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Medical education bodies to cut training after last minute change to funding allocation

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2899 (Published 03 May 2013) Cite this as: BMJ 2013;346:f2899
  1. Helen Jaques, news reporter
  1. 1BMJ Careers
  1. hjaques{at}bmj.com

Medical education organisations are planning to make cuts to their training and workforce plans for 2013-14, after a last minute change to the funding allocation formula left many boards millions of pounds short.

Continuing professional development, workforce planning, and expansion of general practitioner posts could all be hit in the regions where education boards had the biggest unplanned drops in funding.

The organisations that took control of medical education and training in England this April—previously known as local education and training boards (LETBs) but now simply known as committees of Health Education England—were given draft funding allocations in January 2013. However, a decision in March by Health Education England to change the funding allocation formula has meant that five boards are receiving millions of pounds less for 2013-14 than they were expecting.

Health Education South West and Health Education West Midlands both saw their funding drop by more than £15m (roughly 3-4%) as a result of the last minute change. Education boards in the north east, east Midlands, and Yorkshire and the Humber also all had a fall in funding.

Many of the 13 health education organisations had already recalculated their investment plans in response to funding uncertainty. Health education committees were initially expecting to receive funding for 2013-14, based on the sums that they were allocated as deaneries in 2012-13. But the first draft allocations provided in January were, in many cases, several million pounds less than they had budgeted for in their investment plans.

The new allocation formula that Health Education England used to calculate final allocations in March 2013 was based on how much deaneries spent in 2011-12, reducing some boards’ funding even further.

The final allocations for 2013-14 are, in some cases, more than £10m less than the 2012-13 figures that education bodies had based their investment plans on last autumn, and several million pounds less than the proposals put forward in January.

Eight education boards saw their allocation increase after the formula was changed in March. However, all but one of these boards had been allocated less than they had planned for when they were given their first draft allocations in January.

Health Education East Midlands was initially expecting to receive £375.4m worth of funding for healthcare education and training. But instead, it had its allocation reduced by £13.7m (3.6%) to £361.7m. Despite reducing this shortfall to £11.5m by reviewing its budget plans, the organisation is planning to cut investment for some activities, such as continuing professional development for staff and associate specialist doctors, in order to balance its books.

“Historic underfunding for the region has compounded the problem for East Midlands,” the organisation said. “Disinvestment decisions made by our board, which do not need to be made in other regions, may make the East Midlands a less attractive area to train.”

Health Education South West has been allocated £21.8m (6.2%) less than it had originally budgeted for last autumn, and £15.5m (4.5%) less than had been suggested in January, a position that its board describes as “extremely disappointing.” The organisation has proposed cutting back on expansion of general practitioner posts as one way to balance its budget.

The Department of Health has given Health Education England £4883m to spend on education and training of healthcare professionals in England, which it is responsible for allocating to the regional education committees. This sum is 2.76% more than the total given to deaneries in 2011-12, but only £4m more than what was allocated in 2012-13.

Given the ongoing costs that it has to meet, Health Education England has marginally less to distribute than actual expenditure in 2011-12.

Health Education England said: “The [Health Education England] budget of nearly £5bn represents spending of nearly £10 000 a minute on education and training. That is based on the amount previously spent by strategic health authorities in 2011/12 and that is the amount that we have allocated.”

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