Your views: Education and training

Building on the earlier work of the Future Forum on education and training and the Department’s recent consultation, the Forum has now been asked to help to work through the detail, including how the changes are implemented.

How can we make sure that we have the right incentives and accountabilities for developing the healthcare workforce to enable the delivery of world class, patient-centred healthcare?

We are interested in your views in this area, including:

  • How can we ensure that education and training in the new system is flexible and fit-for-purpose for the new way that care is delivered and enables training beyond the job, for example stimulating a culture of continuing professional development or academic and research development?
  • How can we ensure the right balance of responsibilities and accountability and line of sight throughout the new system (for example, Health Education England and the provider-led networks, employers / professions / education sector, whole workforce) including for research training?
  • How do we best ensure an effective partnership with health, education and research at a local level?
  • How can we ensure appropriate and effective patient and public engagement in the new system?
  • How can we improve information on the quality of education and training?
  • How can we improve information on the quality of education and training and what should be the roles and accountabilities of the key players in this?

The NHS Future Forum’s work on education and training is led by Julie Moore.

In NHS Future Forum

11 Responses to Your views: Education and training

  1. Just a general comment – We have looked at the documents published which detail responses to the ‘Liberating the NHS: developing the healthcare workforce’ (which we responded to but were not acknowledged) and the other related documents on the future of workforce development. Our work is very dependent on development of both the health and social care workforce to deliver quality end of life care and we still see so much badged as ‘NHS’.

    It still remains a concern of ours that there is not more joined up development between the health and social care workforce as well as across independent and charity sectors who have health and social care funded contracts. Much of the work we have undertaken and funded is equally accessible to both health and social care e.g end of life elearning through eLfH, competences through SfH and SfC, and we had hoped that more focus would be on common workforce development opportunities across all delivery sectors in the future where appropriate.

  2. Hannah says:

    We must continue to put our target audience at the heart of commissioning and work with our partners to holistically support our target audience to adopt and maintain positive behaviours and enable a better quality of life for all. A Social Marketing Framework is a great tool for professionals to understand and use to do this.

    It is important that professionals are reminded about the insights behind the actions of their target population. What really moves and motivates their audience, what are their barriers and competing priorities, who are the people that should be accessing their services that aren’t.

  3. Mike Barnett says:

    One way of driving cost savings and consistency is to define centrally (in conjunction with the Royal Colleges perhaps) the minimum requirements for mandatory training for each sector and staff group of the NHS, compliance with which will be deemed as:

    1) ensuring patient safety
    2) ensuring the safety of colleagues
    3) satisfying the minimum risk controls required by NHSLA

    This will :
    a) eliminate the phenomenal duplication of effort across the NHS in managing risk and providing associated training
    b) provide a clear minimum benchmark against which performance can be measured and published
    c) eliminate a significant amount of local policy writing/reviewing which costs so much and adds so little value to the patient experience

    • James Bird says:

      I think Mike makes a significant point here. Having worked at a number of NHS trusts there are several ways of accomplishing training, some of which is less than cost effective.

      If we take the example of annual update training which is a requirment in place at all trusts, a universal standard, applied through a distance learning package would suffice for the majority of training, it would also take significantly less time than the 1-2 days usually spent on it. This would set a bench mark standard, and be significantly cheaper for the trusts to undertake. After all the COSH, HASAW etc have not changed significantly since i started employment.

      The other area that should be looked at with urgency is that of advanced practice and the training that is undertaken to perform this. There has been an explosion of roles in professions allied to medicine where more advanced assessment and patient management is carried out, normally to a high standard. However the training that supports these advanced roles is very often locally arranged by trusts, either in house or at a university. There is often no universally accepted standard, which should be laid down by the NMC, HPC as appropriate.

  4. Jackie says:

    There is a strong drive for integration across all the NHS Reform policy areas but it is not as explicit in the education, training and workforce planning reform plans. If we are to achieve the transformation of patient care we need, there must be flexibility in the education and training funding streams to support innovation and skills development across health and social care. The original consultation paper was about workforce planning, education and training and now the focus appears to be on education and training and how to manage the funding.
    We need to ensure the workforce development planning system is fit for purpose to ensure all employers have identified the health and social care workforce they will need and the skills they will require to deliver care in the future. Funding flows and the systems needed to manage these to ensure they are targetted to deliver the right education and training need to be developed to meet that purpose.

  5. Marie Herring says:

    We need to remember that training and education is just one aspect of the staff development to wards a capable and competent workforce. We need to have the assuranace around competency and capability of prcatice within a structured framework that meet the patient and safety and governance agenda especialy in the advanced practitioner role. I feel this sits with provider service and not central regulation

  6. The Faculty of Occupational Medicine has been advised by COPMeD that there is EU legislation which precludes doctors who are training in a speciality from working elsewhere part time at the same time as undertaking their training part time. We have not been able to identify what the legislation is; the chair of COPMeD has advised us that the GMC is currently looking into this.
    We need far greater flexibility in training in our speciality of occupational medicine, it is one that doctors often come to later in their career. This kind of restriction is unhelpful. We would welcome as much flexiblity in training as possible.

