Education, training and workforce planning - Health Committee Contents

1  Introduction

1.  The quality, safety, effectiveness and efficiency of healthcare services depend on the availability of sufficient numbers of well-trained and well-motivated staff. Throughout its existence, the NHS has, therefore, rightly attached a high priority to education and training of both new and current staff. In 2011-12 it spent £4.9 billion, around five per cent of its budget, on education and training.[2]

2.  Despite this long-standing commitment, however, we believe there are two reasons why there is now an urgent requirement for a whole-system review of the education and training of the health and care workforce:

  • The first is the obvious point that the passage of the Health and Social Care Act 2012 means that various institutions and structures within the education and training system will no longer exist, or no longer exist in their previous form, which creates a practical requirement to make alternative arrangements.
  • More substantively, however, we believe that this practical requirement creates a welcome opportunity to address some of the weaknesses of the current arrangements and create new structures which will be better able to meet the needs of the health and care system of the future.

3.  If we are to take advantage of this important opportunity to improve the effectiveness of our education and training structures, it is important to begin with an understanding of the weaknesses of the current system as it has developed. We believe these can be summarised as follows:

  • It is too complex, meaning that few people understand how it operates and that accountability is poor because of the lack of clarity.
  • It is inflexible and does not respond effectively to the changing demands of service delivery.
  • It is regularly accused of being unfair in the way in which it distributes the cost burden of training.
  • There is a danger that its inflexibility may itself prevent or delay desirable changes in provision.

4.  That being so, it is possible to see what the criteria for an effective system of education, training and workforce planning are:

  • The system needs to be service-led.
  • It needs to be transparent and accountable—it has to be simpler than the current system.
  • It needs to be responsive to demand.
  • It needs to be dynamic, in the sense that it must be capable of understanding and reflecting the need for continuous change.
  • As part of that process, it needs to maintain an up-to-date concept of what "good" looks like, and to be able to change accordingly.
  • It must be apparent that the costs of the system are fairly borne by all service providers.
  • The education, training and planning that the system provides need to be of high quality, and need to provide value for money.

It is against these criteria that we have set out to judge the Government's proposals. (The terms of reference for our inquiry are set out in Annex A.)

5.  During the course of the inquiry, 119 memoranda of written evidence were received and five evidence sessions were held. Oral evidence was taken from: Medical Education England, the Health Education England steering group, the Centre for Workforce Intelligence, a Strategic Health Authority cluster, the General Medical Council, the Conference of Postgraduate Medical Deans of the United Kingdom, the Higher Education Funding Council for England, the Health Professions Council, the Nursing and Midwifery Council, Skills for Health, million+, the NHS Future Forum Education and Training group, the Council of Deans and Heads of UK University Faculties for Nursing and Health Professions, a Health Innovation and Education Cluster, a Skills Academy, NHS Employers, the NHS Partners Network, Independent Healthcare Advisory Services, the Junior Doctors' Committee of the British Medical Association, UNISON, the Royal College of Nursing, Unite / Community Practitioners' and Health Visitors' Association, Rt Hon Simon Burns MP, the Minister of State for Health, and officials from the Department of Health. We are grateful to our specialist adviser, James Buchan, Professor in Health Workforce Policy at Queen Margaret University, Edinburgh.[3]

2   Department of Health, Liberating the NHS: Developing the Healthcare Workforce - From Design to Delivery, January 2012, para 124 Back

3   Professor Buchan declared his interest as a columnist for the Nursing Standard and a Professional Adviser to the Centre for Workforce Intelligence. Back

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Prepared 23 May 2012