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Written Statement - Health Education and Improvement Wales Transition Update

Vaughan Gething, Cabinet Secretary for Health, Wellbeing and Sport
In 2014, the Welsh Government commissioned a review of investment in health professional education and workforce development. That review was led by Mel Evans who subsequently published a report in 2015 which made a number of recommendations – one of which was to establish a single body for the commissioning, planning, and development of education and training for the NHS workforce in Wales. Mark Drakeford, AM, the then Minister for Health and Social Services  accepted that recommendation but determined further work was required to scope out detailed proposals for the new single body. Professor Robin Williams, CBE agreed to take this work forward. This report was published in November 2016.  I confirmed the new organisation would be established by April 2018.  

The reports which informed this work – the Evans and Williams Reports – considered a wide range of activity associated with the workforce planning and resourcing agenda. While there are a number of organisations across Wales which are involved in the current arrangements, there are two main organisations - NHS Wales’ Workforce, Education and Development Services (WEDS) and the Deanery within Cardiff University which undertake a large proportion of the work that the new body will be expected to take forward.  The move to a single organisation will create opportunities to build on the strengths of both the Deanery and WEDS, whilst learning from elsewhere. The approach will:

• Simplify and streamline structures and processes to strengthen collaboration across agencies, ensuring efficiency and cost-effectiveness;
• Develop a coherent and focused organisational approach that can drive forward all-Wales approaches;
• Remove artificial barriers – structurally and financially; and
• Optimise the value of the investment made in health education and training in Wales

Over the past six months, the Welsh Government has been working with the key organisations involved, as well as the wider sector, to scope out the new body and the details of how it will operate. I am now able to update Members on the decisions I have taken to date as a consequence of these ongoing discussions.

Firstly, to reflect the role of the new organisation I have decided it will be called Health Education and Improvement Wales (HEIW).

There remains much work to be done between now and April 2018, but I am confident, with the commitment of partners, HEIW will be in a position to make a positive impact in Wales from next year and to play its part in delivering better outcomes for patients.

Functions and remit

In his report, Robin Williams set out a minimum set of functions for the new body.  These were:

• strategic workforce planning – providing clarity about how national and local processes will work together;
• education commissioning – for all aspects of the workforce, working with NHS organisations to ensure education and training resources at a national and local level are focused on strategic priorities – to include both undergraduate and post graduate education and training;
• organisational role design – identifying roles required within the NHS to address changes in workforce models and changes in delivery of care; and
• NHS Careers – working with key organisations to ensure promotion of the full range of NHS careers.

In addition, I can confirm HEIW will also be responsible for providing a strategic approach for the widening access agenda - to identify and implement a range of opportunities for individuals of all ages to access the appropriate programmes, whether academic or vocational to pursue an NHS career. HEIW will ensure mechanisms are in place to promote awareness of potential NHS careers, co-ordinated work experience programmes, apprenticeship opportunities and an increased number of flexible training routes.

To underpin this work, HEIW will require an enhanced workforce intelligence function which will build on the current workforce modelling capacity, currently available within WEDS.

I have agreed that these will be core functions of HEIW.   However, I am persuaded that the bringing together of WEDS and the Deanery in to a new, strategic body is a unique opportunity to do more.

HEIW will provide leadership across a range of important areas. This will include setting the agenda in terms of senior level development ensuring our leaders, clinical and non-clinical, of the future are identified and supported to ensure they have the skills, knowledge and experience to address the challenges they will face as part of a Team Wales approach to delivering a sustainable health care system within Wales. This will mean working collaboratively with others for example Academi Wales to reimagine the offer we make across Wales through our NHS Graduate Programme.

Some individuals have suggested HEIW could take up wider responsibilities for the ongoing development of health care professionals, perhaps even leading a national approach to continuous professional development. While I understand this proposal, it is important health boards lead on the development of their staff.  HEIW will set national expectations for the professional development of staff, but the leadership of Continuing Professional Development for professional staff will remain with health boards and trusts. However I want to ensure HEIW has the capacity and capability to develop and deliver training.

The creation of HEIW will represent a new strategic approach to developing the Welsh health workforce for now and for the future. It will, of course, need the right resources to be successful. For example, that means bringing together within HEIW the funds we use to support the placement of medical and dental undergraduates (SIFT) and the bursaries we offer to those in training, such as student nurses.  It will also mean drawing together in HEIW those who are currently undertaking similar functions in other bodies.  For example, work is currently underway to consider whether elements of the Welsh Centre for Pharmacy Professional Education (WCPPE), Welsh Postgraduate Education Centre for Optometry (WOPEC) and the NHS Liaison Unit should sit within HEIW under the new arrangements. .
In addition, the creation of HEIW provides us with an opportunity to co-ordinate our pan-Wales work on improvement in health services, and I will expect the new organisation to work with 1,000 Lives Improvement and NHS Wales organisations to bring a more strategic focus to work in improvement.  

