Trusts’ budgets will be top-sliced to fund a “quality premium” for organisations providing high quality training for NHS staff, under a proposal in a government-commissioned report.

The recommendation is contained in the education and training report published by the NHS Future Forum today alongside three other papers on information, public health and integration.

All four reports have been accepted by the Department of Health.

The forum wants Health Education England – being established in shadow form this October to allocate training money – to consider developing the quality premium to “reward excellence in training”.

This should build on plans being developed by the Department of Health to develop a commissioning for quality and innovation (CQUIN) payment for education, it says.

It could be achieved by allowing local education and training boards (LETBs) – groups of providers being set up to distribute funds locally – to top-slice NHS providers’ training budgets.

According to the forum, this money would be released when organisations have demonstrated, using metrics including patient and trainee experience measures, that they deliver high quality training.

Forum chair Steve Field told HSJ it would be up to the LETB to decide whether the money should be released or not as “the more control locally we have the better”.

The forum’s report also raises the prospect of many of the shadow LETBs already forming across the country failing to meet authorisation criteria next April unless they change their governance structures. This is because it says that, under “good governance principles”, LETBs should have an independent chair.

The vast majority of emerging LETBs are chaired by an acute hospital chief executive from the region in which the LETB is based, information obtained by HSJ reveals.

There are fears that teaching hospital chiefs sitting on LETB boards would face conflict of interest issues. These concerns are likely to be heightened if LETBs were also able to decide which trusts to award with a quality premium.

Details on the future shape of LETBs were due last autumn but are yet to be published, leaving trusts and strategic health authorities to forge ahead with little guidance.

The forum has therefore urged the DH to produce guidance to “avoid the risk of planning in a vacuum” and “ensure rapid establishment of the LETBs”.

The report also says not all organisations, employers or practices should provide training. Instead, organisations should be “accredited” to provide education and supervision to a sufficient standard in order to accept trainees, it says.

But NHS Employers director Dean Royles said there was a need to “avoid a one-size-fits-all model”.

He added: “”Building early confidence in the new system is essential. Employers will want to see that HEE as well as local LETBs are seen to be driven by patient need and employer demand. If this is the case, employers will relish the opportunity for increased involvement.”

Future Forum recommendations on education and training:

Quality premium for trusts to reward high quality training

LETBs to demonstrate good governance and to have sufficient flexibility

LETBs to agree minimum percentage of funding to support continuing professional development

Not all trusts should provide training

CCGs should only commission from providers able to prove that high quality education and training are “at the heart of their service”

Variations in quality of nurse training to be addressed

Regulation of public health specialists

Employers to have greater role in selection of undergraduate students