Health and Care Bill: workforce accountability and Local Education and Training Boards (LETBs)
Updated 10 March 2022
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NHS Providers said:
The removal of LETBs in statute will be one part of a wider move towards a new operating model for the workforce, and serves to formalise the current, positive direction of travel.
This fact sheet explains the new duty on the Secretary of State to publish a report supporting workforce planning and supply in the NHS as well as the removal of Local Education and Training Boards from statute.
Background
A number of stakeholders, including the Royal College of Nursing, UNISON and some medical Royal Colleges have argued that accountabilities for workforce planning and supply are not currently sufficiently clear. In response, NHS England (NHSE) recommended that the Department of Health and Social Care (DHSC) should review this issue as part of any new legislation.
The new duty will require the Secretary of State to publish a report that sets out how workforce planning and supply is organised in England, in order to provide greater transparency and accountability. This report must be published, at a minimum, every 5 years. This duty will complement the concerted non-legislative action and investment on workforce planning and supply already underway.
A flexible approach is needed because the system and how it works together continues to evolve. An example of such a change, which is also in this Bill and covered in this fact sheet, is the abolition of Local Education and Training Boards (LETBs) to allow the creation of non-statutory Regional People Boards. This will change the way workforce planning is conducted at regional and system level.
LETBs were originally established to perform HEE’s functions at local and regional level and had a direct role in commissioning the education and training required at local level, a role which has diminished following the 2017 education funding reforms. LETB functions are also restricted by legislation which has limited their scope to adapt and interact with the regional directorates of NHS England and NHS Improvement (NHSE/I) and the newly established non-statutory Regional People Boards (which now provide a consistent architecture across England for oversight of Workforce, education and training).
Removing LETBs from statute will reduce duplication of purpose in the system and allow Health Education England (HEE) to establish a flexible and future-proofed regional workforce operating model based. This work will be based on the experience of collaborative working between HEE, NHSE/I and DHSC on the development of the NHS People Plan.
What the Bill will do
This Bill will give Secretary of State a duty to publish, at a minimum every 5 years, a report outlining how the workforce planning and supply system for the NHS is organised. There is also a duty for HEE and NHSE to assist in the preparation of the report, if asked to do so by the Secretary of State.
This workforce accountability report will set out the roles of DHSC and its arm’s length bodies, NHS bodies and others and how they work together, in order to provide greater clarity and transparency. The report will cover the whole of the health service in England including primary, secondary, community care and where sections of the workforce are shared between health and social care – for example, registered nurses, doctors and other regulated healthcare professions.
Subject to passage of the Bill through Parliament, we propose to start work on the report in the spring of 2022 and will proactively involve stakeholders in this process.
The role of HEE and their LETBs are set out in the Care Act 2014. The Bill will remove LETBs from statute with their functions being undertaken by HEE, to whom the LETBs reported.
How these provisions help to improve accountability
The report will provide clarity and transparency as to how the workforce planning and supply system operates, by describing the workforce planning and supply roles of relevant national bodies, including DHSC, HEE and NHSE/I, the newly established Integrated Care Boards (ICBs), Regional People Boards and individual employers - and how they work together in practice at national, regional and local levels. It will not create any new bodies, set out workforce targets or give any bodies new functions, in order to maximise flexibility.
Removal of LETBs from statute will contribute to the removal of inflexible bureaucratic forms within the NHS and allow HEE the freedom it needs to set its own regional operating model that can develop over time.
Further information
NHS England and NHS Improvement, Implementing the Long Term Plan: proposals for possible changes to legislation, February 2019
The NHS England’s recommendations to government and Parliament for an NHS Bill, September 2019.