Last week’s publication of the further policy statement on the future NHS education and training system provides a great opportunity for providers to ensure they have the workforce they need to deliver the world class health services the public wants, says Martin Barkley.

Working in partnership with the professions, higher education institutions and local authorities, trusts will be able to shape the education, training and development of the future and present NHS workforce.

Previously there have been opportunities for providers to get involved but ultimately decisions about training the NHS workforce have rested elsewhere. Too many decisions about workforce numbers and the quality of training have been made without adequate input from providers. 

To some extent this has been the fault of providers for not engaging sufficiently in this crucial area, but it has also been due to the system being somewhat removed from providers, making engagement harder.

Not any more. The new arrangements outlined in Liberating the NHS: Developing the Healthcare Workforce - From Design to Delivery contain a duty for providers to work in partnership to ensure a world class education and training system.

Through the new Local and Education Training Boards (LETBs), providers will be making the decisions.

The LETBs, led by providers in partnership with their key stakeholders, will work across local health economies to plan, educate and train the health and public health workforce. Many of the present strategic health authority workforce and deanery functions will transfer to the LETBs.   

Health Education England will support the LETBs, ensure they have national influence and will also hold them to account for the outcomes they deliver. It will be for the LETBs to devise the local vision to decide what they want to deliver.

Providers will also need to work together in the LETBs to ensure that there is security of supply, not only in terms of numbers of staff, but also the skills and values they possess.  Shortages of skill and staff must become a thing of the past once and for all.

Providers are being given the opportunity to decide what skills and workforce they need and to invest the £4.9bn central education and training funding to meet their local priorities. But this can only happen if providers step up to this role and demonstrate that the LETBs can handle this responsibility.

The onus is now on trust chief executives to lead their local LETB to ensure it is working well and is ready to take on these new responsibilities. 

Shadow LETBs are in various stages of development in the SHA regions, and all should be in place from the beginning of April 2012. The “hosting” of the LETBs will transfer to HEE a year later. In the meantime HEE will establish a delegation scheme to ensure that LETBs operate with autonomy within its national framework.

Before LETBs are able to operate with autonomy they will need to show that their governance arrangements demonstrate a multi-professional approach to quality assurance and quality improvement of the education and training they commission, meaningful involvement of stakeholders including small providers of NHS services, and a partnership approach. 

Other characteristics will need to be assessed as being in place during 2012 and further information on how LETBs will operate will be published within the next four to five months.

HEE will be hosting the LETBs while the new organisational arrangements in the NHS mature. This pragmatic approach takes into account the very diverse range of views that have been expressed about the form of LETBs. 

It is important that during this time providers engage with LETBs, and seize the opportunities to improve the quality of education and training and eradicate shortages of staff by working in partnership, not only with each other but also with the professions, higher education institutions and local authorities.

Key to this is the need for trust chief executives to do a minimum of four things:

  1. invest time in the development of their local LETB and its planning and decision making groups
  2. ensure the workforce plans of their organisation are accurate and credible forecasts, not just for the next year but for five years, and for medical staff, 10 years
  3. identify the key three improvements they want their local LETB to make over the next two years and let the LETB know - without this knowledge there is a risk that key opportunities for improvement will be missed
  4. ensure the quality of education and training has its place on the agenda of trust boards along with other performance information.

The reforms outlined this week provide an unrivalled opportunity to improve the quality of education and training of the healthcare workforce.  Providers need to seize this opportunity now.