House of Commons Select Committee Inquiry intoFoundation Trusts.

Submission by the Council of Heads of Medical Schools

1. TheCouncil of Heads of Medical Schools (CHMS) welcomes this opportunity to submitevidence to the Select Committee. CHMScomprises all of the deans or heads of university medical schools or facultiesof medicine in the United Kingdom that provide undergraduate medical educationand undertake medical research.

2. CHMSwould like to emphasise the overwhelming importance of high quality educationand research for UK healthcare, as well as for UK Plc. CHMS therefore welcomes the explicitstatement of the duty of Foundation Trusts to be involved in education anddevelopment, including partnerships with education providers, in the licenceagreement of these Trusts. There are anumber of opportunities for education and training within the proposals, aswell as for working partnerships between new Trusts and higher educationinstitutions, for example in the creation of academic health centres.

3. Thereis a huge demand for education and research within the NHS and currently thereare over 5,000 university employed staff with honorary contracts to the NHS andthroughout the health professions this number is increasing. It is thus crucial that the critical role ofthe universities in training new doctors and providing further education forqualified doctors is given major consideration. It should be noted that these academics provide not onlyeducation to current and future NHS staff but also have an important role inthe provision of clinical care. Clinical leadership in a number of tertiary orother specialties is already provided by the academic sector.

4. Educationand research are important throughout the NHS, including in PCTs, NHS Trusts,Specialist Trusts; there is an increasing emphasis and need forinterprofessional learning provision. If only some of these become FoundationTrusts, and others fall in quality problems will arise for universities.

5. CHMStherefore has concerns that the critical roles of education and research,lifelong learning, continued professional development, and clinical leadershipcould be affected by the Foundation Trust status. It would be should these roles be not recognised by theGovernment proposals. The important andintimate partnerships between the NHS and universities must continue to berecognised and valued. The lines of responsibility between the FoundationTrusts and Higher Education Institutions, including the universitiesanswerability to regulatory bodies, quality assurance agencies, and funding councilsfor the fruits of this partnership should be defined with this in mind.

6. Thereremains some ambiguity about the position of Higher Education Institutions onthe Boards of Foundation Trusts. Theabsence of a guaranteed place for the universities, which provide teaching andresearch for the NHS, on the Management Board of concern to CHMS particularlywith regard to the development of University Clinical Centre Partnerships. Medical schools being accountable out withthe NHS for the quality of healthcare education and must be adequatelyrepresented on the Management Board and Board of Governors.

7. Thedevolution of financial control from Whitehall to the local Trust level raisesconcerns that differential salary scales will be available within FoundationTrusts and may not be available for those employed by the universities butworking in the Foundation Trusts. Theequality of pay-scales for clinical staff whether employed by universities orby the NHS is vital for recruitment, especially as in general university staffdo not participate in private practice.There are already critical difficulties in the recruitment and retentionof clinical academics in higher education institutions. This is well documentedwithin medicine and is increasingly becoming a problem for nursing and theallied health professions.

8. CHMSwelcomes the opportunity for Foundation Trusts to have a teaching and researchemphasis yet would like to see assurance that funding streams will exist forthis. Equally, that the position ofteaching and research within other Trusts will not be compromised. There is aquestion over the management of teaching and research funds with financialcontrol passing to the Foundation Trusts.It is important that those Trusts that achieve Foundation Trust statushave a continuing requirement to agree formally with Higher EducationInstitutions contracts for deployment of R&D funding and for education andtraining, both clinical placement and facilities support.

9. CHMSwould be pleased to contribute further to the Committees Inquiry or give OralEvidence should that be sought.

Yours sincerely

Professor Robert Boyd

Chairman

6 January 2003