The Royal College of Physicians (RCP) has welcomed a new report from the Health Foundation’s NHS Productivity Commission, which highlights the need for long-term workforce planning, improved retention and investment in training to support NHS productivity and patient care.
The Health Foundation launched the NHS Productivity Commission to identify evidence-based solutions to support productivity growth in the NHS in England. In a new report, Breaking the cycle, the Commission has recommended that the Department of Health and Social Care should develop and implement a workforce plan for the leadership, management and improvement capability needed to support productivity growth.
Professor Mumtaz Patel, RCP president, said:
‘The Health Foundation is right to recognise that NHS productivity depends on a sustainable and supported workforce. Long-term workforce planning, better retention and investment in training are essential if the NHS is to meet rising demand from an ageing population with increasingly complex health needs.
‘We know that workforce shortages are already affecting both staff wellbeing and patient care. Our 2025 next generation survey found that 72% of resident doctors said staffing shortages and rota gaps were negatively affecting their training and wellbeing, while only 65% expected to still be working in the NHS in five years' time. These findings underline why retention must be a central part of any workforce strategy.
‘We also welcome the recognition that productivity depends on developing workforce capability. Physicians need protected time for training, education, research and quality improvement if they are to lead service transformation and deliver better care for patients.’
The RCP strongly supports the shift towards long-term workforce planning, as set out in our response to the NHS England 10 Year Workforce Plan consultation. Sustained investment in workforce growth and support is essential to meet rising patient demand, improve staff wellbeing and ensure the NHS has the capacity to deliver high-quality care into the future. The 10 Year Workforce Plan must also be based on independently verified modelling of future patient need. With an ageing population, more people living with multiple long-term conditions, and increasing demand for specialist services, workforce planning must accurately reflect the scale and complexity of future healthcare needs.
The RCP welcomes the report’s emphasis on improving productivity through investment in the existing workforce, particularly by prioritising training, retention and career development. The report rightly identifies workforce turnover as a significant barrier to organisational performance and efficiency, reflecting concerns we regularly hear from our fellows and members. We have consistently called for a dedicated NHS retention strategy that fosters a positive, flexible and supportive working culture.
We also support the Commission’s focus on building workforce capability, which must include reform of postgraduate medical training. Our 2025 next generation survey found that only 26% of resident doctors felt ready for the next stage of their career, highlighting the need for greater investment in training, supervision and career development.
The report also recognises the importance of non-clinical skills in driving innovation and productivity. For physicians, this requires protected time for activities such as research, quality improvement, education and leadership. The most recent RCP census found that a lack of time in job plans is the single biggest barrier to research participation among consultant physicians. Ensuring doctors have the time and support to develop these skills will be essential to delivering a more productive and innovative NHS workforce.