Key points

  • This report provides the REAL Centre’s projections of future NHS workforce supply and demand in England, up to 2030/31.
  • At an overarching level, our supply and demand projections cover the NHS Hospital and Community Health Service (HCHS) and general practice workforce in England. Our in-depth analysis focuses on two staff groups: registered nurses (across all sectors but focusing on the HCHS), and general practice patient care staff (including GPs and general practice nurses). Together these groups account for nearly 3 in 10 of the 1.4 million full-time equivalent (FTE) NHS staff in England.
  • Our high-level analysis points to an overall workforce supply-demand gap of around 103,000 FTE across the NHS HCHS and general practice in 2021/22 (around 7% of estimated FTE workforce demand). This gap is projected to increase to around 179,000 FTE by 2024/25 before declining gradually to a still substantial 156,000 FTE in 2030/31 (around 9% of projected demand).
  • This report raises significant questions about general practice workforce supply. In all scenarios, we project a persistent shortfall of FTE GPs and general practice nurses. In the pessimistic case, the GP supply-demand gap grows to around 18,900 FTE by 2030/31 – nearly 1 in 2 GP posts (48%) based on projected demand.
  • While the government appears to be on track to meet its 50,000 nurses target by 2023/24, this would still leave the NHS short of around 38,000 FTE HCHS and general practice nurses relative to projected demand in 2023/24. In the longer term, in the current policy scenario the NHS is projected to have a persisting shortfall of around 36,700 FTE nurses in 2030/31.

Workforce shortages were the single biggest challenge facing the NHS well before COVID-19. But the pandemic has driven increased demand for health care, growing waiting lists and a substantial elective care backlog, while impacting negatively on staff wellbeing and absence. This makes workforce planning all the more urgent, particularly in light of ongoing cost-of-living pressures, and in terms of patient safety and satisfaction.

This report provides the REAL Centre’s projections of future NHS workforce supply – the number of staff likely to be in post – and demand, the number of staff likely to be required. It focuses on registered nurses across the NHS HCHS and general practice, GPs and other patient care staff in general practice. In our analysis, a gap between projected workforce supply and demand indicates that the NHS is unlikely to be able to deliver 2018/19 standards of health care using existing care models. Our analysis underscores five key workforce planning themes before drawing out the wider systemic implications for the NHS.

Overall, our report lays bare the scale of the challenge facing policymakers in addressing endemic NHS workforce shortages. Although there is no ‘silver bullet’ solution to England’s workforce shortages, this report adds to a growing body of evidence signalling the need for a comprehensive, fully funded and long-term workforce strategy.

Note: The first version of this report, published on 20 July 2022, contained an error affecting the GP projections. This has now been corrected, and an updated version was published on 25 July 2022.

Cite this publication

Shembavnekar N, Buchan J, Bazeer N, Kelly E, Beech J, Charlesworth A, McConkey R, Fisher R. NHS workforce projections 2022. The Health Foundation; 2022 (https://doi.org/10.37829/HF-2022-RC01).

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