The “incredible imbalance” between the training budgets set aside for nurses and doctors in England has been challenged by workforce and policy experts as they gave evidence to peers during a session on NHS staff morale.
On average, £627,000 of public money is spent on training a specialist doctor, with trainees paying another £100,000 themselves on university fees and living expenses, the House of Lords committee was told by the Nuffield Trust think tank’s director of healthcare systems Candace Imison.
”I can’t see how we can improve and enable the current skills of the workforce against that type of funding cut [to continuing professional development]”
Professor James Buchan
Part of the spending on medics’ training comes from the subsidy paid by the government’s workforce planning body to NHS hospital trusts that host junior doctors after they finish university, she said.
But a far smaller training budget is provided for nurse education, said Ms Imison, noting that from autumn 2017 only around £19,000 would be invested to train each nurse.
She highlighted that from next year nurses would be expected to pay around £60,000 of their own money - for tuition fees and living costs due to bursaries being removed - towards their education, adding: “So you can see this incredible imbalance.”
Speaking at the Lords’ NHS Sustainability Committee yesterday, Ms Imison said there had “not been nearly enough debate” about this disparity.
Candace Imison cutout
Workforce expert Professor James Buchan from Queen Margaret University’s school of health sciences in Edinburgh also raised concerns about inadequate budgets for training nurses, including recent cuts to continuing professional development funding.
He said that budgets allocations were not driven by the future needs of the NHS, which included more team-based working and more care of the elderly.
“Much of the management of care and management of carers [in the future] will have to come from nurses and others in allied health professions working in primary care,” he said.
Retraining acute hospital nurses to work in community roles and supporting nurses to become advanced practitioners would be needed, he added.
But Professor Buchan pointed out that CPD budgets for nurses were being slashed by up to 45% in some areas of England. .
“I can’t see how we can improve and enable the current skills of the workforce against that type of funding cut,” he warned.
The CPD cuts were made following reductions to training budgets by Health Education England earlier this year, which was strongly criticised.
The committee also heard about the wider impact that cuts to NHS spending were having on nurses in England.
Referring to the government’s 1% cap on NHS pay until 2020, Ms Imison said: “As we head into a what looks like a period of extended austerity, I worry enormously about this.”
”Staff have paid the price for austerity. They’ve paid it in terms of real-terms cuts in pay, in extra work they’ve had to take on”
“I think staff have paid the price for austerity. They’ve paid it in terms of real-terms cuts in pay, in extra work they’ve had to take on and they’re facing five more years of it.
“They’re already showing signs of burnout and we’re asking them to do more,” she said.
Ms Imison also highlighted figures showing that that the UK nursing workforce had grown by only 10% since 2004, while across other similarly economically developed countries the numbers had doubled.
Graham Willis, who heads the Department of Health’s workforce analysis research and development team, said two million more full-time equivalent people were expected to be a part of the health and social care system by 2035.
However, many of these people would be carers or in unpaid roles, looking after the elderly, he added.