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Cuts to CPD undermining moves to boost NHS workforce, academic warns

Moves to improve NHS productivity by bolstering existing nurses’ skills is being undermined by significant cuts to training budgets, workforce experts have warned a House of Lords select committee.  
Jim Buchan

Moves to improve NHS productivity by bolstering existing nurses skills is being undermined by significant cuts to training budgets, workforce experts have warned a House of Lords select committee.

During an oral evidence session to the House of Lords Committee into the Long-Term Sustainability of the NHS, nursing workforce expert professor Jim Buchan from Queen Margaret University, Edinburgh, said one of the best ways to improve efficiency was to strengthen existing workers skills.

But he told the cross-party committee that continuing professional development (CPD) budgets were being slashed by up to 45%.

Speaking at the hearing this week, he said: When looking at NHS sustainability, my main message would be that we need to be looking at building the current workforce to enable it

Moves to improve NHS productivity by bolstering existing nurses’ skills is being undermined by significant cuts to training budgets, workforce experts have warned a House of Lords select committee.  


Nursing workforce expert Jim Buchan has told the government that a focus needs
to be building the current workforce. 

During an oral evidence session to the House of Lords Committee into the Long-Term Sustainability of the NHS, nursing workforce expert professor Jim Buchan from Queen Margaret University, Edinburgh, said one of the best ways to improve efficiency was to strengthen existing workers’ skills. 

But he told the cross-party committee that continuing professional development (CPD) budgets were being slashed by up to 45%.    

Speaking at the hearing this week, he said: ‘When looking at NHS sustainability, my main message would be that we need to be looking at building the current workforce to enable it to work more effectively. 

Knock-on effect

‘The Council of Deans of Health [which represents the UK’s university faculties for nursing] reported that CPD budgets have been cut by 13-45%, and I cannot see how you can improve the skills of the current workforce against that funding cut.’  

RCNi launched its #1hour2empower campaign this year urging employers to ensure their nurses can complete 1 hour of CPD per month. 

Professor Buchan told the committee that a recent government pledge to train an additional 1,500 doctors from existing budgets could have a knock-on effect on the training and development of other staff groups. He also said the NHS did not have a ‘good track record’ in developing new roles, such as physicians’ assistants, and would be better off focusing on training up existing workers.  

‘We should not be looking at more of the same and instead should be looking at enabling the current workforce to be as productive as it can. That is in part about enhancing its skills.’  

Needs assessment

He acknowledged this was a ‘low-tech solution’ that could not be ‘pronounced on the front page of a newspaper’, but added: ‘If we don’t put effort into these areas, my real concern is we will be using the limited funding in the least effective manner.’ 

Responding to a question from Lib Dem peer Lord Willis on why 90% of the NHS’s £5 billion annual training budget goes to medics, professor Buchan told the committee that funding was based on historic levels.  

‘Budgets are not driven by identification of needs or training deficits, and we need to look at how we can turn that around, with budgets allocated via a needs assessment across the workforce.’  

Professor Buchan, an associate at the World Health Organization’s European Observatory on Health Systems, which promotes evidence-based health policy-making, pointed out that nurse practitioners carry out about 70% of a GP’s workload, yet require around half the time to train.  

‘Decimation’ of budgets 

He added that the Netherlands was now paying more attention to this as part of its workforce planning, while in the US a drive to upskill nurses to advanced nurse practitioners had worked well.  

Candace Imison, director of policy at the independent health think-tank, described as ‘a decimation’ the cuts to CPD budgets and argued that existing budgets should be protected. ‘Raiding training budgets for funding gaps is a risky maneouvre.’  

She also questioned the pledge to increase by 1,500 medic numbers, arguing that there is in fact little evidence the move will improve patient care.  

‘It costs about £1 million to train seven doctors, or 23 nurses or 45 healthcare assistants,’ she told the committee. ‘I do not think people think nearly enough about the opportunity cost of training doctors. There is good evidence that more nursing staff improves outcomes, but we do not have that evidence for doctors.’  

The committee is expected to publish its recommendations to the government by March next year.  

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