During the Bill's progress through the Lords there have been a number of amendments put forward, including some on workforce and HR issues. Among them were amendments affecting the regulation of healthcare workers, pay and education and training. A number of these received significant press coverage and I wanted to ensure you were informed of the outcome of discussion. I have detailed at the foot of this letter a list of the amendments tabled prior to this 'report stage' (a further stage of debate in the Lords which will last approximately a month) and the outcome from the resulting debate.
Amendments will continue to be debated in respect of workforce issues during report stage and it is clear education and training remains an area where peers on both sides of the house seek to ensure it is embedded within the new architecture. The most recent Government amendments call on the NHS Commissioning Board and Clinical Commissioning Groups to have regard to the need to promote education and training.
While there has been much discussion on these areas as the Bill has progressed, in general the Bill contains very little detail about the reforms to education and training. The Government has said that they intend to publish draft legislation (possibly as part of a Bill covering other issues) on education and training for pre-legislative scrutiny at some point during the second session of parliament, which begins in May. In January the Department of Health published Liberating the NHS: Developing the healthcare workforce - from design to delivery, which provided detail on how the new education and training system will work.
To inform the reforms, NHS Employers consulted with you and submitted evidence in response to both the Government's consultation on their proposals to reform workforce planning and the independent Future Forum's two phase listening exercise, which focused in part on education and training. In addition, I have met a number of peers to inform them about our work in these areas and we have provided factual briefings for the Lords. For more information on the reforms visit our education and training reform web pages.
This week the Bill entered report stage, which will last approximately a month. Peers will next vote on the full amended Bill during a third reading debate, expected in March. The Bill then returns to the House of Commons in order for the Commons and the Lords to agree a final text. The timing of royal assent remains uncertain but is expected in early May. As discussions draw to a close we will continue to work on your behalf to ensure your views are heard.
Outside of activity associated with the Health and Social Care Bill, the Department of Health has now reached the stage in the Electronic Staff Record retendering process where they are seeking views on user requirements for the new system. As your representative organisation we are keen to hear your views and feed them back to the ESR team. I'd be pleased to hear your initial thoughts on what you need strategically from such a system and we can make sure these are taken into account.
On pay, the Government has asked the independent NHS Pay Review Body (NHSPRB) to consider how the pay of NHS staff could be made more responsive to local labour markets. We are currently seeking your views on this important issue to feed into our submission on behalf of employers in the NHS, so please help to ensure that we are representing you by completing our short online survey.
Work on pension reform continues at pace and I will write to you as soon as discussion concludes.
I would welcome any comments or feedback on how we can continue to help and support you. You can contact me at deanroyles@nhsemployers.org. You can also follow us on Twitter and join my LinkedIn page where I will be posting regular updates. For more information on this and similar issues, please see our workforce leader web pages.
With best wishes,
Dean
Dean Royles
Director, NHS Employers
Health and Social Care Bill amendments and outcomes of note
Amendments on education and training
The Government introduced amendment 1E which sought to place a duty on the Secretary of State as to education and training.
Amendment 47A, tabled by Lord Kakkar, sought to insert a new clause placing a duty on the Secretary of State to establish a body called Health Education England.
Similarly, Amendment 47B, tabled by Lord Warner, sought to place a duty on the Secretary of State to "provide or secure" an education and training system and to establish Health Education England to take responsibility for these education and training functions.
Amendment 47B also specified that the budget for education and training should be calculated on the basis of total health service expenditure and, "should be no less than the level of expenditure on education and training at the time of Royal Assent".
Amendment 133ZA tabled by Lord Patel sought to impose a duty on the NHS Commissioning board to promote education and training of the health care workforce.
Outcome
All but the Government's own amendment were withdrawn. The Government pointed to their newly inserted duty on the Secretary of State as to education and training and offered assurance that they intend to publish draft clauses on education and training for pre-legislative scrutiny in the second session. They also said they would publish prior to report stage, a more detailed set of proposals for health education and training in the light of the forthcoming recommendations of the NHS Future Forum. Note Liberating the NHS: Developing the healthcare workforce - from design to delivery was subsequently published on 10 Jan.
Amendment on national pay
Baroness Thornton and Lord Hunt sought to introduce an amendment imposing a duty on the Secretary of State to maintain a national pay and bargaining system for healthcare staff, to cover those staff providing NHS services and services for the improvement of public health.
Outcome
The amendment was withdrawn. Government Minister Earl Howe said employers are best placed to determine the most appropriate pay and reward package.
Amendment on mandated staffing ratios
Lord Patel, Rooker, Willis and Baroness Emerton sought to introduce a duty on the NHS Commissioning Board to mandate for the ratio of registered nurses to registered and non-registered health care support workers required.
Outcome
The amendment was withdrawn. Earl Howe said these decisions are best made locally. He pointed out that the NHS Constitution already stated 'that patients have the right to be treated with a professional standard of care by appropriately qualified and experienced staff'. In addition he said the CQC are there to ensure all providers meet essential safety and quality standards.
Amendment on regulating the support workforce
Baroness Emerton and Lord Patel sought to introduce an amendment which would give the Nursing and Midwifery Council the power to regulate health care support workers in England.
Outcome
The amendment was withdrawn with the promise to return to the issue at report. The Baroness has since tabled another amendment in this regard to be discussed at report stage.
The Government argued that there are already existing tiers of regulation that protect patients and service users and that to date the case has not yet been made for imposing further compulsory statutory regulation.
Amendment on workforce planning
Baroness Hollins and Lord Patel tabled an amendment which sought to impose a duty on the NHS Commissioning Board to ensure flexibility for clinicians to undertake work for the benefit of patients and the wider NHS
Outcome
The amendment was not debated and therefore did not pass.