Health CommitteeWritten evidence from Birmingham Children’s Hospital (ETWP 40)

1. BCH recognises that in order to meet the challenges of the proposed changes for the NHS as a whole, education and training is the key to that success. Wholesale change must go hand in hand with an increase in training for leadership capability and change management, including examination of the culture within which they operate. To truly reflect an NHS that has a workforce that is fit for purpose and practice we must ensure that educational reform addresses the gaps that are currently displayed:

Lack of professionalism in trainees eg need values based recruitment and training programmes.

Lack of understanding of NHS and its wider context.

“Loyalty” to NHS values and NHS constitution.

Leadership capability not embedded in curricula and post graduate training.

Team working capability/multi disciplinary training approach as a fundamental ingredient to clinical outcomes.

Service transformation/redesign capability.

2. Education and training must attempt to address these gaps in a systematic and focussed way involving all users of the service. We have concerns regarding the proposed new tariff in terms of specialist provision and do not feel that the new tariff recognises the higher level of pay for medics that specialist Trusts have to fund to top up basic tariff funding. The timescales proposed for changes are of concern and we feel do not allow for a change in culture and leadership capability to deliver.

3. We would wish the Select Committee adhere to the words of Andrew Lansley in his speech in July 11:

“We will ensure a safe and robust transition for the education and training system. It is vital that change is introduced carefully and without creating instability, and we will take the time to get it right, as the Future Forum has recommended”.

Our more focussed comments are:

4. Engagement

We would wish:

4.1Appropriate stakeholder consultation and involvement in determining the core functions of the new post- graduate deaneries, with recognition that they need to be all-inclusive of all MPET provision.

4.2Appropriate engagement in LETBs enabling Trusts to truly influence the WFP and educational commissioning agenda.

4.3Appropriate engagement of “specialist Trusts” to influence the agenda ensuring the workforce development needs of specialist elements are appropriately considered, funded and managed.

4.4Mechanisms to ensure that local Trusts and PCTs have a greater say in how their workforce is educated.

4.5Mechanisms to ensure local trusts, smaller professions and specialist trusts continue to influence the HEIs/Colleges and external training companies to provide education that is fit for purpose.

4.6Roles of CFWI need to be articulated and utilised effectively for maximum impact to ensure robust intelligence for future working arrangements.

5. Capability/Leadership

5.1Recognition that the development of LETBs will require investment in terms of capability and maturity. We would welcome a culture change in how the groups function with senior level buy-in, and a focus on workforce development in the truest terms to change services to meet the challenges facing the current NHS.

5.2Appropriate leadership at the LETBs to influence the agenda locally, regionally and nationally for WFP/development and education commissioning.

5.3Professional representation at board level is essential to ensure risks with activity; development and commissioning are debated and articulated to enable informed decision making for future provision.

5.4Deanery presence at board level is key.

6. Structure/Architecture

6.1Appropriate arrangements to be developed for the “old SHA” boundaries to ensure consistency, equity and dissemination of best practice across the new SHA boundary for the modelling of LETBs.

6.2Consideration of a Sub Group to shadow boards which will enable active participation from Higher education institutions rather than allowing a formal seat at board level. There is a perception that if the proposed model is implemented which allows representation from this group at board level, there will be a conflict of interest, especially in terms of allocation of funds, provision and quality.

6.3The implementation of clear definitive structures to enable the CEO reference group to operate transparently with clearly defined structures, to ensure they have appropriate data/information to make informed decisions. Partnership groups are essential to this process. Their functions, TOR and membership are key to success and defined deliverable outcomes.

6.4Structures below LETBs need to ensure commissioners and providers can influence the debate. There needs to be a truly capable team that can lead and direct future provision.

6.5The focus for LETBs should be WFP and development influencing education commissioning plans, utilising partnership working to develop service redesign and transformation. Capability needs to be developed at this level to do this.

6.6HEE must ensure that there is a comprehensive system of quality governance and explicit educational outcomes.

6.7Appropriate systems to allow HEE to monitor, govern and influence LETB. Providing challenge and objectivity to ensure successful outcomes.

7. Funding

7.1Recognition and commitment to develop a model of tariff funding for continuing professional development of staff.

7.2Recognition of the need to strengthen and commit to widening participation with associated funding to implement appropriate activity, to shift the balance of the workforce to aid workforce redesign.

7.3Recognition and commitment to address the gap in funding for, and support for ANPs and medics who are essentially fulfilling similar roles.

7.4The need for continued and real investment in educational placements and assessment of trainees to be recognised and retained to ensure trainees have quality educational experiences that reflect the values, professionalism and constitution of the local Trusts and NHS.

December 2011

Prepared 22nd May 2012