Money, Medical Education and Beyond Diana Hamilton-Fairley Joint Director of Education and Quality Health Education South London

The Health and Care System from April 2013

Translation Department of Health NHS England CCGs Health and Wellbeing boards Public Health England NHS Trust Development Authority Health Education England LETBs (HELocal) AHSNs HEIs Health Education Providers Health Watch England Health Watch Local NICE/ NIHR

ONE HEE Health Education England and LETBs National Exec committee Geographical MD, DEQ and HoF x4 Total of 13 LETBs Not Statutory Bodies Provider led Stakeholder representation Core leadership of: Local Director Independent Chair Deaneries part of LETBs North ONE HEE Midlands & East South London & South East

The Workforce Challenge Delivering value based healthcare Aligned with… the needs of the population service commissioning the AHSN Delivering primary healthcare: now more than ever! (WHO 2008)

Value based healthcare Single discipline to inter-professional models Focus on care across a continuum for patients Align educational financial incentives so that focus is on educational quality outcomes not transactions

Education Outcomes Framework Excellent education Competent and capable staff Adaptable and flexible workforce NHS values and behaviours Widening participation : Education and training is commissioned and provided to the highest standards, ensuring learners have an excellent experience and that all elements of education and training are delivered in a safe environement for patients, staff and learners. There are sufficient health staff educated and trained, aligned to service and changing care needs, to ensure that people are cared for by staff who are properly indcuted, trained and qualified, who have the required knowledge and skills to do the jobs the service needs, whilst working effectively in a team. The workforce is educated to be responsive to innovation and new technologies with knowledge about best practice, research and innovation, that promotes adoption and dissemination of better quality service delivery to reduce variability and poor practice. Healthcare staff have the necessary compassion, values and behaviours to provide person centred care and enhance the quality of the patient experience through education, training and regular Continuing Personal and Professional Development (CPPD), that instils respect for patients. : Talent and leadership flourishes free from discrimination with fair opportunities to progress and everyone can participate to fulfil their potential, recognising individual as well as group differences, treating people as individuals, and placing positive value on diversity in the workforce and there are opportunities to progress across the five leadership framework domains.

Using or losing the Tariff Medical Undergraduate 40K p.a.per student for clinical placements £520 per week per student after 30% on costs (varies by trust) Medical postgraduate 50% basic salary for HEE (Deanery) funded posts Trust pays 50% plus New Deal banding 12K educational tariff which includes PGME department and study leave SENIOR EDUCATIONAL LEAD NEEDS TO BE IN CHARGE STEP 1 Meet Finance Director and get full breakdown of Medical Education income Establish how they calculate the cost for each placement (they should have done a return to DH on clinical placement cost and you should have been involved!!) Establish how the money is currently spent in the Trust and who by.

Using or losing the Tariff STEP 2 On current expenditure what is a fixed cost Pay Non-pay Capital / fixed assets What is a flexible cost Study leave Room Rental costs

Using or losing the tariff STEP 3 Consider the agenda for Changes to Foundation Training Increased Community Placements Opportunities for improving education Facilities Faculty Development Specialty based education Leadership and Management Quality Improvement Simulation including Inter-professional / Human Factors training Public Health and Mental Health / Acute Health Training High Quality GP training

Using or losing the tariff Step 4 – Convincing the Finance Director! The money for education now needs to be transparent and audited for HEE Risk of losing it if education not seen to be important in the organisation Responsible Director on the Board Investment in educational facilities and material Investment in Clinical and Educational supervisors / specialty faculty leads If educational quality is poor; Decommissioning of training in specialties towards General Practice leading to loss of Junior Doctors and associated income will be based on quality Need good feedback from students and trainees

Whole new ball game! Summary The Tariff is transparent The current spending is opaque The opportunities to make a difference are big and exciting The Trust is obliged to change You can make the difference between same old, same old and a Whole new ball game!

Thank you