The Department of Health plans to monitor SHAs closely in a bid to salvage the discredited Modernising Medical Careers scheme after problems with the medical training application service, the computer system which matches junior doctors to specialist posts.
A six-page letter sent to SHAs from NHS chief executive David Nicholson lays out a series of 'must-dos', and charges executive directors with overall responsibility for the process.
It says: 'Our aim is to ensure the available training programmes and posts are filled with the most appropriate applicants.
'We recognise that the programme has created a heavy workload for staff, which in itself increases the challenges.'
Weekly checks
It says SHAs must provide the DoH with a long-term plan, complete with predicted milestones and trajectories.
They must also write weekly progress reports which, if not running to plan, could result in a serious dressing-down from the DoH, which has made it clear it sees this as a national priority.
Former Essex SHA chief executive Terry Hanafin was drafted into the DoH three weeks ago to become the MMC's chief operating officer.
He said: 'We're treating the system as a top national priority, in the same way as accident and emergency and 18-week targets.
'Each week we will be looking at the extent to which SHAs have managed to fill posts, and their progress against their plan.
'If their written report shows they're on target, it'll be hands off. If they're diverging from their plan I will be personally asking chief executives what they're doing about it.'
Second-round strategy
The second round of MMC, which finds posts for those unsuccessful in the first round, is being dealt with locally after a high-profile MTAS security breach earlier this year.
The latest directive makes it clear that the DoH wishes to avoid a similar debacle ahead of an independent inquiry into the system, due to report in December.
Mr Hanafin said: 'The health secretary has listened to the concerns of junior doctors and consultants about MTAS and that's why we've moved to a locally managed system.
'It's going to be very tough, because although the computer system had problems, it did a lot of work that will now have to be done locally. But I have got enormous confidence in SHAs' ability to deliver on this.'
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