long-awaited NHS Long Term Workforce Plan for England was published. In this blog we discuss what the plan says and what it could mean for people affected by breast cancer.
Overview
On the 30 June, NHS England (NHSE) published the long-awaited Long Term Workforce Plan for England, something that we have been calling for many years alongside other organisations.
The plan lays out commitments covering recruitment and medical training, staff retention, innovation, and improvement, and continuing professional development.
So far, the government has committed £2.4 billion extra spending for the next 5 years, on both training and recruitment. Although the funding required to cover everything in the plan remains unclear and further budget will be required in the future to ensure the plan is fully implemented. NHSE has also committed to refreshing the plan every 2 years, or in line with fiscal events where relevant.
Impact of the plan on breast cancer services
We know that a fully staffed, and funded cancer workforce is essential for patients to be able to access timely diagnosis and potentially lifesaving and life extending treatments. But we know that the breast cancer workforce is facing significant shortages across vital areas like oncology and radiology.
That’s why this long overdue plan is now a major step forward in helping to address the shortages across the NHS workforce. But we need to make sure it delivers for breast cancer minimising workforce shortages and ensuring that wherever you live in England you can access timely and high-quality care.
We know workforce shortages can vary across the country, and it was positive to see the plan commit to increase flexibility for staff to move between trusts. The digital staff passport is one way to achieve this, as outlined in our 'Blueprint to transform breast screening by 2028', and it was positive to see NHS England (NHSE) commit to rolling these out apace.
We’re also pleased to see a commitment to offering more opportunities for advanced practice. The breast screening programme was an early adopter of looking at new skill mixes and career structures. Advanced practice can provide staff with more options to progress their careers and increase capacity where there are shortages. The workforce plan includes breast cancer as an example where there is an area of demand for these roles. We now look forward to understanding how NHS England will meet the ambitions set out in the plan.
Plans to plug the workforce and offer more training places are promising, however the plan does not provide targeted analysis of the cancer workforce shortages and detailed requirements on the staff needed to meet the needs of cancer patients now and in the future. We urgently need to understand what this will mean for medical specialties, including oncology and radiology which are vital to the early diagnosis and treatment of breast cancer. Ongoing investment will also be needed to make this plan a reality.
We also know that clinical nurse specialists (CNS) play a crucial role in coordinating care and providing information and support to help people with their diagnosis and treatment. For years we’ve campaigned to ensure everyone with secondary breast cancer has access to a CNS. In our 2019 survey of secondary breast cancer patients, only 30% were able to see their CNS regularly.
We’re pleased to see the plan's aim to ensure all cancer patients, including those with secondary cancers, have access to a CNS or other support worker. It sets out that training opportunities will be established and career paths developed.
But we must remember this commitment was first made over 4 years ago in the NHS Long-Term Plan. Secondary breast cancer patients don’t have time to wait. We need to understand what action will now be taken and when to ensure everyone is supported by a CNS.
Read more about our response to the plan here.
What happens now?
The implementation and longer-term funding of the commitments held within the plan will be key to ensuring the plans success. It’s important that NHSE continue to closely monitor and publish reviews of the plan’s success and further commitments made in future plans.
It’s important the views of patient organisations are included in the 2 year refreshes of the workforce plan. We’ll also be continuing to advocate for a fully funded, targeted cancer workforce plan including projections of staff needed to provide vital services for all breast cancer patients.
Many of actions in the plan will take time. But we know right now the breast cancer workforce is in crisis. Whilst there aren’t quick fixes, more must be done to find innovative solutions that free up capacity and support hardworking staff right now. Only then can we ensure breast cancer patients are getting the best treatment and care.
That’s why we’re continuing to work with the Pan-alliance Breast Cancer Group and UK Breast Cancer Group to help guarantee the timely delivery of drug treatment.
We’re also continuing our work to call for investment in the breast screening programme through our #NoTimeToWaste campaign.