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Nursing to gain from plans to cut spending on doctors


More money could be spent on nursing education and training under plans revealed by Health Education England.

Speaking to Nursing Times, Jo Lenaghan, director of strategy and workforce planning at the education and training organisation said it would seek to shift parts of its £5bn budget away from medical training to the non-medical workforce.

This will begin over the next two years and will follow the Shape of Caring Review into nurse education being led by Lord Willis this year.

There will also be an increased focus on continuing professional development and reskilling existing staff to create a more flexible workforce.

Her comments came as HEE launched its 15 year strategic framework at the NHS Confederation Conference in Liverpool last week.

She said there had been significantly higher investment in the medical workforce historically adding: “Why did we do that? I can’t get an answer from anyone that that was based on patient need.”

She said in future through the workforce plan investment and numbers of all staff would be considered together as a whole.

“You will start to see a shift in how we distribute resources both across the professions and between staff in existing roles.

“We don’t hold all the levers, we can’t deliver this on our own, but what we do have is a leadership role and we are saying clearly we need to change what we do as a system.”

HEE currently spends around 60 per cent more of its budget on doctors than nursing and allied health professionals with doctors making up 12 per cent of the workforce compared to 40 per cent nurses and AHPs.

Only 5 per cent of its budget is allocated to workforce development.

HEE’s strategic framework, which admits the current approach to workforce planning is not working, will underpin its investment decisions as part of the annual workforce planning process where it decides on the education and training investment across more than 120 different healthcare roles.

Ms Lenaghan said: “It takes over a decade to train a senior medical or nursing member of staff so every time we make an investment we are locking in a pattern of service delivery. The people we send to university in September will still be working in the system in 2060 so our job at HEE, more than any other part of the system, is to live in the future.

“If we commission a whole load of people to work in the acute sector, no matter what NHS England and others say they won’t be able to deliver a community or home based service because the NHS is delivered by people.

“We as a system have not got this right. The workforce plans are based on what employers tell us they need. If we carry on buying the current model of care it simply won’t be fit for purpose in the future.”

She said the NHS needed a more flexible workforce instead of the rigid 67 medical specialties that currently exist and highlighted examples under consideration including women’s surgeons, physician associates, prescribing pharmacists and orthopaedic physicians.

“It’s not that specialism is bad but the way we currently train people forces them to specialise too early and too rigidly to support them in a career up to 2060.”

She said intensive care specialists in the acute sector were a good example of a generalist model that works well adding that HEE would work with Royal Colleges to help create new roles.


Readers' comments (6)

  • What was the point in destroying nursing diploma studies, then? Is there anybody in the Govenrment who thinks 10-20 years ahead? How about growing army of band 4 APs? Will they become obsolete? These changes are too hasty and dangerous, it is more like an experiment that might (and will) fall at some point.

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  • Peter? Meet Paul! We shall be stealing from him to give to you.

    I worked in an area which NEVER had enough medics to fill the existing posts...And that's before we even consider if that was an adequate number of posts.

    Can we make sure that all specialities are adequately staffed with properly trained medics BEFORE starting to remove money from medical training?

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  • It's all an experiment - why do we let them fool us that they have any more idea of what the health needs of the population will be in 2060 than the man on the street. I'm not against strategic planning -but this timescale?

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  • tinkerbell

    More divide and conquer mentality from HEE, if you can alienate everyone you can have them fighting amongst themselves, doing the job for them, meanwhile without enough doctors and nurses the problem remains. We're all being taken for complete idiots.

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  • You are right tinkerbell.
    Divide and conquer, let us fight amongst ourselves in the meanwhile they push through their own agenda.
    Just imagine if nurses and doctors join together what a strong fort that will be.
    Now if Lead Nurses and Consultants work together for top standards in Care then we will start to see the tide of change.
    I will like very much for doctors and nurses to have a more closer tie in patient care.

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  • tinkerbell

    Anonymous | 5-Jun-2014 9:03 am

    Exactly, the drs I work with are my colleagues, experiencing the same strain and drain. United we stand, divided we fall, we all should have the same aim, to support one another and our patients. We should not be a divided house squabbling amongst ourselves whilst Rome burns.

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