NHS England shake-up brings training and technology into health service

The UK government has announced a shake-up of the NHS in England, merging arms-length bodies in charge of education and training, and digital transformation, with the health service in a move it says will put “workforce and technology at the heart of long-term planning”.

As the NHS tries to clear a huge waiting list, Sajid Javid, health and social care secretary, has accepted the recommendations of a review commissioned from Laura Wade-Gery, chair of NHS Digital, that her organisation along with NHSX — the service’s digital innovation arm — should be brought under one roof to improve co-operation.

The former health secretary Matt Hancock, who resigned in June, created NHSX in an attempt to place the NHS in the vanguard of health technology. However, the agency stumbled during the pandemic, delaying the launch of a Covid-19 contact-tracing app last year.

Health Education England, responsible for the education and training of the health workforce, will also be incorporated into the NHS.

The government in September announced an additional £30bn for the NHS over the next three years and ministers are under pressure to deliver improvements, both to satisfy voters and reassure Conservative MPs restive over the decision to raise national insurance contributions to fund the increase.

Javid on Monday said: “To ensure our record NHS investment makes a lasting impact, I am bringing workforce planning and digital transformation into the heart of the NHS.”

The changes would “support our recovery from Covid-19 and help us tackle waiting lists to give patients excellent care in years to come”, he added.

Amanda Pritchard, NHS chief executive, said health service organisations “have worked more closely than ever to respond to the Covid pandemic and these changes build on that success”.

Chris Hopson, chief executive of NHS Providers which represents hospital, ambulance, mental health and community services, said there was “a logic to placing overall responsibility for NHS workforce issues, which are so central to the success of the NHS, with NHS England”. He also understood the logic of centralising the leadership of NHSX and NHS Digital into NHS England.

However, the organisation’s challenge would be “to ensure sufficient focus on the important, complex and detailed work being undertaken by these organisations in their current separate forms.” The NHS “still desperately needs a fully funded long-term workforce plan, irrespective of where accountabilities sit”, Hopson added. 

However, the move to abolish Health Education England, established under Lord Lansley’s ill-starred reforms in 2012, as a standalone body will raise further questions over how much funding will be allocated to expand the workforce. It follows tension between the Treasury and health chiefs, who were reluctant to surrender part of their settlement to boost HEE after the chancellor Rishi Sunak unexpectedly failed to announce a specific budget for the organisation in last month’s budget.

Simon Stevens, who stood down as chief executive of NHS England in July, successfully kept the education and training budget separate when he negotiated a five-year funding settlement for the NHS in 2018. However, that position is likely to be hard to maintain after HEE’s functions are moved into NHS England.

When the coronavirus hit, England’s health service was short more than 100,000 staff — of whom about 40 per cent were nurses. The Health Foundation, a charity, has estimated that 4,000 more doctors and 17,000 additional nurses will be needed to clear the backlog of 5.8m patients whose care was disrupted by the pandemic.

Successive governments’ failure to anticipate the service’s workforce needs will be in the spotlight on Tuesday when MPs will debate an amendment to the Health and Care bill, put forward by former health secretary Jeremy Hunt. It would require ministers to publish independent workforce projections every two years to ensure the pipeline of clinical staff in training meets future demand.

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