News / Workforce and capital key to mandate ambitions

The 2023 mandate to NHS England sets out three priorities: cutting NHS waiting lists and recovering performance, including through enhancing patient choice; supporting the workforce through training, retention and modernising the way staff work; and delivering recovery through the use of data and technology. 

The confederation welcomed the reduction of core targets as evidence that the government had listened to calls from the NHS. And it also supported the ambition to level-up the NHS’s digital maturity, which it said would reduce the burden on staff and provide opportunities to improve patient care.

But in an analysis of the mandate published this week, the confederation added that a few areas were ‘notable by their absence’. It described the lack of priorities on public health restoration as ‘a missed opportunity’ to shift the focus onto promoting good health and prevention. And the failure to specifically mention parity of esteem between mental health and physical health, and limited references to mental health in general, were also criticised.

However, the representative body said that elective recovery and the mandate ambitions would only be deliverable if the capacity was there to support it. This means having sufficient staff and investment in estates and infrastructure. It repeated calls for the immediate publication of the promised NHS long-term workforce plan and for the government to increase the medium-term capital budget to ‘fix the backlog and to meet the ever-increasing efficiency ask’.

The mandate called for cash-releasing efficiency savings of at least 2.2% in 2023/24, but financial plans submitted by integrated care boards require much higher levels of efficiency to deliver financial balance.

Matthew Taylor (pictured), chief executive of the NHS Confederation, said the core objectives were sensible and already being worked towards by leaders. ‘The priority to support the workforce is central to the mandate, and action on this comes in the shape of the implementation of the NHS long-term workforce plan, which is still to be published,’ he said. ‘Until it’s released, the NHS will have one arm tied behind its back while trying to deliver against this mandate. It is clear the time for publication is now.’

An earlier report from the NHS Confederation said that increasing the amount of capital investment per worker was the way to achieve a more productive health service. Despite this, capital spending on NHS infrastructure, estates and maintenance remained behind other developed countries and had reduced by 17% between 2010/11 and 2017/18.