We know that new starters and existing staff want and need continuing professional development (CPD). NHS Employers (2019) surveyed 563 pre- and postregistration nurses asking ‘what matters most in relation to recruitment and retention?’ and the ‘opportunity to develop’ was in the top three for both groups. The House of Commons Health Select Committee (HSC) reviewed the national nursing workforce shortage and concluded that poor access to CPD was a contributing factor to retention, calling for previous cuts to CPD budgets to be reversed (Merrifield, 2018). Following the review, in 2019, the Government announced £150 million for CPD was to be allocated to NHS trusts via Health Education England (HEE) in 2020–2021 and thereafter to enable employers to provide a £1000 training budget over the next 3 years for each NHS nurse, midwife and allied health professional (HM Treasury, 2019).
The announcement produced positive media headlines such as ‘NHS nurses to be given £1000 each to spend on training in bid to stop staff leaving’ (Gallagher, 2019) saying that this was part of the Government's commitment to ‘improving patient care and securing a sustainable future for the NHS’. And with a statement from the Treasury that the funding will help nurses ‘to develop rewarding, lifelong careers in the health service’.
The Royal College of Nursing (RCN) (2019) picked up on the announcement of a ‘personal training budget’ for all NHS nurses. Although the announcement was welcome, the RCN said it only addressed one cause of nurse shortages in the NHS, and that it failed to make up for previous cuts to CPD. It argued that the funding was a start, but more will be needed in the future to equip nursing staff with the skills and knowledge they need to help transform services for patients.
In November 2019, HEE and NHS Improvement wrote a letter to all trusts entitled ‘Funding for Continuous Development’. This letter outlined the indicative range of funding allocation to be expected and a set of principles to be considered for planning:
The letter said further guidance would be issued, but there has been none so far.
As a Chief Nurse, enabling CPD is a priority. Although the increase in funding is welcomed, there are a number of issues that need to be resolved to enable us to ensure value for money and maximise the benefits.
If the funds are to be used as a ‘personal training budget’ as reported, in some Trusts colleagues have calculated that, based on previous allocations, the ‘new money’ equates to a funding cut, and will not enable the continuation of MSc programmes, let alone increasing numbers of these, which are required for many staff to develop both clinical and leadership skills. The funding would equate to £330 per year per registrant, but MSc modules vary greatly in cost, with some costing over £1000 for one module.
The letter requested that training ideally be commissioned from NHS organisations, which is, of course, preferable to expensive commercial conferences, but there is not enough time to progress at scale to develop the infrastructure and shape programmes to run these courses internally and gain relevant accreditation—not to mention the destabilising effect on our partner institutions in higher education. Although colleagues in my peer group have suggested that we might develop a ‘points-based’ framework for internal training, once again in the timescale there is not sufficient time to work this up, which risks variation.
The letter requested that trusts provide backfill; this is the most challenging issue with current staffing levels, and a costly option.
I am positive that we can move quickly under the new HEE leadership, but rapidly need a national steer that includes transparency around all potential funding. Traditionally, HEE has had significant additional funds that have been allocated in a varied and last-minute manner; this needs to cease. In the absence of further clarity for planning, there is a risk that a varied delivery of this funding will have the opposite effect that it intended, with a negative impact on morale due to an inability to meet development needs.