RCoA response to the 10 Year Health Plan

The Royal College of Anaesthetists has published its initial response to the government’s 10 Year Health Plan, recognising it as an important statement of intent for the future of healthcare in England. 

We will review the plan in detail and listen to the views of our members and patient representatives. We are pleased to see commitments around support for the workforce and a focus on preventive healthcare. However, it is essential that the shortage of anaesthetists is addressed and that proven interventions to improve patient outcomes and efficiency are embedded if the plan’s ambitions are to be realised.   

Dr Claire Shannon, President of the Royal College of Anaesthetists said: 

“The 10 Year Health Plan sets out the government’s vision for the future direction of healthcare in England. We will take the time to review the proposals in full and to listen to the views of our members. As ever, achieving the plan’s aims will depend on the detail of its implementation.  

“Throughout the consultation process, we focused on two core priorities: tackling the crisis in specialty training, particularly the critical shortage of anaesthetists, and embedding high-quality perioperative care that improves patient outcomes and NHS efficiency.

“While we welcome investment in specialty training, much more will be needed. In 2024, there were 25,496 unique applicants for just 12,743 specialty training posts. With competition expected to intensify further this year, 1,000 additional posts will not be enough. We need a sustained and substantial expansion in training places – both to address current workforce gaps and to ensure the growing number of UK-trained medical school graduates can pursue NHS careers. 

“Allocation of these posts must prioritise anaesthetic training. It remains one of the most severely affected specialties, with shortages limiting patients’ access to timely surgical care and constraining innovation in perioperative care. These issues directly affect surgical efficiency and patient waiting lists. We look forward to more detail on how this will be addressed in the 10 Year Workforce Plan.

“The government’s indication that staffing targets set out in the 2023 Workforce Plan will not be met is concerning. The updated plan must provide clear assurance that the NHS will have the doctors it needs to deliver the improvements to care that patients have been promised.

“Retaining the advances in patient safety our specialty has championed over many years is vital. The delivery of safe anaesthesia cannot be broken down into a list of separate tasks – it requires a well-trained medical workforce with a deep, holistic understanding of each patient. The proposed transfer of the Health Services Safety Investigations Body (HSSIB) functions to the Care Quality Commission (CQC) must safeguard the independence and learning culture that has been central to its effectiveness.

“We welcome the commitment to improve the experience of resident doctors and the recognition of the invaluable contributions of SAS doctors, along with support for their career progression.

“Retention remains a serious challenge across the NHS. We have long advocated for measures to improve workforce wellbeing, so the introduction of new employment standards from April 2026 – covering access to appropriate refreshment facilities, workplace safety, tackling discrimination and harassment, occupational health, and flexible working – is a positive and necessary step. 

“Our members play a leading role in patient care before, during and after surgery. The renewed emphasis on preventive health measures, including action on obesity and tobacco, is welcome. There is strong evidence that perioperative approaches such as prehabilitation, shared decision-making and early discharge planning, improve patient outcomes and NHS efficiency. 

“The shift from hospital to community-based care offers an opportunity to embed these approaches more widely, provided services are adequately resourced and integrated with hospital care. It is disappointing that this was not made more explicit in the plan. We hope to see these interventions reflected in the development of Neighbourhood Health Centres, and we are keen to work with NHS England and the Department of Health and Social care to support roll out of perioperative care programmes across the country. 

“While we support the ambition to expand neighbourhood services, most operations and procedures will continue to take place in hospitals. It is essential to strike the right balance of investment across care settings. With continued plurality of provision, it’s important we ensure consistent standards for patients across the NHS and independent sectors and deliver value for money. 

“The commitment to a single patient record is a welcome step towards enabling better perioperative care. Likewise, the focus on technology and the potential for AI to enhance care and training is promising. However, there is a long way to go given current difficulties with ensuring effective operation of basic IT systems within the NHS. Any technology to support care must be co-produced with patients. 

“In the coming weeks and months, we will consider the forthcoming Leng Review, NHS England’s Medical Training Review and the 10 Year Workforce Plan to fully understand the government’s plans for the NHS. We also look forward to ongoing discussions with patient safety bodies. We are committed to working constructively with NHS England, the government and fellow professional bodies to support delivery of improvements for patients, members and NHS staff."