We do not believe that the duty to publish an update on the roles and responsibilities once every five years is an adequate response to workforce shortages that are endemic in the NHS. We are very sympathetic to the detailed joint proposal from the Kings Fund, Health Foundation and Nuffield Trust to place a duty in the Bill to produce annual workforce projections. Equally, we welcome similar proposals submitted by the Academy of Medical Royal Colleges and Royal College of Nursing. The detail in both proposals is key to ensuring that the Department and NHS England can develop strategies to adequately staff health and social care in the short, medium and longer term