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Written Statement - Response to the Health Professional Education Investment Review

Mark Drakeford, Minister for Health and Social Services

A well-educated and trained NHS workforce is essential to providing high-quality care to people across Wales and improving standards in our health service.
 
On April 14, the Health Professionals Education Investment (HPEI) review, led by Mel Evans OBE, was published. It was commissioned by the Welsh Government to consider the investment in health professional education and whether it is delivering the right results for Wales and our health service.
 
The review acted as a catalyst to discuss key issues relating to the education and training of the healthcare workforce. I reconvened the review panel in the summer to consider the 70-plus contributions received after the review’s publication. This work has now been concluded.


The panel made three key recommendations:

  • The need for a refreshed strategic vision for NHS Wales for 2015-30, based on prudent healthcare, which should inform the strategy for the workforce;
  • The development of NHS Wales’ learning culture;
  • The creation of a single body for workforce planning, development and commissioning of education and training.


Together for Health has been our over-arching strategy but we must now build on this work, embed the prudent healthcare principles and deliver for a technology-enabled generation, in which health and social care integration is the norm rather than the exception and where community-based care is the hospital of the future.

The HPEI review highlighted that the vast majority of NHS Wales’ future workforce is already working in the health service today. If we want high-quality healthcare we have to invest in our workforce – we must provide opportunities for healthcare professionals to develop the skills, knowledge and experience they need while they are providing healthcare. The NHS must be a learning organisation, as well as a health service.

Workforce design and development is among the most powerful levers we possess in creating a prudent healthcare system. It will require a greater degree of flexibility in terms of education and training, with step-on and step-off options across a broad range of programmes. During the coming year we will work with the education sector to establish greater flexibility in existing education and training programmes.

The review focuses on the importance of having the right learning culture and providing young people with greater awareness of the full range of career opportunities available in Wales. It also highlights the need to increase the availability of work experience for those interested in entering the care sector.
 
There are some excellent schemes in areas across Wales but to drive this work forward we must map the current range of careers; widen access events and initiatives across Wales and establish a mechanism to promote these opportunities.

More than 10,000 students and trainees benefit from centrally-funded programmes in Wales. We will consider how they can contribute to this learning culture as part of their education and training programmes. This work will be brought together through a national conference on widening access to careers in health which will be hosted by the Welsh Government next year.

The final key recommendation – a single body bringing together the functions of strategic workforce planning, development and commissioning of education and training – will help to address the difficulties many individuals and organisations agree exist within the current healthcare training and education arrangements.
 
I believe there is a need for change, underpinned by a single flexible, funding stream, freed from arbitrary and historical boundaries. A new single set of arrangements will ensure investment and planning decisions are not taken about individual professions in isolation – there are considerable interdependencies across professions. Decisions about education and training must be based on the needs of patients and local populations and a holistic approach to the workforce.

However, if we are to move to a new set of arrangements a clear model of implementation will be needed to deliver against Wales’ priorities. As acknowledged by the review panel, further work is needed to properly scope this model, including its costs and benefits, before a final decision can be made about timescales for implementation.

This work will be led by an individual, supported by the Welsh Government. A stakeholder reference group will be set up to guide this work and act as a critical friend as it progresses. I want this work to be completed within six months and expect organisations to work together to establish the best arrangements possible for Wales.

In the interim, and in parallel to taking this work forward, I expect all organisations involved in workforce planning, organisational design and education commissioning to work more strategically and collaboratively. I also want to see substantial progress in securing greater transparency and accountability over the coming year, including in relation to the level and nature of the investment made by individual NHS organisations across Wales.

The HPEI review was asked to consider whether incentive-based schemes would help to recruit and retain healthcare professionals to and in Wales. The review concluded that the main lever for attracting professionals to the NHS in Wales is the working-learning experience and the environments they will work.
 
However, there are some specialties and areas where Wales – in common with the rest of the UK – is experiencing recruitment difficulties. The panel considered that an approach, which saw a period of service tied into the funding of training programmes, would be a welcome step forward.

In light of this, we will realign the investment we make in medical education so a greater share is provided to those who commit themselves to the NHS in Wales. Further details will be announced in light of Sir Ian Diamond’s review of student finance arrangements in Wales.

This statement has focused on the review’s key recommendations. The HPEI review makes many more, including the need to adopt a multidisciplinary approach to training and to increase exposure to care provided in community as part of that training.
 
These recommendations are already informing our primary care workforce plan, which will be republished this week following a period of engagement with stakeholders. It also highlights the importance of reconsidering the existing funding mechanisms for education in Wales, including the current SIFT funding model and potential incentives.
 
I would like to thank the members of the HPEI panel – Mel Evans, Professor Ceri Phillips, Dick Roberts and Dr David Salter – for all their hard work. The review has provided a platform for debate about important issues relating to education and training of healthcare professionals in Wales.

There is significant support for change – the ideas for change have been discussed extensively; now they must be properly modelled and evaluated, to ensure we have the best possible arrangements in place to educate and train our NHS workforce of the future.