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Plans approved for major reconfiguration of local health education

Controversial plans to restructure a national body responsible for overseeing NHS training have been approved, despite concerns they could dilute nursing expertise and hamper efforts to get the profession’s workforce back on its feet.

The proposals drawn up by Health Education England will see management posts slashed within its 13 regional offices – known as Local Education and Training Boards (LETBs) – in a bid to cut costs by 20%.

It includes scrapping the LETB’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.

LETBs will also lose their managing directors and finance directors, as part of a plan to save the education board £17m in running costs by next March. Health Education England approved the proposals last week.

The plans have sparked fears that Health Education England has a centralisation agenda as it seeks to create a “one HEE” approach to its £5bn role to train the healthcare workforce.

As previously reported by Nursing Times, the move has also 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.

In addition, there have been warnings it could 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 changes approved by the Health Education England board last Thursday included the creation of four new national directors who will be responsible for geographical regions in England.

Each area will also have heads of finance and directors of education and quality. These new area directors will oversee the work of LETBs, which will be run by the new local directors.

Each LETB will continue to have a postgraduate dean who will be accountable to the director of education and quality.

The four new directors will cover:

  • North including North West, North East and Yorkshire and Humber LETBs;
  • South including South West, Wessex and Thames Valley LETBs;
  • Midlands and East covering East of England, East Midlands and West Midlands LETBs; and
  • London and South East including South London, North Central and East London, North West London and Kent Surrey and Sussex LETBs.

A paper submitted to the board described a wide range of concerns expressed during the consultation. But it said no response suggested an alternative approach that would find the required savings.

A second phase of the reorganisation is set begin this October and will look to save £7m by reviewing the “numbers and type of staff” needed to service LETBs.

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