HEE purpose and strategic goals
HEE has refined its purpose and strategic goals to increase the level of our ambition. These goals provide the longer-term perspective, a touchstone from which in-year objectives are constructed. These goals represent what HEE will always reach for; ongoing principles that provide consistency and stability.
HEE is part of the NHS and we work with partners to plan, recruit, educate and train the health workforce.
Future workforce - ‘Reform clinical education to produce the highest quality new clinical professionals ever in the right number’.
Current workforce - ‘Transform today’s workforce to work in a co-operative, flexible, multi-professional, digitally enabled system’.
Quality and patient safety - ‘Deliver and quality assure with partners, education and training that is rigorous, highly sought after and future focused’.
Our objectives are stepping-stones towards our goals, where we will focus our efforts during 2021/22. They will also feature in Regional and Directorate Delivery Plans to ensure greater alignment, synergy and focus on shared delivery across HEE.
Future workforce - Reform clinical education to produce the highest quality new clinical professionals ever in the right number.
This strategic goal is underpinned by six objectives for 2021/22.
Objective - Increase nursing supply to help deliver 50,000 more nurses in the NHS by March 2024 and tackle AHP workforce shortages in a managed way that supports the NHS LTP.
To improve patient services, we will increase the number of nurses available to be employed by the NHS. A variety of initiatives such as the conversion of nursing associates and assistant practitioners to registered nurses, direct nursing apprenticeships, the blended learning degree and return to practice as well as improved retention within the
NHS will mean an enhanced nursing pipeline. Applications for nursing courses have risen by almost a third to 60,130 with an increase in each age group. This is the third consecutive annual increase, contributing to the Government’s 50,000 additional nurses pledge from a September 2019 baseline. Through our Careers Service we will also continue to promote the profession whilst working with Universities to reduce course attrition. More nursing staff should result in speedier, and better care and increased patient safety.
In addition, we will tackle allied health professional workforce shortages across the fourteen professions in a way that supports the NHS Long Term Plan. The demand for Allied Health Professions’ skills across sectors requires focused support to the professions. Targeted growth of pre-registration training, alongside placement recovery will drive innovative expansion of placements and apprenticeships, support worker development, a national programme of ethical international recruitment and career development.
This will help to retain highly skilled practitioners by enabling them to utilise their full trained capability and further advance their practice. Educational reform across each of the professions will support the development of 21st century clinicians to meet the increasingly complex needs of populations to stay well, independent, in work and at home wherever possible.
Objective - Increase the number of GP training places to 4,000 and make a phased move towards all GP trainees spending 24 months in general practice.
This will help us to meet the Government’s commitment to have an additional 6,000 doctors in primary care by March 2024. More GP trainees will reduce the pressure on GPs resulting in fewer leaving the profession, helping to address GP shortages. More GPs working in wider primary care teams will help to promote population health and wellbeing.
Increasing training numbers, coupled with improved retention, and developing multidisciplinary teams that deploy nurses, clinical pharmacists, physiotherapists and others will lead to more personalised, proactive care and more rapid access to care.
Objective - Continue the infrastructure developments of HEE ICS level Primary and Care Training Hubs to support development of colleagues for Additional Roles Reimbursement Scheme (ARRS) roles where funded.
This objective aligns with the LTP and the Government’s commitment to an additional 26,000 primary care professionals. The further roll out of HEE ICS level Primary Care Training Hubs (PCTHs) will have a critical role in helping to ensure the target is met by March 2024 and matching skills to changing patient needs. HEE has committed to infrastructure development and support.
Where funded or commissioned to do so these hubs will support people in new and extended roles as they join primary care teams, for example through preceptorships, and help shape expanded multidisciplinary teams. PCTHs will also develop primary care training capacity with new multi- professional educators, increased clinical placement capacity, and enhanced quality of training and placements. PCTHs will support (CPD) and career development. Finally, PCTHs will work with schools and universities to promote primary care as a great place to work and support workforce planning, working closely with Primary Care Networks (PCNs) and ICSs. HEE will also develop new primary care roles, such as physician associates and clinical pharmacists and continue to expand clinical pharmacists training in general practice, meeting the ambition to have up to six clinical pharmacists in every PCN.
Objective - To help reduce health inequalities, we will widen access to health careers for under-represented groups and develop a ‘what works’ evidence base.
