Estimating the cost of growing the NHS cancer workforce in England by 2029

What is the issue?

Cancer is one of the leading causes of death in England, with the number of cases expected to continue increasing each year due to population growth and longer lifespans. Ensuring the effective diagnosis, treatment and support of people living with cancer requires a range of skilled NHS staff conducting specialist tasks.

Despite attempts to increase the cancer workforce, key cancer-related professions have remained under pressure with vacant posts and staff shortages. Ensuring that there are sufficient numbers of skilled staff in place, now and in the future, is therefore a vital part of improving outcomes for cancer patients.

How did we help?

RAND Europe and the University of Cambridge were commissioned by Cancer Research UK to help determine how much Health Education England (HEE) would need to increase its budget in order to meet its ambition of growing the NHS cancer workforce by 45 per cent by 2029.

The study team used workforce and cost data to build a demographic stock-flow model to provide important information about which workforces will require the most significant interventions by HEE if they are to grow by 45 per cent, as well as the estimated costs.

The findings of this study may help to inform the next government spending review, by outlining the budget settlement required to promote workforce growth.

What did we find?

• The study identified several different ways of increasing staff numbers joining a profession: by increasing training places, international recruitment and encouraging higher retention levels.
• Aside from gastroenterology, all professions would need additional government investment to meet the 45 per cent growth ambition.
• The total extra cost to HEE is estimated to be between £142 million and £260 million over ten years.
• The histopathology workforce is forecast to decline by 2 per cent by 2029, without any interventions. To meet the 45 per cent growth ambition, the profession would require 580 more staff at a potential maximum cost to HEE of £118 million.
• The feasibility of the modelled cost scenarios in this study will likely be affected by external circumstances such as the COVID-19 pandemic and the UK’s exit from the EU. Equally, scenarios that rely heavily on increasing the number of professionals trained may be limited by the number of work placements available.

What do we recommend?

1. NHS England and Improvement should ensure that their next People Plan adequately reflects the NHS’s ambitions for cancer care in England by clearly articulating details of how many staff will be needed to deliver quality services to a growing number of patients in the long term.
2. NHS England and Improvement, working with HEE, should review how it can influence its pipeline of staff to the professions where they are most needed, with a particular focus on histopathology.
3. The UK Government should provide long-term funding to HEE, aligned to the NHS Long Term Plan, to secure a sufficient pipeline of future NHS cancer staff.
4. NHS England and Improvement, along with HEE, should assess the feasibility of the different scenarios for increasing inflows.
5. Building on the NHS People Plan 2020/21, NHS England and Improvement, in collaboration with HEE, should ensure that consideration of likely future demand and planned future modelling of the workforce is translated into clear ambitions for the growth of different cancer professions.
6. NHS England and Improvement, the National Institute for Health Research and other funders should commission work to fill the research gaps identified in this study, to inform the NHS’s approach going forwards with a fuller understanding of the needs of the cancer workforce and the constraints to its growth.