Are you saying some areas have too many doctors?

We acknowledge that there are not enough doctors across the country and will continue to push for additional funding across medical and care workforces. The programme’s focus is to ensure the funding for postgraduate doctors in training is available to all areas based on a population need for both now and in the future.

We will continue to increase overall training posts, by allocating any additional funding to areas in the country considered to be in greatest need. In turn, this reduces the effect of these changes on areas that are currently deemed better medically served. The historical imbalance in the distribution of tariff-funded training posts is such that it would not be affordable to achieve a fair distribution of medical training simply by increasing training posts in underserved areas.

To demonstrate this, in the case of Haematology, ‘levelling up’ or increasing training posts across England to the same level as London would require that we more than double the number of HEE-funded haematology posts from 260 to 566. If we were to include Trust-funded training posts in this example, then an additional 500 posts would be required for Haematology alone. Put into actual terms, there are three Trusts in London who individually have equal or greater numbers of Haematology training posts than the whole of the North-East locality area.

HEE and NHSE acknowledge many services are under pressure. Nevertheless, significant health care inequalities exist across England, and we need to develop services within the current Department of Health and Social Care’s (DHSC) financial parameters. It also offers an opportunity for us to review training and staffing in some areas and look at other models in which we may deliver services.