Download - Money, Money, Money – the Cost of Education Health Education North Central and East London

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


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)


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


Who do we Pay?

5

2014/15 Projections by Funding Stream

14%

71%

7%

2%2%4%

Universities & Medical SchoolsNHSStudent Support UnitNon NHSPayIncome


Training Funding


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


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


• 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


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


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


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


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

Download - Money, Money, Money – the Cost of Education Health Education North Central and East London

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