Exclusive: Training for some specialist medical roles in the NHS could be scrapped under plans by Health Education England to transform the future NHS workforce.

In an exclusive interview Jo Lenaghan, director of strategy and planning at the education and training organisation said the NHS was failing to properly plan its workforce and HEE would begin making changes in the next two years.

She said HEE would seek to shift parts of its £5bn budget to create new jobs with less “rigid specialist pathways” as well as investing more in non-medical roles and re-skilling the existing workforce.

“In the next two years you will start to see a shift in how we distribute resources both across the professions and between staff in existing roles,” she said.

Her comments come as HEE unveils its 15-year strategic framework at the NHS Confederation conference in Liverpool this week.

The framework, which admits the current approach to workforce planning is not working, will underpin investment decisions by HEE as part of the annual workforce planning process.

Ms Lenaghan told HSJ: “It takes over a decade to train a senior medical or a nursing member of staff so every time we make an investment we are locking in a pattern of service delivery. The people we send to university in September will still be working in the system in 2060 so our job at HEE – more than any other part of the system – is to live in the future.

“If we commission a whole load of people to work in the acute sector, no matter what NHS England and others say they won’t be able to deliver a community or home based service because the NHS is delivered by people.

“We as a system have not got this right. The workforce plans are based on what employers tell us they need. If we carry on buying the current model of care it simply won’t be fit for purpose in the future.”

She said the NHS needed a more flexible workforce instead of the rigid specialties and highlighted examples under consideration including women’s surgeons, physician associates, prescribing pharmacists and orthopaedic physicians.

Ms Lenaghan added that intensive care specialists in the acute sector were a good example of a generalist model that worked well. HEE would work with royal colleges to create new roles, she said.

“It’s not that specialism is bad but the way we currently train people forces them to specialise too early and too rigidly to support them in a career up to 2060.”

Ms Lenaghan said HEE would shift more investment to non-medical staff and continuing professional development in partnership with employers that have primary responsibility for training the existing workforce.

She said there had been significantly higher investment in the medical workforce historically adding: “Why did we do that? I can’t get an answer from anyone that that was based on patient need.”

She said in future the national workforce plan would consider investment and numbers of staff together as a whole.

“We don’t hold all the levers, we can’t deliver this on our own, but what we do have is a leadership role and we are saying clearly we need to change what we do as a system.”