Health CommitteeWritten evidence from The Priory Group (ETWP 10)

Executive Summary

The Priory Group (“The Priory”) as the largest independent sector provider of mental health, specialist care and specialist education services by number of beds, is keen to contribute to the education and training of the NHS workforce where appropriate.

The Priory is recognised as an “approved practice setting” by the General Medical Council and can offer medical trainees a range of experiences that would be difficult to achieve through receiving training solely within NHS providers.

As the NHS moves to a more diverse provider market, it will be vital that non-NHS providers are fully engaged in the development of education, training and workforce policy, and that equity between NHS and non-NHS providers is secured.

The Priory welcomes the Government’s intention to ensure a level playing field in training and education amongst providers, and the Health Select Committee’s investigation of how to ensure that all providers play an appropriate part in developing the future workforce. However there are a number of areas of education and training policy that need to be addressed in order to deliver a truly level playing field:

(a)Equity of access to trainees for all providers.

(b)Clarity around funding flows available for education and training.

(c)Maximising the quality of training offered to medical trainees.

The Priory reports on its workforce development in its annual Quality Account and believes that all providers should include issues relating to workforce development in their quality account.

Ensuring all Providers Play an Appropriate Part in Developing The Future Workforce: Equity of Access to Trainees

1. In its call for evidence, the Committee has said that it will consider how all providers of healthcare play an appropriate part in developing the future workforce. Existing disparities in equity of access to trainees for non-NHS providers will need to be tackled if this goal is to be realised.

2. Currently there are limited opportunities for independent sector providers to gain access to medical trainees. This is because decisions on placing trainees are currently taken by NHS providers and the situation has deteriorated following the implementation of “host providers” which get first pick of trainees over other providers. There is a perception that educational placements are allocated on the basis of the need to staff NHS organisations, rather than on the quality of educational placements available, or wider workforce planning considerations. This inequality in access needs to be tackled in order to meet the Government’s aim of a level playing field in education and training.

3. Under the Government’s reform proposals, the new body Health Education England will become responsible for providing sector-wide oversight for the planning and commissioning of education and training. One way of addressing the issue of access to trainees would be for the Department of Health when developing further guidance on the remit of Health Education England (HEE) to give HEE an explicit duty to ensure equity of access to trainees between different providers.

How Funding should be Protected and Distributed: Clarity of Funding Flows

4. The Committee is also looking at how funding should be protected and distributed in the new system. There is currently a lack of clarity around funding flows to support education and training, which the Government recognised in the consultation Liberating the NHS: developing the healthcare workforce. The Priory welcomed the Government’s commitment in the consultation to tackle this by introducing “transparent funding flows for education and training”.

5. Currently, funding arrangements are not consistently applied between regions in England, and funding is often not made available to independent sector providers. This means that trainees are missing out both on the range of possible experiences and access to patients with specialist needs that can be gained from working in independent sector providers. Trainees themselves can bring new ideas and play a role in stimulating innovative work practices, and it is important that these ideas are both available to the NHS and the independent sector.

6. The Government’s longer-term reform plans propose that every provider of NHS services may be expected to contribute to a levy for training. Before this is implemented it is vital that clarity and equity of funding flows is established first in order that the levy can deliver maximum benefits.

Ensuring Appropriately Trained Healthcare Staff: Maximising Training Quality

7. Educational placements must be based on workforce planning needs and the learning opportunities available in order to ensure the highest quality training possible and develop a sufficiently experienced healthcare workforce.

8. The Priory provides specialist mental health services and offers care to some of the most severe and complex cases. For example our adolescent mental health, eating disorder and forensic secure services comprise a large proportion of the national bed stock for those treatment areas, and our addiction services have an international reputation. Trainees working solely in the NHS sector cannot benefit from the experience of working with these complex patients because of the rarity of such NHS services. In addition, more than half of all beds for forensic services are in the independent sector and have no trainees attached, and approximately 50% of Child and Adolescent Mental Health Service (CAMHS) and EDU beds are now also in the independent sector.

9. The independent sector could, by being able to take on educational placements where appropriate, contribute significantly to the education of the healthcare workforce. However there are currently limited opportunities for medical trainees to gain experience in these settings due to a lack of access to training budgets for independent sector providers. The Government’s reforms must tackle this issue in order to maximise the quality of training offered to medical trainees in the future.

Ensuring High and Consistent Standards: Reporting on Workforce Development

10. Ensuring high and consistent standards will require providers to report on their workforce development. The Priory recognises that human resource management is critical to the success of a healthcare organisation. The Priory regularly reports on workforce measures in its annual Quality Account and believes that all providers should include issues relating to workforce development in their quality account.

11. In the Priory’s most recent Quality Account for 2010–11, the Priory reported on the results of a staff opinion survey which revealed improvements in the majority of areas surveyed. The Priory has also reported on completion rates of the programme in its bespoke learning and development programme. This programme has won several awards including the Institute of IT Training “e-learning project of the year” 2007.

About the Priory

12. Established in 1980, The Priory Group has become the UK’s largest independent sector provider of mental health, learning disability and specialist education services, by number of beds. The Group is also one of the top three independent providers of secure and rehabilitation services by number of beds. Services provided include acute psychiatry, secure and rehabilitation services, complex care, specialist education and elderly care and dementia services. As of 1 December 2011, The Priory Group has 272 facilities and approximately 7,200 available places across the UK.

December 2011

Prepared 22nd May 2012