HEE staff cuts threaten medical education and patient care, BMA and unions warn

Plans to cut staff at Health Education England could damage the care of patients and affect the number of doctors in training, trade unions have warned.

On 23 February HEE, which is responsible for medical education and training in England, wrote to all its 2614 staff announcing a scheme to allow them to take voluntary redundancy to save money.

In 2014 the Department of Health for England announced that it was cutting HEE’s budget, which ran to £4.9bn (€5.8bn; $6.1bn) in 2015-16,1 by 20% by 2020.2 The move was a result of a 20% cut to the department’s own budget and is on top of the £22bn efficiency savings being demanded of the NHS.

In response to the demands, HEE announced that it was consulting on substantial changes designed to ensure its sustainability, reduce its senior staffing bill, and cut its running costs.

An email sent to staff said that, though the voluntary redundancy scheme was open to everyone, staff members did not have an automatic right to voluntary redundancy. It said that it would have to consider various factors when approving applications for voluntary redundancy, such as “the requirement to retain qualifications, skills, and experience which are essential to HEE” and “the needs of the organisation and financial implications.”

Commenting on the plans, Nick Bradley, national health officer for Unison, the trade union that represents HEE staff, warned that cuts could have an effect on patient care. “Unison utterly opposes further cuts to NHS services, although we support any voluntary redundancy scheme that allows staff to leave on their own terms,” he said. “But there’s now a real danger the organisation won’t have enough resources to coordinate workforce planning and education properly across the NHS, threatening a lower standard of patient care.”

Krishna Kasaraneni, the BMA’s lead on GP education, training, and workforce, warned that any cuts to HEE’s budget would have a knock-on effect on GPs’ training. “I understand that [HEE] have to make around 20% to 30% savings by 2020, but that translates to frontline staff and our training programmes. From a general practice point of view it will be the end of general practice training as we know it,” he told The BMJ.

He added, “[Training GPs] requires a significant level of financial investment, personal investment, and a lot of time from the GPs and the practices involved. If the funding for that, which is already inadequate, is cut further, or the provisions for general practice training are compromised in any way, people will stop training GPs.”

Commenting on the redundancy plans, Ian Cumming, chief executive of HEE, said, “HEE faces the requirement to reduce the amount of money we spend on running the organisation to reflect both the reduction in our administration budget over the coming period and the need to free up resources to reinvest in our priorities as an organisation, which includes primary care.

“HEE and our trade union partners are committed to avoiding compulsory redundancies wherever possible. We are committed to using a voluntary approach. It therefore makes sense to run this scheme now, as all of the savings that accrue will in turn reduce the total amount required from the wider changes currently being planned for the 2017-18 financial year.”