Health and Social Care Bill

Memorandum submitted by the Medical Schools Council (HS 48)

The Medical Schools Council is the authoritative voice of the UK’s 31 undergraduate medical schools.   Council has serious concerns that with insufficient time for orderly transition, the functions and roles of the post-graduate (PG) Deaneries currently discharged through the SHAs will be lost. In addition, the wider national roles of PG Deans as senior educationalists and professional advisors are ignored. If both sets of roles and functions are lost there may well be dire consequences for post-graduate medical education and the future medical workforce.

The Bill requires amendment to safeguard the effective discharge of the responsibilities with which the PG Deaneries are charged even after abolition of the SHAs. This includes the recently legislated responsibility for the revalidation of doctors in training; with the PG Deaneries being designated bodies and the PG Deans described as the Responsible Officers.

Workforce issues for medicine

1              Medicine is a national resource with educational requirements that must meet national and international standards and which, for all doctors, must be rooted in a deep understanding of science. Funding must be ring fenced and allocated transparently and in sufficient volume to meet the requirements of the numbers commissioned centrally - decisions cannot be left to local Skills Networks.  High quality education requires national coordination and regulation.

2              Medical Education is a continuum from Medical School to retirement, overseen by the GMC, and so Medical Schools need to be true partners of NHS colleagues in primary and secondary care - designing new systems together - and preparing doctors for the myriad, ever-changing roles required of them – see the Consensus Statement on the Role of the Doctor.

3             The extent of the proposals for Skills networks is too large for them to be effective. They could be advisory bodies providing intelligence on workforce needs, but contracting must be done in a profession specific way. Employers must not quality assure the posts that they themselves provide to train the staff whom they also employ. Ring fenced budgets for quality control, quality management and quality enhancement should sit with the post-graduate deans in the universities.

4              Post-graduate deans could have Honorary contracts with Medical Schools and be physically located in the Medical School to facilitate the continuum of education, improve the transition process from student to employee, co-locate responsibility for quality management of medical student placements and doctor in training posts and engage with evolving scholarship & educational innovation.

5              There is little evidence that the current system is in need of radical reform, evolutionary improvement and enhancement would seem a more appropriate approach.  Nor is there evidence that a multi-professional approach is required.  Inter-professional education to enhance team working once students have confidence in the unique requirements of their own profession is the way forward.

6              Clinical academic medicine is of vital importance to UK plc and is threatened by current proposals - higher fees will discourage intercalation; reduced NHS bursaries will limit widening access; the NHS Outcomes Framework requires no commitment to research and education; a focus on local issues will endanger the bigger picture - particularly with regard to smaller specialties.  Without clinical academics innovation, efficiency and productivity will stall.

February 2011