The influence of smaller trusts and the independent scrutiny of NHS education and training could be undermined by government reforms, HSJ has learned.
Local education and training boards will be formed by groups of NHS trusts. The boards are due to take over the £5bn multiprofessional education and training budget from strategic health authorities in April 2013 and will be overseen by Health Education England.
In response to fears raised by the NHS Future Forum’s first report in June, the Department of Health said it would develop a “careful transition process on education and training, to avoid instability”. Further proposals due this autumn have not arrived.
But in the absence of guidance, trusts have already started to form widely varying boards, most of them based on SHA boundaries.
London is forming three local boards but this could increase to five or more. HSJ understands questions are being raised as to how London’s large deanery could feasibly be split into so many bodies while retaining economies of scale.
The DH has not dictated how many boards there should be, but its director of workforce development Jamie Rentoul told MPs two weeks ago there would probably be 10-15 – similar to the number of deaneries.
It is thought likely the boards will mainly form around the 14-18 new academic and health science networks described in the DH’s Innovation, Health and Wealth report this week.
NHS East Midlands deanery director David Sowden told HSJ some boards would be “very chunky”, potentially reducing the influence of smaller trusts.
“I would struggle to have a meaningful relationship with 30 chief executives,” he said.
He was concerned trusts were already “halfway down the field” and if the DH forced them to drastically change their models the timescale for transferring SHA and deanery staff would be “squeezed”.
“We need to know [the policy] by late January to make our social enterprise workable,” he said.
There is also a fear that some local boards are incorporating deaneries, reducing external scrutiny of their spending decisions and increasing the risk of conflicts of interest arising.
A letter from the Academy of Medical Royal Colleges and the Conference of Postgraduate Medical Deans to health secretary Andrew Lansley on 25 November, seen by HSJ, warned deans “must” be able to move trainees away from organisations failing to meet standards.
HSJ understands HEE senior responsible officer Chris Outram is meeting representatives from the four SHA clusters in the next fortnight. The DH is waiting for the NHS Future Forum’s second report, expected next month, before announcing further policy details.