Health CommitteeWritten evidence from the Family Planning Association (ETWP 14)

1. Executive Summary

1.1 FPA is one of the UK’s leading sexual health charities, with over 80 years’ experience of providing the UK public with accurate sexual health information, education and advice services.

1.2 We are a provider of non-clinical sexual health training for a range of healthcare staff and non-clinical professionals. Our training courses cover a range of sexual and reproductive health issues from the basics of contraception to a “first impressions” course for reception and administration staff.

1.3 FPA welcomes the clear statement from the Government in Liberating the NHS: Developing the Healthcare Workforce consultation that, “education and training are integral to ensuring the values and calibre of staff”. We agree that training is vital to the delivery of safe and high quality services. However, we have significant concerns that removing the central oversight of education and training currently exercised by the Department of Health will lead to a lack of consistency in the training provided.

1.4 We believe that it is vital that the new workforce development system is supported by sufficient funding to ensure that professionals can access the training they need, including cover for their posts where this is necessary.

1.5 FPA welcomes the recognition that there needs to be workforce planning and development specifically for the public health workforce, which includes the sexual health workforce, but there needs to be more clarity around how the training for the public health workforce and healthcare workforce will be integrated, planned and managed.

2. Local Skills Networks

2.1 FPA has significant concerns that training will no longer be delivered in a systematic and coherent way if responsibility for planning and commissioning it is devolved to local skills networks. Our concerns are based on the experience of the devolution of decision making on sexual health training for nurses.

2.2 Previously the English National Board for Nursing (ENB) and its equivalents in Scotland, Wales and Northern Ireland co-ordinated training for nurses in a variety of disciplines including sexual health. Following the dissolution of the ENB no other organisation took on this co-ordination and oversight role. Instead, individual institutions now make decisions about the training they offer with the result that there is not a single recognised curriculum for sexual health training and nurses who have attended different institutions may have a qualification with the same name but will not necessarily have all of the same knowledge or skills. This makes it difficult for employers to assess whether nurses have the competencies they require. In addition, the majority of courses are now delivered by higher education institutions which means the courses are too long and at too high a level for what many nurses need or want. There is also a lack of co-ordination for practical placements with some nurses struggling to get the clinical training they need because it is not always clear how to access it or who should pay for it or the places are so limited that other professionals are given priority. FPA is concerned that this lack of co-ordination will be replicated across the country if responsibility for training is devolved solely to a local level.

3. Protection of Funding

3.1 FPA has significant concerns about the funding available for training and education within the NHS. As a provider of non-clinical training we are aware that training budgets are often seen to be an easy target for cuts when budgets are under pressure. In some cases this means that there is not any funding at all available for training but in others that can mean that funding is available for the training but not for any cover to fill posts making it virtually impossible for professionals actually to undertake training. It is vital that the new workforce development system is supported by sufficient funding to ensure that professionals can access the training they need, including cover for their posts where this is necessary.

3.2 In addition, FPA is concerned that the proposals for a tariff for the delivery of training could deter some providers. For example, the vast majority of contraception training takes place in community contraception clinics. When training is taking place this can reduce the capacity of the clinic and therefore have an impact on the number of people who can be seen, unless there is funding for the post of the trainer to be covered during the training. The consultation document implies that the tariff will be developed based solely on the cost of the training provided and will not take account of the wider potential costs to services of providing training. We are concerned that this could act as a deterrent to providing training, especially in an environment where healthcare providers are competing with one another.

4. Public Health Workforce

4.1 In the Public Health White Paper, Healthy Lives, Healthy People comprehensive sexual health services were identified as part of public health. FPA welcomes the commitment in Developing the Healthcare Workforce that preventative medicine will remain a key area of work for all NHS staff. We agree that there needs to be workforce planning and development specifically for the public health workforce. We also welcome the further details on plans for the public health workforce that were included in Healthy Lives, Healthy People: Update and Way Forward. However, we are still awaiting the publication of a public health workforce strategy which will contain more detailed proposals on the public health workforce.

4.2 There is currently not any clarity around how clinical training for people delivering public health services will be planned and managed. For example, sexual health services will be part of the new public health structure but many of the skills required to deliver these services are clinically based, such as carrying out STI tests and initiating treatment. It is not clear how strong links will be made between public heath workforce planning and healthcare workforce planning to ensure these training needs are identified and met.

4.3 We are also concerned about the potential loss of expertise in the non-clinical public health workforce through the transition period into the new public health structure. As the reforms will change the way sexual and reproductive health services will be commissioned we are concerned that experienced commissioners from Primary Care Trusts may be lost along with their local knowledge and expertise.

December 2011

Prepared 22nd May 2012