  7. Jean Rogers says:

    Education and training for all health care professionals has always been an issue. We need to stop duplicate training when moving trusts and have a clear electronic passport of training that can be accessed by those who need to access it.
    Mandatory training needs to be standardised and again not repeated when someone moves trust ensuring local induction is all that is required.
    Funding and study leave need to be standardised and equitable across the professions with nursing funding and study leave not being the first to be cut every time there is a crisis. This goes for all professions at all levels.
    To ensure newly trained staff that are fit for practice and purpose in house training needs to be brought back and students home based so their is consistency in what they learn. Clinical skills need to be assessed in the placement environments which means educators need to teach these skills practically as well as theoretically.

  8. tony chandler says:

    Note the date for comments has passed but having looked at these comments and from the webchat yesterday.I still think it important to underline the need for education and training ( and CPD) for the wider workforce (bands 1 of 4) as well as health care professionals. I will comment about how new roles at band 4 – assistant practitioners- can contribute to delivery of more seamless and improved healthcare outcomes by November 18th but just to note the critical contribuion these new roles also make to productivity, improving team capability and of course the bottom line. For Band 4 roles to be successfully introduced they need to be part of an established and funded education and career progression route to enable appropriate staff with qualifications at academic level 2 and 3 and at pay bands 2/3 to develop and have the confidence to become trainee assistant practitioners – typically studying at academic levels 4 and 5.
    And yes ! I haven’t met anybody in my work in the service around APs who does not think that registration of at least assistant practitioners would allow this group to expand on a firm basis, with transferability and recognition assured, and the delegation and public safety issues resolved to the satisfaction of professionals, patients and the assistant practitioners themselves.
    This is so important.Much progress has been made in recent years around the learning of support staff but there is a very real danger that with the end of Joint Investment Framework and the current reforms to MPET and the SHAs that Bands 1 to 4 will slip off the radar yet again.Can they be included in Health Education England(and Skills Networks) remits please?
    Thanks
    Tony

  9. Sara Huggard says:

    I would like to make a comment about nurse training. I was a student nurse from 1993 until 1996. I followed in a family tradition, as my mother is a nurse who trained at St. Thomas’s Hospital, and went on to train as a midwife and eventually a Health Visitor. My mother carried on working into her seventies, such was the demand for Health Visitors in Luton at the time. By contrast I was failed at the end of a three year training course, based at the University of Hertfordshire and St. Albans and Hemel Hempstead Hospital. I desperately wanted to be a nurse, but the course, and the tutors were what i can only describe as inadequate. I was actually failed on my final placement at the BUPA hospital in Bushey, having passed all other placements and the written work that was required. I was bitterly dissappointed, after three years dedicated hard work, to be told i was not good enough to be a nurse. I was told i could not retake the placement. But not only was it dissappointing for me, but a terrible waste of money and resources to put someone through all that training for nothing. There were a lot of failings with the course. There was a lack of discipline amongst students (I got into trouble when a student nurse was kicking my chair during a lecture, and i complained and walked out. I was reprimanded for making a complaint). There were a huge number of foreign students, and they appeared to get preferential treatment. But there was a drop out rate of 50% apparently. I at least completed the course, but was judged not good enough to qualify. My reasons for wanting to train as a nurse were based on personal experience. I think of myself as a compassionate and caring person. I had completed a three year degree course at Aberystwyth University, and in my final year, a dear uncle died, suddenly, with an aortic aneurysm, then my only serious boyfriend, during my time as a student, tried to commit suicide. I left university with the idea that becoming a student nurse would be the thing to do.
    I am not sure how training courses are run now. But during my time at the University of Hertfordshie, nurse tutors seemed to live in Ivory Towers, rarely venturing onto wards and lecturing by rote from text books with what seemed little practical, hands on, experience.
    If you want to help the NHS, then it needs to start with the way nurses are trained, not wasting resources, and policing universities who do not uphold standards of training.

  10. tim manners says:

    Id like to focus on some detail re College supported surgical training for doctors. I am a front line NHS surgeon with no axe to grind or College position to foster.

    We have the longest route to CCT or equivalent in the world – up to 8 years post 2 foundation years post 5 years med school, and this in age when we need fewer generalists. Most progress in recent years has been in ensuring quality standards and governance arrangements. Delivery remains still largely non curriculum based, apprentice style one to one trainee with consultant.
    This was driven by the need for junior doctors to run the NHS, especially NHS night time cover.

    Times have changed – units are much larger, and the smaller ones are learning how to do without junior cover. Juniors are also inclined to question why they should sit for 6 months in a subspeciality “firm” which bears no relation to their final choice of career. During that 6 months they are increasingly reduced to observer status.

    We could look at international comparisons and think again about a US style of training (do differentiate US training which is excellent from US delivery which is market driven and variable across the population to say the least).

    Given the fact that FY1 and 2 seem here to stay, this could be followed by competitive entry to a curriculum based 3 year basic speciality training in the large units, followed by competitive entry to 1-2 year fellowships in chosen subspeciality.

    Crucially the funding must follow the trainee, so NHS units are incentivised to train.