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Health Education England, Local Education and Training Boards (LETBs) and reform of healthcare education: implications for surgical training

机译：健康教育英国，当地教育和培训委员会（租赁）和医疗保健教育改革：对外科训练的影响

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Background National Health Service (NHS) reforms have changed the structure of postgraduate healthcare education and training. With a Government mandate that promotes multi-professional education and training aligned with policy driven initiatives, this article highlights concerns over the impact that these changes may have on surgical training. Discussion The creation of Health Education England (HEE) and its local education and training boards (LETBs), which are dominated by NHS healthcare providers, should result in greater accountability of employers in workforce planning, enhanced local responsibility and increased transparency of funding allocation. However, these changes may also create a potential poacher-turned-gamekeeper role of employers, who now have responsibility for junior doctors’ training. Analysis of LETB membership reveals a dearth of representation of surgeons, who comprise only 2% of board members, with the input of trainees also seemingly overlooked. A lack of engagement with the LETBs by the independent sector is a concern with increasing numbers of training opportunities potentially being lost as a result. The new system also needs to recognise the specific training needs required by the craft specialties given the demands of technical skill acquisition, in particular regarding the provision of simulation training facilities and trainer recognition. However, training budget cuts may result in a disproportionate reduction of funding for surgical training. Surgical training posts will also be endangered, opportunities for out-of-programme experience and research may also decline and further costs are likely to be passed onto the trainee. Summary Although there are several facets to the recent reforms of the healthcare education and training system that have potential to improve surgical training, concerns need to be addressed. Engagement from the independent sector and further clarification on how the LETBs will be aligned with commissioning services are also required. Surgical training is in danger of taking a back seat to Government mandated priorities. Representation of trainees and surgeons on LETB committees is essential to ensure a surgical viewpoint so that the training needs of the future consultant workforce meet the demands of a 21st century health service.
机译：背景国家卫生服务（NHS）改革改变了研究生医疗保健教育和培训的结构。通过政府授权，促进与政策驱动举措一致的多职业教育和培训，这篇文章突出了这些变化可能对外科培训可能产生的影响的担忧。讨论NHS医疗保健提供者主导的健康教育英国（HEE）及其当地教育和培训委员会（租赁）的创建应导致雇主在劳动力规划中更具责任，加强当地责任和提高资金分配透明度。然而，这些变化也可能造成雇主的潜在的Poacher-Surf-Bughekeeper作用，现在对初级医生的培训负责。卢比成员的分析揭示了外科医生的代表性，他们仅占2％的董事会成员，其中受训人员的投入也似乎忽略了。独立部门缺乏与机构的敬意是越来越多的培训机会，潜在丢失的培训机会可能导致。鉴于技术技能收购的需求，新系统还需要认识到工艺专业所需的具体培训需求，特别是关于提供仿真培训设施和培训师认可。但是，培训预算削减可能导致对外科培训的资金减少不成比例。外科训练岗位也将濒临威胁，计划外的经验和研究的机会也可能会下降，并且可能会将的成本转移到受训者上。总结虽然有几个方面是最近的医疗保健教育和培训系统的改革，但有可能改善手术培训，令人担忧需要解决。还需要从独立部门参与，并进一步澄清如何与调试服务对齐。手术培训有危险，占据政府强制优先事项。 Letb委员会的学员和外科医生的代表对于确保外科观点至关重要，以便未来顾问劳动力的培训需求符合21 St 世纪卫生服务的需求。

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