HEIW will provide professional advice to the Welsh Government on issues related to its functions.

Finally, I will expect HEIW to work closely with Social Care Wales in relevant areas of its work to develop an integrated view of workforce needs now and in the future across both health and social care. This will include continuing support and development of shared career opportunities for workers across both sectors.

Governance

The Welsh Government will establish HEIW as a Special Health Authority using powers set out in the National Health Services (Wales) Act 2006. I will bring forward legislation to achieve this in two stages, beginning with an order and regulations over the coming months to allow us to proceed with the recruitment of the independent board that will oversee the work of HEIW.
The Welsh Government will begin the recruitment process for the Board members and for the new Chief Executive in the autumn. This will allow governance arrangements to be established in advance of the new organisation beginning its work.

Given the importance of these changes, and the timescales ahead, I have decided to appoint Dr Chris Jones as the interim Chair from 1 October, to guide the transition to HEIW, subject to the will of the National Assembly in relation to the legislation necessary for HEIW’s establishment. Chris’ appointment will ensure that HEIW has clear leadership as it is developed. He brings with him a wealth of experience, not least from his successful role as Chair of Cwm Taf University Health Board, which will come to an end at the end of September. Between now and the formal creation of HEIW, Chris will sit as a member of the Programme Board that is managing the transition, chaired by the Welsh Government’s Director of Workforce and Organisational Development in the department of health and social services. As a member of that board, Chris will sit alongside members with a range of expertise, including representatives of Chief Executives of NHS Wales and the employers of the affected organisations.

The appointment of Chris reflects the importance I place on the year ahead as we establish HEIW and its place within the NHS in Wales. Chris’ experience within the NHS will be key to this latter point, shaping the new relationships between HEIW and the boards and trusts of NHS Wales. HEIW will of course need longer-term leadership.  I will therefore undertake a full public appointments process to ensure the appointment of a permanent Chair prior to the end of September 2018.

People

My top priority over the period ahead will be for the Welsh Government to work with the staff affected by the transition to HEIW to ensure that any changes are understood and handled sensitively. However, there will be changes for some and I want to ensure those changes are done with staff, not to them. Of course, staff can be reassured by the protections offered through the Transfer of Undertakings (Protection of Employment) Regulations and we will work with them and their trade unions throughout the process.

One of the most important such changes will be where people work. I am committed to HEIW becoming a truly Wales-wide organisation, working with education providers and the health sector across the country. However, I am also aware of the current locations of the staff that will be brought together to create HEIW - most are in Cardiff or Nantgarw. These staff will be critical as we shape the new organisation and therefore I have decided that the main location for HEIW should be within the south-east Wales footprint. I will announce the location in the autumn of this year.

Part of NHS Wales

The new organisation will be a new body in the NHS Wales family, playing its role alongside health boards and trusts on the NHS Wales Executive Team.  The staff will be NHS employees and where possible all systems and processes will be those of NHS Wales. HEIW will utilise the significant success of the Shared Services approach alongside the rest of NHS Wales.  

HEIW, working alongside other health bodies in Wales, can deliver a step change in our support for professionals. By removing artificial barriers, HEIW can take further the culture of collaboration across the health sector in Wales, ensuring the priority for all our work remains the well-being of patients.

The transition, of course, cannot be allowed to disrupt the excellent work being done across Wales to recruit, train and develop our professionals. I will expect no decrease in the strong results achieved this year.

Consultation

I believe this statement takes us a significant stage forward in the transition towards HEIW. However, there remains much to do and to consider between now and April 2018. The creation of the new organisation will only be a success if the sector works together to deliver it. I am pleased that a programme board with membership from across the sector is overseeing the transition, supported by dedicated workstreams that bring expertise together to tackle important areas such as organisational development, governance and finance. These arrangements, alongside the important stakeholder events being put together by my officials, should ensure people know what is happening and how to contribute to the process.

In line with the recommendation from the recent Medical Recruitment Report by the Health, Social Care and Sport Committee, I will publish an action plan and timeline for the creation of HEIW in September this year. I will then issue a consultation later this year on our detailed proposals for HEIW.

Contacts

The Welsh Government transition team can be reached at:

HEIW@wales.gsi.gov.uk