The workforce challenge: The NHS cannot transform without addressing its people problem 

The NHS 10-Year Plan rightly recognises the future of healthcare cannot be delivered without a fit for purpose workforce. 

In Chapter 7, the focus turns to the people who power the system. It offers a vision for a sustainable, flexible, purpose driven workforce that is not only large enough, but equipped to deliver more preventative, personalised, digitally enabled and community based care. 

It’s an ambitious vision and one that resonates strongly with every NHS leader, GP, nurse and allied health professional I work with. But as always, the devil is in the delivery. 

While the plan lays out the direction, it skirts over some of the most pressing concerns voiced by those on the ground. It doesn’t answer the core question many are asking, how can the system close the chasm between strategic aspiration and operational capacity without pumping in more funding or time? 

For pharmaceutical, medtech and device companies, this chapter presents a powerful opportunity to deliver products and support the people who deliver care. That means aligning to workforce pressures, helping solve system pain points and embedding support at the frontline. 

Five urgent workforce pressures the NHS must overcome 

The chapter begins by outlining the core challenges facing the NHS workforce today: 

• Too few people, in the wrong places, doing the wrong jobs. 

• A persistent shortage of staff in almost every profession and geography. 

• An ageing workforce and a shortfall in new entrants, especially in General Practice and community care. 

• Skills and role mismatch, with high degrees of overqualification, underutilisation and burnout. 

• Growing pressure on recruitment, training and retention. 

While the NHS Long Term Workforce Plan (published separately) provides a 15-year view, this chapter restates its aims through the lens of delivering the wider transformation agenda. (I should add that the 10-Year Plan also promises an updated workforce plan later in 2025).  

That includes: 

• Expanding the primary and community workforce. 

• Recruiting and training thousands more allied health professionals, pharmacists and physician assistants. 

• Creating new flexible roles that can adapt across settings. 

• Embracing technology and AI to reduce administrative burden. 

• Developing local talent pipelines and integrated workforce planning. 

But there’s a catch. Despite repeated use of the phrase “new ways of working,” the workforce is exhausted, many feel undervalued, and some tell me the pace of innovation is outstripping their ability to safely deliver care. 

Why General Practice leaders are sounding the alarm 

I work closely with GPs, federation and PCN leaders across the country. Their concerns are growing, not receding. 

There is real fear that the 10-Year Plan continues to ask more of General Practice without giving more back. For many, “new roles” have meant additional complexity. Supervision responsibilities are increasing. Training pipelines are stretched. Recruitment in coastal, rural and deprived areas remains a crisis. 

There is deep scepticism about phrases like “optimise skill mix” or “unlock productivity” when GPs are already running double the number of consultations compared to a decade ago. 

What they need is: 

• Protected time for supervision, mentoring and peer development. 

• Investment in digital infrastructure and data support. 

• Fewer short term pilots and more sustained funding. 

• More support with administrative burden and diagnostic interpretation. 

This is where industry can step in, not as an outsider but as an enabler. 

If your product adds friction, it won’t fly 

Chapter 7 offers a moment of clarity for pharma, medtech and device companies. If your offer doesn’t make life easier for NHS staff, if it adds training time, if it increases steps, if it requires yet another login, it will struggle to scale. 

In my new book Embedded, I say: “Your product isn’t just competing for attention, it’s competing for headspace in a system already at cognitive overload.” 

To succeed, companies must move from selling features to solving workforce problems. That means designing solutions that: 

• Save time, reduce steps or automate routine tasks. 

• Require minimal onboarding and integrate with existing platforms. 

• Empower non-medical roles, e.g. health coaches, care co-ordinator, social prescriber etc, to deliver parts of the pathway. 

• Come with pre-trained implementation support and clinical protocols. 

• Reduce referrals, simplify workflows and support shared decision making. 

If your technology or treatment increases workforce efficiency and improves care quality, then you’re not just a supplier, you’re part of the workforce solution. 