Reducing health inequalities improves communities, individual lives and the NHS. HEE will play its part by identifying and attracting non-traditional entrants through partnerships with further education colleges and the Prince’s Trust. Improved education and training pathways will boost the availability of community-based health workers, helping HEE better link health and social care through peripatetic care assistants and other workers straddling both sectors to deliver services in communities, hospitals and homes. A broader-based community approach incorporating access to employment; apprenticeships; and volunteering can help develop a home-grown workforce reflective of the communities we serve, improve social mobility and further reduce inequalities. Promoting and developing health workers with less formal training to support doctors and nurses needs to be fully maximised. We will examine the systemic problems and barriers that prevent sufficient career progression for staff from diverse backgrounds as well as providing greater awareness amongst diverse groups of the breadth of roles available within the health and care sector. The benefits of such an approach will be better links between health and social care, a more diverse and skilled workforce, and when combined with a focus on preventative work in local communities it can have a big impact on reducing the demand for NHS services.
Objective - Increase the supply of people trained to fill the roles to enable delivery of the LTP outcomes for mental health and cancer and diagnostics.
This contributes to wider LTP and People Plan goals. It prioritises investment in training the future mental health workforce, specifically, expansion in psychological therapies for children and young people, boosting advanced clinical practitioner, psychiatrist, and mental health nurse numbers.
We will also prioritise the training of clinical endoscopists and reporting radiographers to support cancer and diagnostics. Increasing training places for clinical psychology and child and adolescent education and training should result in more rapid access to the care and treatment that children and young people require. Working with our partners through our work with cancer alliances we will take forward the Cancer Workforce Plan and the continued investment in cancer and diagnostic services will increase the numbers of skilled staff which will enable earlier and faster detection and is a key part of improving survival rates further.
Objective - Deliver medical education reform proposals to improve the efficacy and flexibility of our medical education system.
To increase the flexibility and responsiveness of medical education and training we will, depending upon funding, take forward reforms around:
- developing plans to enhance the generalist skills of doctors to improve the quality of care and support the ambitions of ICSs:
- ensuring our investment in medical education and training is better aligned to population health need; changing the geographical distribution of training posts to ensure future doctors are more equitably distributed and aligned with demand.
- embedding the innovations brokered during the pandemic by reforming our processes around medical recruitment, progression and assessments.
- working with medical schools to ensure graduates are better prepared for their transition to the Foundation programme.
- widening access and participation to medical careers to those with different backgrounds and experiences through the development of a undergraduate medical apprenticeship.
- enhancing the support for doctors as health leaders through CPD, diversity in the profession and leadership as well opportunities for Specialty and Associate Specialist (SAS) doctors to return to training.
The outcome of more flexible training options combined with improving the working lives of doctors is that medicine is seen as an attractive career option and we can recruit more doctors and dentists that the NHS needs, as well as keep more of those that we already have. This will result in doctors equipped with the skills the NHS needs and patients receiving high quality care.
Current workforce - Transform today’s workforce to work in a co-operative, flexible, multi- professional, digitally enabled system.
This strategic goal is underpinned by five objectives for 2021/22.
Objective - Adapt education and training to accommodate changes in technology and support the workforce to adapt to changes in roles as a result.
The way people interact with digital technology in their everyday lives is being reflected in service delivery so must be rapidly included in education and training. The disruptive innovation caused by COVID-19 has accelerated this need. The creative application of technology and artificial intelligence for example can result in the reimagining of care delivery if successfully allied with a comprehensive understanding of patient behaviour and greater co-production with healthcare staff. We will continue to grow education resources and learning opportunities through HEE platforms such as e-Learning for Healthcare (e-LfH). HEE will also lead in building a digitally literate workforce for leaders, digital experts and the wider workforce, utilising the NHS Digital Academy. The implications of digital technology are clear, particularly when combined with the capacity of health workers with much less formal training to support doctors and nurses in driving forward advances in technology – task shifting, protocols for assessing and triaging patients, clinical decision support tools, access to specialist advice, ability to quickly upload still and video images for review are just some of the benefits of a more technologically capable workforce.
Objective - Support the expansion and development of multi-disciplinary teams to achieve a diverse, sustainable skills mix in primary care.
HEE will continue to facilitate the development multi-disciplinary teams with the right skills by expanding the ‘HEE Star’ training and the practical guide to making the most of multi-disciplinary teams. This will lead to improved patient outcomes, increased productivity and improved patient and team satisfaction.
