Health Professional Education Investment – Report on the Single Set of Arrangements

Professor Robin Williams CBE, FRS

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  1. In a statement made on 3 November 2015, setting out the Welsh Government response to the Health Professional Education Review, the Minister for Health and Social Services stated if we want high quality healthcare we have to invest in our workforce, providing opportunities for healthcare professionals to develop the skills, knowledge and experience they need whilst they are providing healthcare. Workforce design and development is among the most powerful levers we possess in creating a prudent healthcare system. This will require a greater degree of flexibility in terms of education and training.
  2. Traditionally professionals have been trained and developed to work in a system which is primarily based on hospital-based care, whereas the majority of current and future demands for health and social care arise from an increasing elderly population with co-morbidities, whose needs require multi-skilled staff working in an integrated environment across professional and organisational boundaries.
  3. For this reason the Minister for Health and Social Services commissioned a review, in August 2014, into the way in which the Welsh Government currently invests in the planning, development and commissioning of health professional education and workforce development in Wales.
  4. The review was undertaken by an independent panel chaired by Mel Evans OBE, previously chair of Powys Teaching Health Board. It considered the commissioning arrangements and models of operation and systems in other countries, as well as discussions with stakeholders involved in the commissioning and provision of education and training. Its key aim was to ensure it leads to an environment within Wales which builds a culture that supports learning in the working environment.
  5. The general consensus amongst these stakeholders was that the current system and configuration of commissioning and delivering education and training programmes within Wales was unduly complex, not well aligned with policy direction, not meeting the needs of the service, relatively inefficient and required fundamental overhaul. The panel’s report was published in April 2015 with the following recommendations:
    1. the need for a clear, refreshed strategic vision for NHS Wales for 2015-2030, based on the prudent healthcare agenda and which should inform the strategy for the workforce within the same period
    2. a single body for workforce planning, development and commissioning of education and training must be established
    3. the NHS in Wales should be the vehicle for developing Wales as a learning culture.
  6. The Minister for Health and Social Services broadly supported the recommendations but wanted to give individuals an opportunity to comment on the panel’s report and to provide feedback on a number of key areas regarding implementation. A six week period of engagement therefore commenced on 25 May 2015.
  7. The Minister for Health and Social Services agreed the need for change and accepted the report’s recommendations. In the case of the recommendation for a single body, however, he requested further work be carried out, stating a single body would need to be underpinned by a single flexible funding stream, freed from arbitrary and historical boundaries. It would need to bring together the functions of strategic workforce planning, development and commissioning of education and training, which would help address the difficulties many individuals and organisations agree exist within the current healthcare training and education arrangements.
  8. I was asked to take this work forward to scope the new model, including its benefits and costs. I have been supported by specialists who have knowledge in the areas of NHS workforce, the delivery and design of education and training programmes and curriculum and regulation: Professor Donna Mead OBE, vice chair of Cwm Taf University Health Board, Dr Alun Rees the inaugural vice president for Wales of the Royal College of Physicians and Professor Ceri Phillips head of the College of Human and Health Sciences at Swansea University.