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Ministerial foreword
I was delighted when responsibility for the NHS workforce returned to my portfolio last year. There are important synergies between other areas in my portfolio, including elective recovery and service delivery, and the centrality of the NHS workforce to the ability to deliver on all our other health objectives and plans is clear to all.
I would like to take this opportunity to thank Health Education England (HEE) for their tremendous efforts, and the continuing quality of their work, in supporting the education and training of healthcare workers during the incredibly challenging period of the COVID-19 pandemic.
The pandemic has shown more than ever the interdependence between health and social care and the need for close collaboration, mutual support and common understanding. While HEE’s legal remit is largely the healthcare workforce, this of course includes healthcare workers in social care and more broadly, involves HEE working with the social care system at all levels to make sure the healthcare needs of those who receive social care are met as well as those in the population as a whole.
On 22 November 2021, the Secretary of State set out his intention to create a new organisation, integrating HEE with NHS England (NHSE), along with NHS Digital and NHSX. I would like to place on record my thanks for the professionalism that HEE’s senior leadership have displayed in taking forward the integration of HEE with NHS England. The decision to create a new organisation that will be responsible for workforce, service and financial planning for the NHS comes as a direct result of responses we heard from stakeholders regarding the issue of workforce planning during the passage of the Health and Care Act.
The first stage is underway – this involves closer working betweenthe organisations. Following parliamentary passage of the Health and Care Act containing the enabling powers, the Department of Health and Social Care (DHSC) will bring forward secondary legislation for the formal legal merger. Any secondary legislation will be preceded by the fulfilment of any necessary statutory consultation requirements.
This change will help ensure that service, workforce and financial planning are integrated in a single organisation at national and local levels. The national system for leading the NHS will be simplified, ensuring a common purpose and strategic direction. It will also enable us to drive the changes we need in education and training both further and faster, to enable employers to recruit the health professionals they need to provide the right care to patients in future, and to better meet the needs of the future.
To support longer term strategic planning, in July 2021 my department commissioned HEE to work with partners to review long-term strategic trends for the health workforce and regulated professionals in social care. This will review and renew the long-term strategic framework for the workforce, to help ensure we have the right skills, values and behaviours to deliver world-leading services and continued high standards of care. This will look at the key drivers of workforce demand and supply over the longer term and will set out how they may impact upon the required shape of the future workforce to help identify the main strategic choices facing us, to develop a shared and explicit set of workforce planning assumptions.
Building on this work, the department has recently commissioned NHS England to develop a workforce strategy, and will set out the key conclusions of that work in due course.
Taken together, these significant pieces of work, alongside HEE’s other activity set out in this mandate, will help ensure our NHS has the right workforce to meet current and future needs.
Edward Argar
Minister of State for Health
Introduction
The government announced on 22 November 2021 an intention for Health Education England (HEE) and NHS England (NHSE) to come together to form a new organisation, subject to the passage of the necessary legislation. This mandate therefore covers 1 year only and also reflects that during 2022 and 2023 HEE will be in transition to the new organisation.
Health Education England’s role
HEE works with partners to plan, recruit, educate and train the health workforce – so that the NHS has the right number of staff, with the right skills and values, equipped to work differently and in a compassionate and inclusive culture. This requires HEE to ensure the future supply into the workforce, to transform and upskill the current workforce to use new science and technology, and continually to seek improvements in quality of training in the interests of patients and learners alike. The Care Act 2014 sets out HEE’s remit and range of roles and responsibilities in detail, including its duty to ensure an effective system for education and training for the NHS and public health. The Care Act also places a duty on HEE to have regard to the NHS Constitution.
Accountability
The current Framework Agreement between the DHSC and HEE defines how the department and HEE work in partnership to serve patients, the public and the taxpayer; and how both HEE and the department discharge their accountability responsibilities effectively. HEE will also work collaboratively with NHS England and other partners, playing its part in building effective relationships to achieve shared goals, for example to support delivery of the NHS Long Term Plan.
The mandate frames the deliverables within available resources. DHSC, HEE and NHSE will work together to review progress against the themes and deliverables in the mandate and, where necessary, agree additional action to mitigate any risks.
The mandate objectives
There are 16 objectives for HEE in 2022 and 2023, grouped under the following 7 key themes.
1. Restoration and recovery of services, and continuing coronavirus (COVID-19) response
In support of the NHS Operational Planning Guidance for 2022 and 2023, HEE should give priority to working collaboratively with its arms-length body partners to maximise the availability of staff for the restoration and recovery of services in 2022 and 2023, as well as to ensure workforce supply in the medium and longer term. This should involve taking education and competency development opportunities including those which bring new staff into the NHS, and a continued focus on the health, wellbeing, and safety of staff, trainees and students. Specifically, HEE and NHSE should work in partnership to align service redesign and workforce planning, supporting systems at all levels to accelerate work to transform and grow the workforce.
In parallel, HEE should ensure that, as far as possible, future student graduation and trainee progression is restored to the expected academic schedule. Where this is not possible, all mitigations for which resources are available should be put in place. HEE should continue to support students and trainees in ways which minimise attrition from courses.
HEE will prepare comprehensively for the forthcoming public inquiry into the COVID-19 pandemic and transparent communication with DHSC on the level of preparedness. Once the inquiry has launched, HEE will fully engage with and respond to the inquiry as required.
2. Government healthcare workforce priorities
HEE should progress its contribution to the 50,000 nurse programme, as agreed with the DHSC-led programme board. It should work together with programme leads in DHSC and NHSE, and deliver in line with agreed project plans and trajectories, ensuring that milestones are met, and risks managed and escalated as necessary. Project SROs will be supported within the organisation to discharge their roles appropriately.