Design for the whole team – not just consultants 

The chapter calls for a radical rethink of NHS career pathways. It supports more flexible roles, broader scopes of practice and multi-professional teams working across organisational boundaries. 

We’ve already seen this in action with the rise of first contact physiotherapists, General Practice Pharmacists, health and wellbeing coaches, and care co-ordinators.  

But their success varies by region. Where implementation is rushed or unsupported, outcomes stall. Where it’s embedded with training, trust and pathway clarity, the model works. 

For industry, the implication is clear. Solutions must be usable across disciplines and they must be suitable for AHPs as well as doctors. They must also be compatible with remote, in-person and hybrid care models and be capable of being delivered by the wider team, not just senior clinicians. 

Many companies have built their model around a specialist or consultant level prescriber. In future, uptake will depend on non-medical staff being able to deliver, interpret or supervise your intervention. 

This is an opportunity for companies to co-develop training, design skill sharing frameworks and work alongside NHS workforce leads to unlock capacity. 

Understand local workforce gaps if you want to scale 

The plan acknowledges the stark variation in workforce distribution. Some parts of the country simply do not have access to key professionals. This affects everything from early diagnosis and long-term condition management to specialist follow-up and continuity. 

ICSs are being asked to take a lead role in tackling this. That includes building “grow your own” models of local recruitment and retention, targeted investment in deprived and underserved areas and new workforce models designed for place-based care. 

For companies looking to scale their offer, this shift matters. It means the same national product might need: 

• Different delivery models in different ICSs. 

• Variable levels of training and support. 

• Tailored messaging and engagement based on local workforce capacity. 

If you want to win the market, you need to understand the workforce pain points at Place level and build your value proposition around solving them. 

Digital tools must reduce burden, not add to it 

One of the most promising commitments in this chapter is to use technology to remove tasks from clinicians’ plates. Too often, “digital transformation” is interpreted as more apps, more portals and more complexity. But the plan is more pragmatic. 

It wants to: 

• Use automation to reduce administrative tasks. 

• Support triage, workflow routing and information gathering. 

• Improve rostering, capacity tracking and workforce deployment. 

• Enable professionals to work across settings with minimal friction. 

Many of the GPs I support are crying out for integration, not innovation. They don’t want a new tool, they want one login. One place to record. One place to access results. And ideally, systems that talk to each other. 

If your digital solution requires multiple logins, new workflows or long training times, it will struggle. But if you can embed your service into the core digital fabric of the NHS and offer time savings, you become part of the workforce multiplier effect. 

From product features to frontline impact – A new test for value 

A future fit workforce is one that is multidisciplinary, place based and digitally enabled. It will be supported to deliver preventative, proactive and person centred care as well as equipped to manage risk and complexity, not just follow guidelines. It also needs to be respected, retained and given the tools to grow 

For pharma, medtech and diagnostics companies, the question is no longer: “What does my product do?”. Now, it’s; “What does my product enable this team to do better, faster, or more safely?” 

You’re not just part of the treatment landscape. You’re part of the workforce landscape. And if you design for that and show how you reduce burden while improving care, you’ll earn your place in the new NHS. 

At www.scottmckenzieconsultancy.com, we work directly inside the NHS, supporting provider organisations, commissioners and system leaders to implement real change. We then help pharma, medtech and device companies interpret what’s happening, so they can engage the right stakeholders, align with NHS priorities and get their innovations embedded into care pathways. 

With 10 years in pharma and more than 20 years working within the NHS, Scott brings a unique dual perspective, now captured in his upcoming book, launching September 2025, Embedded: How Pharma, MedTech and Device Companies Can Get Their Products into NHS Pathways and Stay There, which distils everything he’s learned into a practical playbook. Whether you’re launching a new product or trying to unlock stalled adoption, Embedded shows you how to reframe your offer, align with NHS priorities and make change stick.