Objective - Through the HEE Centre for Advancing Practice expand clinical practice for nurses, allied health professionals, pharmacists, dental care professionals and healthcare scientists.
Enabling existing staff to continuously advance their practice will lead to more efficient and effective use of existing staff skills, enabling staff to realise their full potential within the workforce. This is an essential part of retaining our valued clinicians in clinical roles and enabling patients to access specific skill sets earlier in their pathway. Building strong, modernised, multi- professional teams and recognisable advanced practice capability will support workloads to be safely and respectfully redistributed within teams e.g. within primary care. It essentially represents the intellectual underpinning to strategic workforce planning based on capability and skills rather than traditional roles as we drive a more flexible workforce with professionals working at the top of their licence, not the top of their capacity.
Objective - Strengthen the training, learning and development available to volunteers, carers and their families.
We will strengthen the support available to the 300,000 existing and over 750,000 volunteers who stepped forward to support the NHS during the pandemic who make a vital contribution to the health service. Volunteering benefits the volunteer, patients, families and staff. We will scope and design the National Volunteering Portal to speak directly to volunteers, community groups, the voluntary sector and volunteer service managers and their teams. The portal will act as a national gateway to volunteering opportunities, as well as opportunities in education, training and development. We will also drive forward the reach and impact of the National Volunteer Certificate, create new and innovative online learning and training opportunities which will be available to national passporting schemes or a national volunteer reserve scheme as and when they develop.
We will promote and develop a toolkit to sustain employer supported volunteer initiatives across the NHS and a national NHS volunteering forum to ensure volunteers have scrutiny over our portfolio and that that they are able to fully participate in shaping our future ambitions.
We have developed an online training and support package for carers to enhance the skills, development, and resilience of unpaid carers and we will review this to ensure it is fit for purpose and identify any learning gaps. We are also planning to develop additional e-learning sessions and include a communications campaign to increase awareness. Increased numbers of volunteers and carers with the right level of support will allow doctors and nurses to spend their time focusing on providing the best healthcare for patients.
Objective - We will work with NHSE/I to shape the Operating Model for NHS people and workforce issues, including the role of ICSs and the new NHS Bill.
HEE will agree principles to inform our developing relationship with ICSs in delivering recovery and developing resilience through our Operating Model in the transition year to ICSs becoming statutory bodies. HEE’s Operating Model development programme will articulate, design and develop HEE’s future role in partnership with the health and care system, linked to anticipated statutory change from April 2022.
Working with NHSE/I and ICSs we will seek to agree operating models that make it as easy as possible for us to align planning, finance and delivery. This will include NHSE/I’s four pillars of change (i) the NHSE/I operating model; (ii) NHSE/I system oversight framework: (iii) ICS implementation and development including a people operating model and proposed workforce duty preparation and finally (iv) NHSE/I approach to improvement.
Quality - Deliver and quality assure with partners, education and training that is robust, highly sought after and future focused.
This strategic goal is underpinned by four objectives.
Objective - Create the first system-wide and consistent NHS patient safety syllabus and education and training framework to improve NHS patient safety.
Working with education providers HEE will introduce the new national patient safety syllabus and the associated educational modules for staff in England. Patient safety training must be core to health education and training. Consistency across professions will aid multi-disciplinary working and the safety of patients. An e-learning programme will also be developed, available to all 1.4 million staff, in the fundamentals of patient safety to create a culture of safety across the NHS. Ultimately this should result in improvements to patient safety throughout the NHS as training is provided to all staff who contribute to the system of patient care.
Objective - Set out our clear expectations for the quality of healthcare learning environments by embedding our refreshed HEE Quality Framework and Quality Strategy for 2021 - 2024.
NHS quality depends on the capacity, capability and competence of our healthcare workforce, which is ultimately secured through their selection, training and regulation. Patient safety will be compromised if any of these components fail. We will embed our revised Quality Framework and Strategy during 2021/22. This will signal the standards we expect of providers planning placement shape and capacity in response to demand, changing patient needs and new service models whilst maintaining high quality training.
Objective - Ensure the learner voice is heard and acted upon by using data and insight to measure, monitor and improve the quality and experience of education and training.
We have recently published the analysis of the feedback from the latest multi-professional National Education and Training Survey (NETS) which captured feedback from a record number of healthcare learners about the quality of their placement learning environment. The bi-annual survey, triangulated with other data and insight, will enable us to seek improvements in areas of concern and promote good practice more widely across the system.