A Territorial Army for the NHS

The policy proposal for the NHS Capacity challenge identified in Q1b above is to create an NHS Reserve or Territorial Army akin o the military’s TA.


To build a trained and experienced reserve team, able to to support the NHS in times of crisis or seasonal work overload.


The NHS would identify specific roles or functions which (a) are most likely to suffer from staff and skill shortages either seasonally or in times of crisis such as pandemic, epidemic, natural or transport disasters, terrorist attacks etc. ; and which (b) lend themselves to discrete or specialist training as described below .

The difference between this Reserve programme and a normal volunteer programme is that reservists will be selected and trained with a specific function or role in mind , which they can perform with a minimum of supervision as and when the need arises. The Covid Pandemic suggests a number of possible areas for Reservist training including : intensive care treatment, operation of ventilators and administering of vaccinations. Other examples might include basic nursing; first aid and trauma treatment, operation of specialist intensive care equipment , ambulance driving or simply general porter/auxiliary services.

A recruitment campaign would be aimed mainly at young people regardless of their level of education but a rigorous assessment process would identify which role was most suited to each candidate . Background and psychological checks would also be undertaken to ensure general ability and suitability of the candidate concerned.

Each successful candidate, a Reservist, would enter into a contract with the NHS through which he/she would commit to an initial and annual refresher training programme and to be available for a service call up for a minimum period each year on an -as needed basis. Employers would be encouraged, incentivised or even required to offer terms to new recruits which would allow Reservists to give the necessary commitment of time. Training would consist of a two part programme covering (a) general NHS standards and principles such as ethics, data protection, hygene etc and (b) the specialist skills needed to fulfil the requirements of relevant function. The specialist training would include some practical, on the job, experience which would be refreshed annually.

Each Reservist would be paid an annual sum in respect of his/her minimum annual commitment plus a per diem amount to reflect any additional time spent in NHS service. Other incentives could be considered such as tax breaks on Reservist payments, free rail /bus passes and an exemption from jury service.

Advantages. The Advantages of the NHS Reservist scheme would include:

– 1. Capacity Building : The creation of a flexible and auxiliary work force which could complement permanent NHS staff with the skills and knowledge that are most needed in times of seasonal stress or unexpected crisis;

2. Financial : Resources that are scalable will allow the NHS to avoid some full career training costs which are likely to increase as the supply of trained overseas staff becomes more scarce after Brexit. It could also reduce the amount paid to Medical/ Nursing supply agencies to cover temporary shortages; 3. Career Opportunities : The Plan could be a convenient entry point for young people who are not ready to commit, full time, to the NHS – but whose Reservist experience convinces them that they do indeed have the necessary vocation to care for others.

4. Utilisation of resources: The Plan is suited to the current employment climate of ‘gig economy’ workers and zero hour contracts and would provide an anchor of continuity for those who have no long term career prospects or commitment

5. Citizenship Enhancement: A Reservist Plan provides an opportunity for people to contribute to, and thereby earn a stake in society. It would help to ‘round off ’ those who pursue their main careers in professions such as law, finance or IT and would provide some real life experience and people skills for those who are otherwise cloistered in an office or ‘virtual’ environment .




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