NHS workforce planning right now is like watching someone juggle chainsaws while unicycling across a tightrope. Oh, and they’ve just been told to go faster! Impressive that we haven’t seriously hurt ourselves yet? Sure. Sustainable? About as much as my ‘this year I will get fit’ new years resolution, which lasts approximately 0 days.

Here’s the reality: We’re burning through £10bn+ yearly on temporary staff, paying up to £5,200 per shift for emergency cover (enough to fund a band 5 nurse for almost 2 months), and still acting surprised when winter happens. Every. Single. Year. Spoiler alert: winter will come again. Probably right after autumn, if past performance is anything to go by.

This isn’t some small administrative hiccup. We’re talking about efficiently deploying 1.7 million human beings to provide the best possible care to around 70 million people. No pressure, right? That unicycle with chainsaws doesn’t seem too daunting now, does it?

The most dangerous part? We’ve normalised this chaos. It’s become so routine that we barely blink when wards run at 60% staffing or when doctors pull double shifts. We’ve created a culture where heroic firefighting is more celebrated than preventing the fire in the first place. It’s like living in a house where the roof has been leaking so long, you’ve forgotten it’s not meant to rain indoors. In fact, we’re just buying better umbrellas each year instead of fixing the roof. Summer comes, we throw them out, and six months later, the great umbrella scramble begins again.

The Real Cost

Every vacancy isn’t just a number on a spreadsheet. It’s a ward struggling to provide safe care. Every agency shift isn’t just an expense – it’s money we could’ve spent on permanent staff, training, or actual patient care. Instead, we’re spending the equivalent of building 10 new hospitals annually just on temporary staffing.

Our tools? We’ve got fancy e-rostering systems that come with high price tags, but somehow we’re still scrambling to fill next week’s shifts. Ironically, the most used app for rostering is WhatsApp for swapping shifts, which costs nothing. And don’t get me started on annual job planning – that elaborate ceremonial dance where we pretend next year will be completely predictable with no thought about demand. With 20% compliance and plans outdated by day two, we’re basically planning for the hope that nothing changes.

So What Actually Might Work? Here’s where I put on my serious hat (yes, I can be somewhat serious):

• Reality-Based Planning: Stop pretending we can predict exact staffing needs years in advance. Start with demand and build flexible systems that can adapt. Yes, this means dynamic and ever-changing plans. I run a company and I wouldn’t dream of asking my support team exactly what queries they plan to answer over the next 12 months. Why? Things change, always.

• Long-Term Political Backbone: We need workforce planning protected from political whims. Each budget unveils a new “saviour strategy” – great for headlines, not so great for actually solving problems. They are so predictable, repetitious and generally futile.

The Light at the End of the Tunnel (Hopefully Not Another Train)

Here’s the hopeful bit – because contrary to how this might sound, I’m actually generally optimistic. Take the Countess of Chester, currently following a demand-led planning round focused on increasing productivity ethically. They’re gathering forensic-level management information that will inform important strategic workforce decisions. Will it solve all our problems? No. But it’s a bloody good start. If you look at the curve, they are way ahead of it.

I see a future where using the right tools aligned with the right approach will have a transformative impact. Planning and operational deployment need to be closer together, not on opposing banks of a river. Management information, trend analysis, and yes, AI, will be vital for meaningful strategic workforce decisions.

Let’s Talk Solutions

What’s happening in your patch? What’s the most creative (or desperate) workforce solution you’ve witnessed? Or better yet – what’s actually working? Share your stories below.

In the coming weeks, I’ll be diving deeper into each aspect of this crisis – from the political merry-go-round to practical solutions. Stay tuned. Or buy me a pint of lemonade, and I’ll tell all.