This month, the RCN responded to the Department of Health and Social Care’s (DHSC) consultation for its new 10 Year Workforce Plan which will be published in Spring 2026. The Workforce Plan is intended to accompany the 10 Year Health Plan, published in June 2025, which set out the government’s plan to reform the NHS via “three shifts”: from acute to community, from sickness to prevention, and from analogue to digital.

We are clear that without urgent action to address the nursing workforce crisis, the ambitions of the 10 Year Health Plan risk being unachievable, compromising patient safety and workforce sustainability. The new Workforce Plan must truly value the contribution of the nursing workforce. It must be fully funded and include detailed modelling and policy mechanisms to avoid the mistakes of previous workforce plans, such as the 2023 NHS Long Term Workforce Plan.

Section 1: the 3 shifts

Regarding the Government’s “three shifts”, we highlight concerns that in the effort to find efficiencies and increase productivity of the existing workforce, the government risks eroding the valuable role of registered nurses. Instead, registered nurses must be central to the Government’s transformation of the NHS. 

Our response highlights the serious challenges facing the community nursing workforce, including staff shortages and unmanageably high caseloads, and calls for urgent investment in the district and community nursing workforce to achieve the shift from hospital to community.

We also outline the key role of specialist public health nursing staff in preventative healthcare and urge the government to prioritise building and strengthening capacity in the health visiting and school nursing workforce. 

The government has emphasised a focus on digital transformation to make the NHS more efficient and improve patient experiences. The RCN is supportive of improving the quality and accessibility of digital tools. However, the priority should be ensuring all nursing staff have access to appropriate IT to deliver safe and effective care, with adequate training and support to use them. 

Where AI tools are introduced, these must support, not replace, nursing roles. Nursing leadership must be embedded in the design and governance of any digital or AI health interventions, to ensure that they work safely and effectively for nursing staff.

Section 2: modelling assumptions

The DHSC also sought views on considerations for workforce modelling and planning. The RCN recognises that good workforce modelling must reflect actual demand and population needs, rather than being determined by available funding. In line with the findings of the 2013 Francis Inquiry, we call for modelling to include a focus on patient safety, including safe staffing levels that are mandated and monitored.

We also call for sustainable workforce planning to prioritise nursing workforce retention, this must include work/life balance, access to professional development, and feeling valued for their work.  

Career structures should reflect the true responsibilities of nurses. We recommend that registered nurses should automatically progress to Band 6 following a period of preceptorship. The government consider a loan forgiveness model, to incentivise nursing staff to keep working in the NHS. 

We recognise that the internationally educated nursing workforce will continue to play an important role in the NHS workforce and immigration policies must recognise this and support the retention of internationally educated nurses. We are also clear that international recruitment must be ethical and sustainable. 

Section 3: productivity gains from wider 10 Year Health Plan implementation 

Regarding the questions about productivity gains, we are clear that investment in nursing has measurable impacts on patient outcomes and system efficiency and should therefore be a priority in efforts to increase productivity. 

We note that the working conditions that nursing staff currently experience can be a barrier to productivity. If nurses are stressed because of staff shortages and high caseloads, they are more likely to miss work due to illness and turnover rates are likely to be high. Investment in nursing will support safe and effective care, including reductions in missed care, mortality, and improving patient flow. 

Section 4: culture and values 

The consultation also asked for views on how the culture and values of the NHS as an employer can be improved. Our response highlights a range of issues facing nursing staff, including burnout, discrimination, violence, and moral injury from high caseloads and persistent staffing shortages and makes the case for action to address these. 

Workplaces must have strong, compassionate nursing leadership, and nurses must feel empowered to escalate issues. This should be supported by legal protections for nurses raising safety concerns.

Nurses must have access to appropriate wellbeing support at work, and we recommend embedding the knowledge and skills of the Professional Nurse Advocate and mandating restorative supervision programmes across all settings to support reflective practice, professional supervision, and workforce wellbeing.