NHS Future Forum - How training needs to change

The NHS Future Forum is advocating change in education and training, writes Julie Moore.

Julie Moore: 21st century care (Photograph: NHS Future Forum)
Julie Moore: 21st century care (Photograph: NHS Future Forum)

In this second phase of the NHS Future Forum, the education and training workstream is listening to a range of professional groups from the acute sector and primary care.

Training needs to change. In particular, there is concern that doctors are made to specialise early in their careers and this leads to inflexibility. We have heard concerns from people that this can tie doctors into long careers in one specialism. This presents certain risks, such as not allowing people to retrain to work with new therapies or treatments, as well as expecting doctors to continue working in high-pressure jobs such as urgent care or intensive care for their entire career.

Generalist role
In hospital medicine, we have heard a lot about the role of the generalist being lost in the rush to specialise. We are told the generalist role is increasingly important as patients live longer, with many people having more than one long-term condition. This role will therefore become more critical in the future.

In primary care, we have heard concerns that GP training is too short and we might not be preparing doctors adequately for the significant shift of care into the community that will need to happen in the new system. It has also been voiced that GPs do not receive enough training in some important areas, such as mental health, yet often see many patients with mental health needs.

So how do we give our professionals the skills they need for the future? We know that medical advances such as gene therapy have the potential to transform care pathways for patients, but what does that mean for the clinical staff who need to work in these areas?

Standards and quality
We are listening to concerns about the standards, quality and location of training. For example, how do we ensure our healthcare facilities are good places to train? How are we monitoring the standard of training and its frequency? How easy is it to adjust training to meet advances in patient care?

Continuing professional education is another question on people's minds. So far, this has been a concern voiced most often in primary care, where people can feel more isolated. We have heard anecdotal evidence of nurses working in frontline care who have had no extra training in many years. It has also been raised by allied health professionals, who say there is significant variation across the country in how they access development opportunities and support.

These are challenging questions. At the same time, we have heard about advances in education and training that mean doctors have a more rounded education than ever, and with this comes a better understanding of the skills needed for care in the 21st century and the way we in the NHS can deliver them.

  • Julie Moore, chief executive of University Hospitals Birmingham NHS Foundation Trust (UHB), leads the education and training workstream of the NHS Future Forum.

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