Deficit crisis: ground won for training must be held in face of cash battles

Yet again, training budgets have become collateral damage in the battle to overcome budget deficits.

As HSJ reveals today, strategic health authorities are raiding£117m from training this year, undermining the service-level agreement between SHAs and education bodies just a week after health minister Lord Hunt announced it.

Long-term training and workforce planning were two of the early wins for Labour's stewardship of the NHS. Having decided to drive down waiting times and boost capacity, ministers embarked on a twin-track approach of recruiting overseas to provide a quick boost to the headcount, while substantially expanding training programmes for health professionals to meet future demand.

Off course

But the deficit crisis has helped throw training plans off course. Inflicting pain on training to tackle a deficit may in some cases be necessary, but a clutch of SHAs are now taking this much further by cutting training to boost reserves.

Some of the training budget reduction may be achieved by efficiency savings, but most will simply be a cut in provision.

The government's service-level agreement - a response to criticism of the 10 per cent cut in training by SHAs last year - looks to be a dead letter within days of being published.

Short-term mindset

Influential bodies have been quick to condemn the SHAs, with the British Medical Association, the Council of Deans for Nursing and Health Professions and NHS Employers all rounding on them.

Just like the NHS, the training institutions need planning and financial stability to handle supply and demand. Sharp fluctuations triggered by short-term financial pressures run the risk of undermining the ground made in training and workforce just at the time when a tight spending round will pile on further pressure.

SHAs need to accept that training is part of the solution to delivering long-term financial stability, not an impediment. Training drives up performance and productivity, which translates into higher-quality, more effective and safer care.