Press Release - Educating and Training the Future Health
Professional Workforce for England
1 March 2001
The Audit Commission and the National Audit Office today
published the results of their comprehensive joint review of
education and training for existing and trainee nurses, midwives
and other healthcare staff. Getting the development of these staff
right is fundamental to meeting patients’ needs, improving
services, reducing risks and modernising the NHS.
The reports make significant practical recommendations for
improvement which the NHS is encouraged to address as a
priority.
Sir John Bourn, the head of the National Audit Office,
said today:
"Educating and training increased numbers of nursing,
midwifery and other health professional students is a key way of
overcoming the shortage of such staff in the NHS. The NHS and
higher education institutions must continue working together to
improve value for money, to ensure more students complete courses,
to reduce the constraints on providing practical experience, and to
invest in new capacity where needed. Healthcare professionals
provide much of the service that patients need and expect, and a
cost effective world class education and training system must be
the foundation for delivering this."
Sir Andrew Foster, the Controller of the Audit
Commission, said today:
"Healthcare staff are the lifeblood of the NHS.
Developing their skills and abilities is vital both to the quality
of patient care and the modernisation of the NHS. We need to
actively manage and plan for the training of our nurses, therapists
and other staff. Everyone, from front-line staff to trust board
members, must show commitment to a culture which values and expects
training and learning."
The Audit Commission’s Hidden Talents report focuses on
the existing healthcare workforce and looks at how trusts can get
the best value from their training and development activities. The
National Audit Office’s report to Parliament, Educating and
Training the Future Health Professional Workforce for England,
reviews the effectiveness of arrangements between the NHS and
higher education institutions for educating and training
pre-registration health professional students.
The detailed findings of the two reports are set out in the
attached annexes.
Notes for Editors
- The Committee of Public Accounts is expected to take evidence
on the National Audit Office report on 4 April.
- The Audit Commission report Hidden Talents: education,
training and development for health-care staff in NHS trusts
(ISBN 1 86240 270 1) is available at www.audit-commission.gov.uk/hidden-talents/
, or from Audit Commission publications (t: 0800 502030).
- The NAO report Educating and Training the Future Health
Professional Workforce for England is available for download
at http://www.nao.org.uk/or from The Stationery Office (t: 0845
7023474).
- A separate report by the Auditor General for Wales, entitled
Educating and Training the Future Health Professional Workforce
for Wales, has also been published today and is available on
http://www.agw.wales.gov.uk/
- The Audit Commission for local authorities and the NHS in
England and Wales is an independent body under the provisions of
the Audit Commission Act 1998. Its duties are to appoint auditors
to all local and health authorities and to help them bring about
improvements in economy, efficiency and effectiveness directly
through the audit process and through value for money studies.
- The Comptroller and Auditor General, Sir John Bourn, is head of
the National Audit Office employing some 750 staff. He and the
National Audit Office are totally independent of Government. He
certifies the accounts of all Government Departments and a wide
range of other public sector bodies; and he has statutory authority
to report to Parliament on the economy, efficiency and
effectiveness with which Departments and other bodies have used
their resources.
Press Notice NAO/AC/01/01
All enquiries to NAO Press Office:
Tel: + 44 (0) 20 7798 7400
Audit Commission Annexe
Hidden Talents: education, training and development for
healthcare staff in NHS trusts
Patients expect healthcare staff to have access to the
education, training and development that they need to provide a
modern and responsive service. However, the Audit Commission’s
‘Hidden Talents’ reveals that this is not always the
case.
Some services in England and Wales do not actively plan for the
training needs of nurses, therapists and other healthcare staff.
And the availability of development opportunities varies widely,
depending on where staff work, and what they do.
Findings include:
- One third of staff had not agreed training needs with their
managers in the last 12 months;
- Some NHS trusts spend five times as much as others on training
per healthcare staff member;
- In a minority of trusts, over a quarter of the
post-qualification nurse training places are not being used;
- Some groups, such as part-time staff and nursing auxiliaries
and assistants, can miss out on training compared to
colleagues.
The Audit Commission found many diverse examples of innovative
practice around the country, and presents case studies from which
others can learn. The Commission recommends that trusts
should:
- better identify the implications of service developments for
staff training;
- review how much they spend and in what ways;
- develop more flexible training to improve access for all staff;
and
- work with Higher Education to better match training to service
needs.
