Health Education England ‘People are the neglected area of reform’ Focus On Education Commissioning Chris Jeffries HEE Finance Transition lead

Health Education England “ HEE will provide leadership for the new education and training system. It will ensure that the shape and skills of the future health and public health workforce evolves to sustain high quality outcomes for patients in the face of demographic and technological change” “HEE will ensure that the workforce has the right skills, behaviours and training and is available in the right numbers, to support the delivery of excellent healthcare and drive improvement. HEE will support healthcare providers and clinicians to take greater responsibility for planning and commissioning education and training through development of the Local Education and Training Boards (LETBs) which are statutory committees of HEE”

Drivers for change

The only reason HEE exists is to ensure high quality care is delivered to patients Success criteria Improvements in safety Improvements in experience Improvements in clinical outcomes Innovation Outcomes

There will be 13 LETBs LETBs operating in shadow form, with delegated authority from current SHA. All on schedule to submit their Draft Investment Plans to HEE by 30 September 2012 Authorisation Criteria and Process developed in co-operation with LETBs to be published July 2012 The new landscape - LETBs

LETB responsibilities Producing annual workforce plans to ensure the demand for the local healthcare workforce is identified in line with local and national priorities Producing annual education and training plans to ensure supply of the local healthcare workforce is in line with local and national priorities Holding and allocating funding for education and training Commissioning high quality, good value education and training in line with professional needs and the Education Outcomes Framework Securing partnerships with clinicians, local authorities, health and well-being boards, universities, commissioners, etc.

LETB Operating Principles LETBs are provider led bodies which act as sub-committees of HEE under the following key operating principles: Local Decision Making Inclusive Approach of Providers – all providers of NHS funded services not just NHS organisations Good Governance and Sound Financial Management Stakeholder Engagement & Partnership Working – strengthening presence of primary care Quality and Value – Year on Year Improvement Security of Supply - sustainability Accountability & Transparency – to its stakeholders and HEE

How HEE will work with LETBs HEE will not be a regulator breathing down the neck of LETBs HEE will focus on ‘what’ needs to be delivered. LETBs will focus on ‘how’ this will happen locally HEE will agree national objectives, LETBs will have delegated resource to get on with it A distributed model of leadership

Future scope of MPET Future workforce funding – to support the direct training of the future workforce; Workforce Development Funding –flexible funding provided to LETBs to support innovation, quality improvement and local priorities; Education support – funding provided for the costs of supporting education and training; Management costs – funding for the management and administrative costs of the system; National Activity Funding – including nationally commissioned activities, and hosted allocations.

Tariff development Undergraduate medical placements in secondary care and non medical placements Tariffs have been developed based on the costing exercise undertaken in 2009, uplifted to reflect current activity and prices. DH have worked closely with a transition group, including representatives from NHS providers of education to develop an appropriate transition policy to ensure providers are not destabilised during implementation. SHAs are agreeing transition plans with providers by 5 October so that tariffs for these areas can be implemented from 2013/14

Tariff development Postgraduate medical education in secondary care An evaluation has been undertaken with strategic health authorities and their providers on the proposed move to a tariff based approach for postgraduate medical education in secondary care. These proposals provide a tariff based on 50% salary support and a clinical placement rate. A further validation exercise is currently being undertaken by SHAs and a transition policy being developed. Subject to the outcomes of this, a decision will be taken in November on when to implement these tariffs.

Tariff development Undergraduate and postgraduate medical education in primary care A reference group has been set up by DH to take forward the development of primary care tariffs, including representation from the service and professions. This group has developed costing methodologies to be used to develop tariffs for primary care, which are being tested. Given the complexities in this area, it is expected that tariffs would be implemented in 2014 at the earliest

Tariff development Longer-term reference costing To ensure that education and training tariffs reflect the true cost of training and remain current a longer-term reference costing approach will be introduced. This costing process will be undertaken alongside service reference costing to ensure that the interplay between service and education and training is clearly identified. Reference costs working group, comprising education and costing experts from the NHS. This group has developed a methodology for costing education and training which is currently being tested through a small-scale cost collection. SHAs have been asked to identify further providers to undertake a cost collection during the second stage of testing. First reference cost collection for education & training will be undertaken in 2014 to inform 2016/17 tariffs.

It’s a balancing act

It’s your workforce Higher provider involvement and engagement Improving local workforce planning including medical and dental Greater responsibility for education quality Better planning for placements Taking responsibility for the workforce and education agenda

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