Health Education England approves savings plan for major reconfiguration

The HEE board approved proposals last week which will see LETBs lose their managing directors, directors of finance and directors of education and quality as part of a plan to save the education board £17m in running costs by next March.

The plans have sparked fears that HEE has a centralisation agenda as it seeks to create a “one HEE” approach to its £5bn role to train the healthcare workforce.

Among the changes approved by the board on Thursday include the creation of four new national directors who will be responsible for geographical regions in England.

Each area will also have heads of finance and directors of education and quality.

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These new area directors will oversee the work of LETBs, which will be run by the new local directors.

Each LETB will continue to have a postgraduate dean who will be accountable to the director of education and quality.

The four new directors will cover:

• North including North West, North East and Yorkshire and Humber LETBs;
• South including South West, Wessex and Thames Valley LETBs;
• Midlands and East covering East of England, East Midlands and West Midlands LETBs; and
• London and South East including South London, North Central and East London, North West London and Kent Surrey and Sussex LETBs.

HEE’s board also agreed that the new post of local director would not need to have a clinical background as was originally suggested in a consultation which closed on 4 August.

A paper submitted to the board described a wide range of concerns expressed during the consultation.

It said: “There were concerns that LETBs would be unable to deliver their core functions; that employers would stop engaging and supporting LETBs locally; that the pace of change was too quick, both in terms of timescale but also too soon after the creation of HEE; that local leadership would be insufficient to support LETBs; that the changes were all about centralisation and removing autonomy from LETBs; and that the success of LETBs and HEE in the first year would not be sustainable in the new model.”

But it said no response suggested an alternative approach that would find the required savings.

One consultation response seen by HSJ described the proposals as “disproportionate” with significant risk.

It added: “Any sense that LETB decision making will shift to a geographical office or that approval needs to be gained from elsewhere will seriously erode the support that has been built over the last 18 months.”

A second phase of the reorganisation is set begin this October and will look to save £7m by reviewing the “numbers and type of staff” needed to service LETBs.