How to know who's heading up in the shadow cabinet reshuffle

Have they passed the Question Time test?

It is an open secret in Westminster that Ed Miliband will hold a shadow cabinet reshuffle at some point before the Labour conference, so who is line for promotion? One Labour MP told me that a good rule of thumb is to look at those who have recently appeared on Question Time (often for the first time), regarded as a useful test of their media abilities. 

Recent Labour panellists have included shadow Northern Ireland secretary Vernon Coaker (23 May), shadow immigration ministers Chris Bryant (16 May) and shadow climate change minister Luciana Berger (25 April), all of whom other sources have told me are likely to be promoted in the reshuffle. Stella Creasy (currently shadow minister for crime prevention), who has already appeared several times on the programme, is another expected to move up the ranks. 

MPs also suggest that Rachel Reeves, currently on maternity leave, is likely to shadow "a major spending department" when she returns, with Chris Leslie, who has acted as Ed Balls's deputy in her absence, possibly replacing her as shadow chief secretary to the Treasury. 

Incidentally, a senior Labour figure told me last week that Alistair Darling would almost certainly have to return to the frontline after "saving the Union" next year (Darling is chair of the Better Together campaign) but not as shadow chancellor (rightly so, in my view; Ed Balls's performance yesterday showed why he is such an asset for Labour). The source suggested he could take on the role of party chair, one of the posts currently held by Harriet Harman. Here's what Darling had to say when recently asked by Andrew Neil on The Sunday Politics if he would "come and help the battle to give the Labour Party economic credibility".

I am very confident that my colleagues, Ed Miliband, Ed Balls, are very aware of what they have to do and they will do it. Because we owe it to the people that support us and the people we’ve yet to win over to put forward an argument that is going to convince people. Heavens, you know, you rightly said this government is in one terrible mess at the moment as far as the economy is concerned. They’re way off track, none of their plans are stacking up, they’re losing credibility. We need to have a compelling alternative. There is one, and I will be helping my colleagues do that. But at the moment, for the next 18 months, you know where I am.

To translate, he's ruling nothing out. 

Luciana Berger, currently shadow climate change minister, is one of those in line for promotion.

George Eaton is political editor of the New Statesman.

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The NHS's sustainability is under threat if more isn't done to look after its staff

More work is needed to develop the health service's most precious resource.

As the NHS nears its 70th anniversary, the time is ripe for a workforce rescue plan. Staffing worries, even more than funding pressures, are the biggest cause of concern for NHS trust leaders. There are not enough trained health workers in the UK to meet today’s needs, let alone those of the future.

Demands on hospitals, mental health and community trusts, and ambulance services are growing. More patients need treatment. Increasingly, they require complex care, with specialist expertise. This is not just about numbers. We need a clinical workforce that is skilled and equipped to work in new ways to deal with the changing needs of the population it serves. 

That means improving the supply of people coming to work for the NHS, and doing more to develop and motivate them so they want to stay. These problems are not new but the scale of the challenge has reached a tipping point which threatens the future sustainability of the NHS.

Ministers rightly point out that the NHS in England has more clinical staff than ever before, but numbers have not kept pace with rising demand. The official "shortfall rate" for nurses and midwives across England is close to 10 per cent, and in some places significantly higher. Part of this is down to the recognition, after the events at troubled health trust Mid Staffordshire, of the importance of safe staffing levels. Yet for successive years during the coalition government, the number of nurse training recruits fell.

Far from being a problem just for hospitals, there are major nursing shortages in mental health and community trusts. Between 2009 and 2016 the number of district nurses employed by the NHS in England fell by more than 40 per cent. Just as the health service tries to accelerate plans for more treatment closer to home, in key parts of the workforce the necessary resources are shrinking.

There are also worrying gaps in the supply of doctors. Even as the NHS gears up for what may prove to be its toughest winter yet, we see worrying shortfalls in A&E consultants. The health service is rightly committed to putting mental health on an equal footing with physical health. But many trusts are struggling to fill psychiatry posts. And we do not have enough GPs.

A key part of the problem is retention. Since 2010/11 there has been a worrying rise in “leaver rates” among nurses, midwives, ambulance staff and scientific technical staff. Many blame the pressures of workload, low staffing levels and disillusionment with the quality of care. Seventy per cent of NHS staff stay on for extra hours. Well over a third say they have felt unwell in the past year because of work-related stress.

Add in cuts to real basic pay, year after year, and it is hardly surprising that some are looking to other opportunities and careers outside the public sector. We need a strategy to end pay restraint in the NHS.

There is also a worrying demographic challenge. Almost one in three qualified nurses, midwives and health visitors is aged 50 or older. One in five GPs is at least 55. We have to give them reasons to stay.

NHS trusts have made important strides in engaging with their workforce. Staff ratings on being able to report concerns, feeling trusted to do their jobs, and being able to suggest improvements are encouraging. But there are still cultural problems – for example around discrimination and bullying – which must be addressed locally and nationally.

The NHS can no longer be sure that overseas recruits will step in to fill workforce gaps. In the early 2000s many trusts looked beyond Europe to meet nursing shortages. More recently, as tougher immigration and language rules took hold, a growing proportion came from the EU – though not enough to plug the gap.

Now we have all the uncertainty surrounding Brexit. We need urgent clarity on the status of current EU nationals working in the health and care systems. And we must recognise that for the foreseeable future, NHS trusts will need support to recruit and retain staff from overseas. The government says it will improve the home-grown supply, but that will clearly take time.

These problems have developed in plain sight. But leadership on this has been muddled or trumped by worries over funding. Responsibility for NHS workforce strategy is disjointed. We need a co-ordinated, realistic, long-term strategy to ensure that frontline organisations have the right number of staff with the right skills in the right place to deliver high quality care.

We must act now. This year's long-delayed workforce plan – to be published soon by Health Education England – could be a good place to start. But what we need is a more fundamental approach – with a clear vision of how the NHS must develop its workforce to meet these challenges, and a commitment to make it happen. 

Saffron Cordery is the director of policy and strategy at NHS Providers