Money, Money, Money – the Cost of Education Health Education North Central and East London Helen...
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Transcript of Money, Money, Money – the Cost of Education Health Education North Central and East London Helen...
Money, Money, Money – the Cost of Education
Health Education North Central and East London
Helen JamesonDeputy Managing Director
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Content
• Education and Training Spend• Types of Spend• Tariffs• Tariff standardisation• Local Education Investment
Strategy
www.hee.nhs.ukwww.ncel.hee.nhs.uk
NHS FundingTreasury(£105bn)
Health Education
England (£5bn)Education and training of :• Undergraduat
e medical students
• Postgraduate Medical students
• Non Medical students
NHS England (£28bn)
Provision of primary care (Dentist, GP etc.) and specialist services
CCGs (£63bn)
Provision of:• Secondary care• Tertiary care• Community care• Mental Health
services• Ambulance services
Public Health England (£5bn)
Provision of Public Health services
Other ALBs (£4bn)
www.hee.nhs.ukwww.ncel.hee.nhs.uk
HE NCEL Funding
HE NCEL Funding £000s %Training Funding (Programme)
439,720 98.6%
Admin Funding 6,197 1.4%Total Funding 445,917
Admin funds the management and commissioning costs of HE NCEL
• This shouldn’t exceed 1.47% of total spend in 2014/15
• It is expected that at least 20% saving will be required by 2015/16
• Innovation and redesign of systems will be required to continue to identify savings
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Who do we Pay?
5
2014/15 Projections by Funding Stream
14%
71%
7%
2%2%4%
Universities & Medical SchoolsNHSStudent Support UnitNon NHSPayIncome
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Policy That Determines LETB Education And Spending
• Care Bill • Part 3 relates to HEE
• HEE Mandate - Outlines key deliverables for MPET investment• Health Visitors• Apprentices• Investment in band 1-4 workforce• Dementia training and end of life care• Broadening Foundation Training• Increased GP numbers• Transparent and equitable funding across the country
• Francis report (290 recommendations)• Investment in pre qualification nursing experience• Transformation to an affordable workforce
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Align Investment to local service priorities• Current workforce profiles and skill shortages• Reconfigurations – Royal Free• Specialist healthcare facilities - GOSH• New developments in technologies - Proton
Beam therapy• Demographics - NCEL’s geography is marked by
pockets of deprivation sandwiched by relatively wealthy communities. Life expectancy at birth varies from 75-89; this variation illustrates major health inequalities Demographics - NCEL’s geography is marked by pockets of deprivation sandwiched by relatively wealthy communities. Life expectancy at birth varies from 75-89; this variation illustrates major health inequalities
Local requirements that drives LETB spend
index of multiple deprivation scores North Central and East London
www.hee.nhs.ukwww.ncel.hee.nhs.uk
• MPET funding is distributed through:Local tariffs - individual to each LETB • GP placement tariffs (£20m)• Less than full time trainees (£10m)• Public Health trainees• Postgraduate medical trainees in Primary Care• Undergraduate medical students in Primary Care• Undergraduate dental students• Non medical salary support for students (£20m) • Workforce Development funding (£20m)
Block/fixed payments• National activities (£15m)
Direct Training Funding
www.hee.nhs.ukwww.ncel.hee.nhs.uk
National tariffs (67% future workforce funding) – varied by MFF/London weighting only
• Undergraduate medical placement tariffs (£80m)• Non medical placement tariff (£7m)• Postgraduate placement fee & salary tariff (£104m)• Tuition benchmark price tariff (BMP, £40m)• Bursary/student loan fees (£35m)
Direct Training Funding
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Moving from Local tariffs to a national tariff system
• Current tariffs the first step on the journey • NHS Placement providers 5 national tariffs• HEE contracts with more providers for placements
• HE NCEL paid c20 providers local SIFT tariff now pays over 100!• HE NCEL paid c15 providers local non medical tariff now
reimburses over 70!
• Education Resource Group - moving to up to c200 tariffs depending on agreed currencies
Tariff standardisation
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Outcomes
• Transparency and equity of funding • ERGs should more accurately reflect the cost of education and training• Funding follows the student/trainee – low volume, high value tariff
system vs service tariff which is high volume, low value?• Will help to improve quality
• More complex system to administer – leading to more back office costs
Tariff standardisation
www.hee.nhs.ukwww.ncel.hee.nhs.uk
Local Education finance strategy
With an ever shrinking budget but increasing demands how does HEE afford to deliver both national and local priorities?
• 50% GP expansion – 1 GP trainee = 2 Postgraduate trainees per annum = 10 nursing students per annum
• To invest in training we will need to disinvest in other courses• Alternatively costs may be transferred to Providers – this doesn’t help
the system
The system needs to look at the lifetime cost of education and training – PLiCs and SLR for education to enable strategic investment decisions