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Local health education cuts spark fears for nurse training

Plans to restructure a national body responsible for overseeing NHS training could dilute nursing expertise and hamper efforts to get the profession’s workforce back on its feet, it has been warned.

Proposals drawn up by Health Education England would see management posts slashed within its 13 regional offices – known as Local Education and Training Boards – in a bid to cut costs by 20%.

This includes scrapping the board’s directors of education and quality, who play a key role in deciding local training arrangements for nursing. The education and training of nurses and other health professionals will be the responsibility of the postgraduate dean – a role traditionally associated with the training of doctors.

“There is a risk that the voice on education for nurses and allied health professionals will be diminished in the new structures”

Jessica Corner

The move has prompted concern that much-needed expertise and focus on training more nurses could be lost at a time when trusts are struggling with nursing staff shortages.

It could also perpetuate the idea of a long-standing imbalance in favour of the attention and resources given to the training of doctors, compared to nurses and other non-medical healthcare workers.

The Royal College of Nursing stressed the need to ensure a balanced approach to healthcare education planning that recognised the vital role of nursing.

“We have raised concerns about the need to have a balance in developing workforce planning for a multi-professional workforce alongside recognising the unique contribution each of the professions make to patient outcomes,” said Stephanie Aiken, the RCN’s assistant head of nursing for education, training and development.

“Nursing is the largest part of the healthcare labour market but that doesn’t always seem to be understood,” she said.

She told Nursing Times there was a risk the new structure could “maintain the status quo” of the historic disparity between medical and non-medical professionals.

“Nursing is the largest part of the healthcare labour market but that doesn’t always seem to be understood”

Stephanie Aiken

It was, therefore, vital any new structure drew upon nursing expertise and also acknowledged the fact the many nurses work outside the NHS, she added.

“If you don’t have that focus and understanding, then it makes it much more difficult to understand the future needs of the service and the education and training required to meet those needs,” said Ms Aiken.

The Council of Deans of Health also raised similar concerns.

“We understand Health Education England needs to reduce costs and streamline some of the commissioning and back office functions,” said Dame Jessica Corner, the council’s new chair and dean of the faculty of health sciences at the University of Southampton.

Jessica Corner

“But I am worried some of the great local partnership working that we have worked hard to build over the last year between trusts, universities and LETBs may be undermined in another re-organisation,” she warned.

“There is also a risk that the voice on education for nurses and allied health professionals will be diminished in the new structures,” she told Nursing Times.

A spokeswoman for Health Education England confirmed the role of postgraduate dean would be intended to cover all healthcare professions under the restructuring plans, but stressed that the powers and responsibilities of LETBs would stay the same.  

“The dean’s role is and will continue to be multi-professional and not just medical,” she said. “As the consultation also makes clear, we will continue to ensure a multi-disciplinary workforce focus.

“Deans will work across the spectrum of health and, where relevant, social care, supported by a team of associates and operational staff so the provision of education reflects changing service models and delivers and an integrated workforce,” she said.

The proposed new structure also includes the creation of four regional directors for education and quality, and a national director for education and quality.

Under the plans, the postgraduate deans would become accountable to these directors at Health Education England, which has also sparked concerns at some LETBs of a loss of local influence on education and training.

The Realising Our Potential restructure plans come little more than a year after Health Education England took up its responsibilities in April 2013.

Readers' comments (3)

  • Strange that HEE say the Post Graduate Dean's role is multi professional. That may be true in some LETBS but in many that means medicine plus dental and pharmacy . In most LETBs nursing is not in any way part of the PG Dean role.

    Currently Deans in LETBs report to DEQs who have the overall professional education oversight, including Nursing and Midwifery however these roles are being abolished.

    Given the GMC requires a medical practitioner to be the responsible officer for doctors in training, it seems likely that the Deans will be medics and focus on their responsibility for junior doctors. There is no word from HEE about how nursing workforce development will be safeguarded and we are going back to Medical (the smallest part of the workforce) and Non Medical (everyone else- who clearly don't need have role specific strategies as medics do).

    A backward step indeed

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  • michael stone

    I think it would be quite good, if they manage to actually achieve:

    '... so the provision of education reflects changing service models and delivers (and) an integrated workforce'.

    I'm not saying that this will achieve that, I have no idea - this might be a simple combination of post-Francis 'criticism' [that 'something 'must be wrong' with nurse training], combined with 'we need to save some money'. I don't really understand how clinical education works - I've sent some recent e-mails to try and find out at what stage, medics acquire their knowledge of law (as opposed to of medical ethics).

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  • I am assuming that the dean does not work on his/her own and that there is a whole staff of people. I makes spence to have all of health and social care in one faculty. Perhaps then we can change the us and them attitude and starts to work as properly allied proffessions who understand each other's role. This is not necessarily a negative move.

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