In conversation with:


Alison Hunt, Head of Financial Systems, Health Education England

What does Health Education England do?

Our Chief Executive likes to say that we train 300 professional clinical groups – people think of nurses, dentists, physiotherapists and doctors (there are 48,000 trainee doctors at the moment), but there may be only 50 trainees across the country in some professions. We concentrate on clinical training, especially qualifications which allow patients to be assured of clinical standards and the relevance of the expertise to the level and nature of their condition.
If you go to medical school for five years and get your medical degree, which is a GMC registration qualification, you can’t yet practice independently as a doctor – for that you need further training. So you’ll have a consultant or GP, with others under their supervision, as those people haven’t yet got their certificate to practice independently. Similarly nurses will possibly take a degree in nursing, and can go on to take second registration qualification, eg in intensive care or children’s nursing. But not everyone goes on to a second qualification. We also assist with the development of further clinical expertise, eg Masters degrees relating to clinical research – here, we are involved, but there is more employer focus and funding independent of us.

Only much more recently have we become involved in other training – because from April 2016 we took over the NHS Leadership Academy as a result of the Rose Review. We have a limited role in terms of social care, as we don’t train social workers: if we train people for health, they may go on to work in social care, but more by accident than design. We are NHS-focused, as we are taxpayer funded, but may also train people in private sector settings. 

We have the responsibility to ensure a balance between the clinical staff having the right training and experience, and the need for the NHS to have a sufficient supply of staff to meet the needs of the service. There can be up to 15 years training for a doctor, so forward planning is critical and quite complicated.

What does that cost?

To do all those things we currently need to spend about £100m per week. That sounds a lot, but it’s a very qualification-oriented service. Although we are essentially funded by taxpayer, people who are training also make their own contributions, eg undergraduate medical students will pay for their university fees and accommodation – we pay the final year’s fees plus for the registration training.

There have been recent changes to training funding, can you explain?

The Treasury, the departments of Health and Education, and Universities UK held discussions which led to a change in the training of nurses from the coming academic year starting this autumn: the NHS will not cover all their costs as now, but will expect of more contribution from individuals / families in the same way as if you are doing a chemistry degree. That has received a lot of publicity. 

What is your role?

I have worked in Health Education England and previously in workforce education and corporate finance for two Strategic Health Authorities. My role now is to make sure, nationally, that we have the systems and finance in place to coordinate the contracts we need.

What one thing would you like to change about how NHS finance works in practice?

We have the structure and management arrangement where everything has to balance within the financial year, which commercial organisations and councils don’t have to do – it’s better to be able to work on the basis of being able to carry money forward from one year to the next. I’d change that, as we are too driven by the short term – especially in a business such as ours, in which 15 year planning span is needed.

What do you wish you had learnt when starting out in your career?

I wish I’d had the opportunity to learn more about computers and IT. And, going way back, I didn’t appreciate that teamwork is everything!

What are your proudest professional moments?

First, we set up the systems for Health Education England to go live 1 April 2013 – I was very relieved when everything worked! Second, I was working in one of the 24 SHAs responsible for workforce development when all were evaluated by the Audit Commission, and we came out in the top two for delivering best practice and meeting objectives.

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