Facing the Facts, Shaping the Future

13 December 2017

The establishment of Health Education England (HEE) in 2012 meant that there was a national body responsible for workforce planning.

On 13 December 2017, HEE launched a consultation with stakeholders and the wider public on Facing the Facts, Shaping the Future – a draft health and care workforce strategy for England to 2027. HEE produced the draft with NHS England (NHSE), NHS Improvement (NHSI), Public Health England (PHE) and the Department of Health. The consultation closed on 23 March 2018, with the draft stating that responses would feed into a finalised strategy to be published in July 2018.

The draft described:

  • the current state of the health care workforce
  • progress over the previous 5 years and ongoing workforce actions
  • an approach to preparing the NHS and social care workforce to meet changing expectations and future challenges, through to 2027.

While the number of NHS professionals employed had increased by 7% since 2012, growing demand and changing needs meant that vacancy rates had also increased, with 45,000 clinical vacancies in the NHS.

In the draft strategy, HEE proposed six main principles for workforce development:

  • Securing self-supply of staff
  • Investing in education and training
  • Providing career development to support retention
  • Ensuring equal opportunities for people from all backgrounds
  • Supporting flexible working
  • Aligning service, financial and workforce planning.

The draft strategy also announced an England-wide technology review across England, led by Dr Eric Topol, cardiologist and digital medicine researcher, assess how to prepare the health care workforce for a ‘digital future’. The Topol Review was published in February 2019.

Public health and adult social care

While the draft focused on the NHS workforce, it also outlined the need to develop the public health workforce in line with an increasing focus on a preventative approach to health care services, for example in the Five year forward view for the NHS in England.

While stating that HEE did not have ‘formal responsibility’ for adult social care, the draft strategy included social care workforce planning in a short chapter and its accompanying consultation questions, given the policy goal to improve health and social care integration.


Given the growing pressures on the health care workforce, plans for a strategy were welcomed. However, responses to the consultation from the British Medical Association and the Nursing and Midwifery Council – and a roundtable discussion of the draft strategy between key stakeholders – raised some of the difficulties involved. These included ensuring good quality data was available to calculate future workforce projections, and developing a national-level strategy which could also respond to challenges at regional and local levels, given the significant variation in workforce supply and demand.

Later developments

Ultimately, HEE did not publish a finalised strategy. The organisation announced in October 2018 that it would align more closely with NHSE and NHSI and, in January 2019, the NHS Long Term Plan stated that NHSI now had lead responsibility for the NHS workforce.

In this context, plans for a HEE-led workforce strategy were superseded by those for an NHS People Plan, with an interim plan published in June 2019.


Health Education England.
Facing the Facts, Shaping the Future – A draft health and care workforce strategy for England to 2027.
Health Education England; 2017.

National Audit Office.
The NHS nursing workforce.
National Audit Office; 2020.

The King’s Fund.
Developing a strategy for the health and care workforce in England: Summary of a roundtable discussion.
The King’s Fund; 2018.

British Medical Association.
BMA consultation response: A draft health care workforce strategy.
British Medical Association; 2018.

Nursing and Midwifery Council.
NMC response to Health Education England consultation ‘Facing the Facts, Shaping the Future’.
Nursing and Midwifery Council; 2018.

Health Education England and NHS Improvement.
Public Statement from Health Education England and NHS Improvement [webpage].
Health Education England; 2018.