Sir David Behan: HEE needs to be clearer about its purpose

In his first interview as chair of HEE, Sir David said the arm’s-length body needed to “focus and concentrate” on “settl[ing] the issue about its purpose”.

Sir David, who was chief executive of the Care Quality Commission from 2012 to 2018, said this was the “most important” piece of work he did at the watchdog, adding: “When I went to CQC, I had gone to an organisation that was broken and needing fixing.”

However, he added: “I don’t think HEE is in that position; it isn’t broken.”

He acknowledged provider trust chief executives hold animosity towards HEE and some had told him HEE “feels too remote for them as an employer”. 

Although employers talk “positively” about their relationship with local HEE teams, Sir David noted there is “too much variety in the quality of those relationships”. He said HEE must have closer relationships with employers. 

However, he stressed that HEE’s role must not only be to listen to employers as to what workforce they need now and in the future, but also take on a “strategic perspective about how science and technology will impact on care pathways”.

Sir David said he has been surprised at how “fragmented” the world of education and training is and how many organisations have a stake in the future and current workforce.

He added: “The only way is to collaborate with those organisations, to work with them… You’re not going to get one organisation that controls the lever and you can’t create one organisation that meets every aspect of health and care.”

Sir David stressed it was critical for HEE to work with NHS Improvement and NHS England to ensure the workforce implementation plan is delivered. 

“HEE staff have been equal contributors to the development of that work,” he said. “I don’t think we feel like second class citizens in that at all.”

As well as needing to do something about the fragmentation of workforce development, Sir David said the “other fragmentation which has been critical is the separation of service planning, workforce planning and financial planning”. He called for collaboration between arm’s-length bodies, universities and employers.

“It doesn’t make sense to me,” he said. “My commitment is to address [fragmentation]. Securing the future workforce is too important to let this fragmentation continue.”

Sir David also set out the advantage for having HEE as an independent statutory body with its own budget. 

“In any industry, there is always a temptation to raid the training budget to balance other budgets,” he said. “If you look at the history of the NHS, there is evidence that is what happened.”

He also said trusts are often concerned with immediate and urgent issues but HEE can take a strategic view. 

Sir David emphasised the importance of HEE’s relationship with NHS Improvement. He said he sits on the regulator’s board as a non-executive director and there would be “reciprocal arrangement” which was a “symbol of beginning to work in a stronger way between NHSI and HEE”.

It was revealed in October last year that HEE was to become accountable to NHSI. A statement released at the time said the two organisations “would work more closely together to ensure the national workforce system is well aligned”.