David Behan steps up calls for multiyear funding settlement

Sir David Behan set out at HEE’s board meeting this week, and again at a sector conference, that he would like to see a “multiyear settlement for [HEE’s] spending, looking at what we need to do until 2025”.

A government Budget is due on 11 March, and a spending review covering several years is likely later in the year.

Sir David said at the Council of Deans conference this week: “What happens over this next few months will be important — we’ll have a Budget and the spending review will begin. Perhaps there is an opportunity to look at what we need over the next 10 years.”

The September 2019 spending review included a 3.4 per cent real terms increase for HEE in 2020-21, but there is no plan for funding beyond that year, which would be needed to plan properly — and which has been holding up the pending people plan from NHS England and Improvement.

The 2020-21 growth includes £210m, with £60m for the final people plan and £150m for continuing professional development for nurses and allied health professionals.

It is unclear whether NHSE/I would publish the final people plan after the Budget, even if it has only a single-year settlement. It is understood officials believe there are elements of the work which can be delivered with the one-year settlement — such as making the NHS the “best place to work” and a “leadership compact” — but it would be difficult to commit to taking on more trainees without longer-term funding.

Sir David said: “It’s clear we need to turn on all the staffing supply taps if we are to meet the commitment the government has made and increase the nursing workforce by 50,000 by 2025. Further investment in CPD will be key over this next period of time.”

CPD transparency

The budget HEE has to spend on CPD has been cut steadily since 2012 and, in 2017, it fell from £190m to £84m. These cuts have been widely blamed for contributing to NHS staff retention problems.

In his first interview with HSJ after starting the role, Sir David said the removal of money from CPD budgets was spent on increasing the number of nurses, describing it as a “trade-off”.

Sir David said this week: “One of the things I have been surprised by in my 12 months at HEE was the complete absence of transparency about what money is being spent on training, particularly on CPD.”

He also called for a “far more open conversation” about the investments employers are making on developing their own staff.

“What I’m not clear [about] is what trusts are spending themselves on CPD,” Sir David said. “I’m beginning to see more clearly there is an employer responsibility to ensure the registered workforce are undertaking courses to allow them to be revalidated.”