Select Committee on Health Written Evidence

Supplementary memorandum by NHS Employers (MMC 45A)



  NHS Employers is the employers' organisation for the NHS. Part of the NHS Confederation, we provide support and representation to employers in England.

  We submitted written evidence to the HSC Inquiry into MMC on 16 October 2007 and Sian Thomas, Deputy Director of NHS Employers, provided oral evidence to the Inquiry on 24 January 2008.

  During the Inquiry's oral evidence session, Ms Thomas was asked to provide employers' views on the final report of the independent inquiry into MMC, led by Professor Sir John Tooke, and in particular our views on Recommendation 47, the establishment of NHS Medical Education England.

  Ms Thomas noted in her response that this was a new recommendation from the Inquiry and we had yet to complete our discussions with employers on their views about the proposal. Ms Thomas agreed to provide this supplementary written evidence setting out these views following consultation with employers.


  The Panel recommends the formation of a new body, NHS Medical Education England (NHS:MEE). This body would fulfil the following functions:

    —  hold a ring-fenced budget for medical training;

    —  define the underpinning principles of postgraduate medical education and training (PGMET);

    —  act as the professional interface between policy development and implementation on PGMET;

    —  develop a national perspective on training numbers for medicine working with the revised medical workforce advisory machinery;

    —  ensure that policy and professional and service perspectives are integrated in the construct of PGMET curricula and advise the regulator on the resultant synthesis;

    —  coordinate coherent advice to Government on matters relating to medical education;

    —  promote national cohesion of Postgraduate Deanery activities;

    —  scrutinise SHA medical education and training commissioning functions, facilitating demand led solutions whilst ensuring maintenance of a national perspective is maintained;

    —  commission certain sub-specialty training;

    —  act as the governance body for MMC and future changes in PGMET; and

    —  work with equivalent bodies in the Devolved Administrations thereby promoting UK wide cohesion of PGMET whilst facilitating local interpretation consistent with the underlying principles.

  It is proposed that NHS:MEE would be accountable to the Department of Health's Senior Responsible Officer (SRO) for medical education and would be advised by an Advisory Board with professional, service, academic, BMA and trainee representation.


  The NHS Employers Policy Board, comprising of senior managers from a range of NHS organisations across England, supported by members of the Medical Workforce Forum, an advisory group formed of senior clinical, HR and organisation managers and stakeholders with experience and interest in medical workforce issues, recognised the benefit of co-ordinating advice and support on medical education and training issues but expressed concerns about the proposal, including:

    —  the proposal appears to conflict with the desired intention outlined by the Next Steps review led by Lord Darzi to integrate the planning of workforce, finance and service issues;

    —  the creation of a new central national body does not seem to fit with the desired policy direction of local devolution of decision making;

    —  consideration of medical education and training issues in isolation from those for other staff in a multi-disciplinary NHS is not helpful;

    —  employers tended not to support the ring-fencing of specific budgets; and

    —  the proposal does not seem to support the desirable intention, set out clearly in the Tooke Report, of getting those involved in the policy and commissioning of education for doctors closer both to undergraduate medical schools and to the service.

  Employers have expressed a clear view that if the proposal is accepted by Health Ministers there were several important principles which had to be met. These were:

    —  the need for substantive and genuine employer involvement;

    —  the need to ensure a co-ordinated approach with non-medical education and training; and

    —  the need for responsibility for funding for postgraduate medical education and training to continue to rest with postgraduate deaneries as part of the SHAs and with local organisations.

  Employers have also recognised that, as this was a new recommendation, there had been no formal consultation on the proposal and felt there should be time for proper consideration of the issue by all stakeholders. Equally it is important that proposals arising from the Tooke report align closely with the findings of the Next Steps review.

14 February 2008

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