HEE should progress its contribution towards the government’s commitments on primary care, as agreed with the ministerial delivery board. This should include maintaining the number of GP training places at or above 4,000 a year, a phased move towards all GP trainees spending 2 years rather than 18 months in general practice, and the full roll out of ICS primary and community care training hubs.
3. Delivery of NHS Long Term Plan priorities
In line with the resources made available, HEE should take forward actions to increase the supply of people trained to fill the roles needed to enable delivery of the service objectives across NHS Long Term Plan priorities, including for mental health, cancer and diagnostics.
HEE should continue to lead work jointly with DHSC and NHSE on supporting the workforce objectives of the Long Term Plan. This will include further progress on addressing equality, diversity and inclusion in all aspects of HEE’s work, supporting system partners to tackle health inequalities and focus on prevention, including through educational opportunities, the distribution of trainees and curricula development.Recognising the importance of continuous professional development, HEE will also support NHS staff as they act flexibly in response to the pandemic and recovery, continue their development of new competences and take on new roles.
Building on HEE’s own operating model for the health workforce and its education and training, HEE should support NHSE on shaping its future operating model for the NHS, including the supporting culture and governance arrangements, and with a particular focus on the developing roles of place, integrated care systems and regions.
4. Long term workforce planning and reform to transform services
Following separate commissions from ministers, HEE should:
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conclude its work with partners to develop a long-term strategic workforce planning framework for the health system and the regulated social care workforce
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work in partnership with NHSE to develop a long term workforce strategy for the system
HEE should continue to develop its proposals for reform of professional education, in partnership with DHSC and NHSE. HEE should also explore the use of blended learning approaches to promote full utilisation of innovative and immersive technologies and support flexibility and widening access in education provision.
HEE should continue to work with NHSE on wider system transformation, leading support for workforce redesign, and building capacity and capability to better define innovative workforce solutions which optimise the use of resource. In support of this, HEE should also enable the widest possible adoption of simulation in education and training through its Learning Hub and other Technology Enhanced Learning national platforms.
HEE should continue to lead in building a digitally literate and adaptable workforce through the delivery of sustainable products and offerings for the whole workforce, including its senior leaders and digital experts. These should form the basis of HEE’s NHS Digital Academy service, as the home for digital learning, development, training and education.
HEE should continue to work with DHSC and our system partners on the development of a workforce digital and data strategy to underpin the learning requirements of the health and care workforce.
The pandemic has shown more than ever the interdependence between health and social care and the need for close collaboration, mutual support and common understanding. HEE’s legal remit includes healthcare workers in social care, and HEE should continue to develop its work with the social care system at all levels. In particular, HEE should promote an integrated approach to the health and social care workforce and take forward its joint initiative with Skills for Care to support Integrated Care Systems to join up their local workforce planning and development for health and social care.
6. Bringing HEE and NHS England together
HEE should work collaboratively towards the successful integration of its work with NHSE’s. As necessary it should provide finance, activity and outcomes information to support this, and also in year financial discussions with DHSC – acknowledging that the HEE’s programme budget for 2022 and 2023 is currently £5.04 billion (HEE also receive funding from NHSE and NIHR).
7. Core responsibilities
HEE should continue to take forward its core responsibilities for healthcare education and training under sections 97, 98 and 108 of the Care Act 2014.
Conclusion
HEE should focus on supporting the health system to deliver elective recovery, to manage COVID-19 and to maximise student and trainee progression. Expectations of progress in delivering the other objectives during 2022 and 2023 will be adjusted if necessary, to take account of this.
Education Outcomes Framework
The educational outcomes below underpin this mandate and have been developed with partners across the health and education landscape. The educational outcomes support improvements in education and training that have a real impact on the quality of care delivered to patients and service users. HEE has developed its own indicators to track and report on progress through the publication of its annual report.
Excellent education
Education and training are commissioned and provided to the highest standards, ensuring learners have an excellent experience and that all elements of education and training are delivered in a safe environment for patients, staff and learners.
Competent and capable staff
There are sufficient health staff educated and trained, aligned to service and changing care needs, to ensure that people:
- are cared for by staff who are reflective of the changing demography of the population they serve
- are properly inducted, trained and qualified
- have the required knowledge and skills to do the jobs to meet service needs, whilst working effectively in a team
Flexible workforce, receptive to research and innovation
The workforce is educated to be responsive to changing service models and to innovation and new technologies, with knowledge about best practice, research and innovation, that promotes adoption and dissemination of better quality service delivery to reduce variability and poor practice.
Widening participation
Sourcing talent and providing leadership that flourishes, free from discrimination and with fair opportunities to access careers, progress and fulfil potential, recognising individual as well as group differences, treating people as individuals, placing positive value on diversity in the workforce and with role models are promoted and encouraged. This will include opportunities to progress across the five leadership framework domains.
Volunteering
Following the production of the HEE Volunteering Strategy, deliver proposed products to support the recruitment and enhanced experience of volunteers across the NHS. Additionally, encourage and support NHS staff themselves to take advantage of volunteering opportunities within health and social care, and ensure senior clinical and managerial leadership value the vital contribution volunteers make to the service.
NHS values and behaviours
Healthcare staff have the necessary compassion, values and behaviours (including supporting colleagues) to provide person centred care and enhance the quality of the patient experience through education, training and regular continuing personal and professional development, that instils respect for patients.
