HEE tells trusts to prioritise training, or services will suffer

The quality and performance of services will suffer if medical training is not ‘prioritised and funded’ by trusts, Health Education England has warned.

HEE has set out actions in its “Covid training recovery interim report” that must be done alongside NHS England, the Department of Health and Social Care and others to protect post-covid workforce recovery.

At the beginning of the pandemic, junior doctors’ training was severely disrupted because thousands of staff were redeployed to covid wards, while most routine elective operations and diagnostic procedures were stopped.

HEE says training has still not returned to pre-covid levels, and fears there could be further disruptions over winter if significant volumes of elective care are cancelled.

According to its report, if medical training is not “prioritised and funded”, the “long-term costs to service are significantly greater”.

“If delivery recovery is prioritised over training recovery there will be an initial increase in service delivery time and value, but this will be followed swiftly by a reduction in service delivery time and value,” it warned.

The report stressed England’s 55,000 junior doctors will be “critical to managing the significant NHS care backlog post-pandemic”.

The report sets out 18 joint commitments between HEE, NHS England, the DHSC and others, including better supporting the consultant educator workforce, delivering more virtual clinics and the independent sector taking on an increasingly important role in medical training.

Sheona MacLeod, deputy medical director for education reform at HEE, told HSJ: “[Employers] can do training recovery and service recovery at the same time.

“If you don’t integrate training and service recovery, it will slow off, and there won’t be the workforce to deliver it.

“Education tends to get pushed down when anyone thinks about anything urgent as a priority.

“We have to continue to develop trainees… you often hear ‘we have to get them to deliver now’, without realising in six months if you don’t train those doctors they won’t be delivering the service.”

Professor MacLeod called for finances in the NHS to be “balanced” to prioritise training time and particularly supervisor time.

“If you increase pressure on services, you squeeze supervisor time to deliver more and teach less,” she warned.

On the use of the private sector for training, she said: “We want training to happen everywhere that doctors work, and in the future we’d like to see more training in the community for all healthcare professionals.

“If more healthcare is delivered in the private sector, more training must be delivered in the private sector.”

She described the experience of trainees in the private sector as “variable” but said there were areas that have been “very receptive” about training.

HEE stressed in the report that because of the number of medical trainees affected by the pandemic, if every trainee was “simply given a [training] extension… additional funding would be needed at a cost of £350m”.

“Furthermore, the workforce supply would halt, resulting in insufficient numbers of consultants and GPs,” the report said.