National Audit Office Annexe
Educating and Training the Future Health Professional Workforce
for England (HC 277)
Today’s National Audit Office report highlights the importance
of educating and training increased numbers of nursing, midwifery
and other health professional students as a key way of overcoming
the current serious shortage of such staff in the NHS.
The NHS Plan (July 2000) proposed a number of measures to
overcome the shortage of healthcare staff of which a fundamental
one was a large increase in the number of training places (an
increase of 5500 nurses and 4450 therapists and other health
professionals entering training each year by 2004).
Sir John Bourn, head of the NAO, has concluded, however, that
delivery of this planned expansion in the numbers of new staff
undergoing training depends on increased investment in teaching
staff and accommodation at higher education institutions; achieving
improved value for money in the provision of training courses; a
reduction in student drop out rates; and a larger number of good
quality practice placements.
The National Audit Office report found that the numbers of new
students entering nursing and midwifery courses each year had grown
by 50 per cent since 1994-95, with concerted recruitment campaigns
resulting in more applications for NHS funded courses. Although the
number of healthcare professionals qualifying had increased
markedly, the National Audit Office report also found:
- acknowledged problems in NHS workforce planning had contributed
to current staff shortages;
- higher education institutions had accommodated year on year
increases in student numbers since 1994-95 while maintaining
quality but there were indications that the institutions were now
beginning to reach full capacity;
- about 1 in 6 students did not complete their courses, in line
with the average for all university courses;
- the need for sufficient practice placements is a constraint on
expanding student numbers and the NHS and universities need to work
together to develop and implement joint strategies, involving more
innovative approaches for identifying and using placements, if the
quality of the student’s experience is to be maintained and/or
enhanced;
- further improvement in value for money and the contracting
system was possible: while the price per student has gone down in
real terms, the costs and prices for similar qualifications at
different universities varied greatly; many course contracts failed
to specify outcomes; contract monitoring could be improved and the
recovery of overhead costs was less than for non-NHS
contracts;
Sir John found many examples of good partnership working between
the NHS and higher education institutions. However, he pointed to
the need for joint responsibility for providing practice
placements, working to reduce drop out rates and facilitating more
investment.
The NAO report acknowledges that the Department of Health has
taken a number of initiatives to address these problems. They
include in particular the workforce planning consultation exercise
and implementation of subsequent recommendations, and also their
work with the UK Central Council for Nursing, Midwifery and Health
Visiting and the Quality Assurance Agency for Higher Education to
improve quality, and with the English National Board for Nursing,
Midwifery and Health Visitors on practice placements.
However, the report makes the following key
recommendations:
- to improve the skills of personnel and improve, at local and
national level, the common data and planning systems used for
workforce planning to achieve better estimates of future education
and training needs;
- to share good practice to reduce student attrition from
courses, monitored using a standard definition;
- to move to a more collaborative approach to contracting with:
greater sharing of information on costs; consideration of generic
pricing and standard price benchmarks; and greater focus on
outcomes within the contracting process;
- together with the Higher Education Funding Council and the
Vice-Chancellors and Principals of universities in England, to
examine the current framework for the treatment of capital and
research in contracts and, if necessary, develop and issue new
guidance;
- to involve higher education institutions at all levels of
planning of education and training, with shared responsibility for
recruitment, selection and retention of students; and for
identifying and managing practice placements;
- to ensure that the new Workforce Development Confederations
implement proposals for effective partnership working with non-NHS
employers, higher education institutions and, where appropriate the
relevant professional bodies, and develop effective arrangements
for identifying and sharing good practice.
Notes for Editors
- In 1999-2000, the NHS spent £705 million on pre-registration
training places and student bursaries for some 50,000 student
nurses and midwives and 14,000 health professional students. This
training is provided under some 100 or so NHS pre-registration
contracts, by 73 higher education institutions and leads to degree,
and, in the case of nurses, degree or diploma, level professional
qualifications.
- Thirty-nine NHS Education and Training Consortia determine the
number of places to be commissioned, based on workforce development
plans from NHS Trusts, health authorities, social services and
other employers of healthcare staff. From April 2001 these will be
replaced by 24 Workforce Development Confederations which will take
on a wider role for developing the existing and future NHS
workforce.