Health Professional Education Investment Review

Mel Evans, Ceri J. Phillips, Richard N. Roberts, David Salter

March 2015

Download Report


The Panel’s primary function was to undertake a review of the way the Welsh Government currently invests in the planning, development and commissioning of health professional education and workforce development in Wales. In carrying out its work the panel was tasked to:

  • Explore the arrangements currently in place and identify strengths and weaknesses in the system.
  • Undertake an analysis of the Investment made in health education in Wales; assess the current level of return on Investment and whether it is at an appropriate level.
  • Consider the current ‘managed model’ for education commissioning adopted in Wales alongside other approaches in the UK / other countries and provide recommendations about an approach to be adopted in future.
  • Consider whether the establishment of a single body which brings these functions together would be beneficial to Wales and if so what functions should it include.
  • Consider the extent to which incentive based arrangements could be beneficial to the education and training agenda in Wales.
  • Consider the wider policy approach in respect of prudent healthcare and what this means for education and training of healthcare professionals and staff groups.

The Minister for Health and Social Services commissioned the Review in August 2014. To inform its launch and objectives, a letter was circulated to the Chief Executives of the Local Health Boards and Trusts and Vice-Chancellors of the Welsh Higher Education Institutions and the Panel were briefed regarding the current arrangements and undertook a review of the literature to glean information pertaining to commissioning arrangements and models of operation in other countries and systems. Initial discussions took place with stakeholders who were involved with involved in the commissioning and provision of education and training, which were followed by a number of stakeholder events and meetings arranged throughout Wales.

There was a general consensus among stakeholders that the current system and configuration for 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.

Further, there was strong representation presented that the on-going training and development of the NHS workforce was also a key component of the review and that should be reflected within the ‘contracts’ of staff – and a removal of the notion that staff development was a necessary but dispensable aspect of HR – when the financial climate was not conducive to ‘luxuries.’
The following themes emerged during discussions and conversations which have informed the recommendations arising from the review:

  • The need for a refreshed strategic vision for NHS Wales
  • Developing a workforce plan that is aligned with the strategic vision
  • The creation of a single body to cover funding, commissioning and equity of education and training provision
  • Developing NHS Wales as learning culture

The Panel is unanimous in making the following recommendations:

  • We need 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.
  • A single body for workforce planning, development and commissioning of education and training must be established.
    • There must be a more collaborative all-Wales approach to commissioning, based on an improved process of workforce planning, undertaken by the single body – at arms-length from Welsh Government – with responsibility for aligning funding mechanisms to promote equity and the budgetary management of education and training of the workforce in NHS Wales.
    • The funding of on-going training and development, which must become part of the DNA of NHS Wales, and a system of continuous improvement has to be established as a matter of priority.
    • A greater emphasis on the use of multi-disciplinary teams, including allied health professionals, in the planning and delivery of healthcare must be facilitated by the single body, to enable a more cohesive approach to patient management.
    • The financial divide that exists between the budget for medical and dental training and that for non-medical professional education and training must be removed.
  • The NHS in Wales should be the vehicle for developing Wales as a learning culture
    • The establishment of learning ‘compacts’ for all NHS staff, in all sectors and across all grades, to create the culture of continuous improvement within NHS Wales, should be one of the initial tasks of the new single body.
    • The emphasis on hospital-based training and development needs to be adjusted to embrace community settings and reflect strategic direction and include greater emphasis on appropriate developments, such as telemedicine and use of e-Learning schemes.
    • Health Boards and Universities need to interact more closely with the education sector to provide meaningful work experience programmes for all school children to enhance awareness of the working of the health and social care system, to instil a degree of pride in the NHS and inspire young people to work in the health system in Wales following their interaction and contact with professionals and patients.