The NHS is a vast and complex beast with an employee base spanning across many sectors and cultures, over hundreds of trusts and boards across the UK. Christiana Tollast takes a snap shot view at just some of the training and development issues that an organisation of such magnitude must deal with…

Irrespective of whether you're a fitness fanatic or eating your five a day, the chances are that if you're living in the UK you'll have had experience of the National Health Service (NHS). So when talking to people with experience of working in training and development within the NHS, and those who supply the organisation with its training needs, it is little surprise that just one word seems to sum up the biggest training challenge for the NHS: resources – or rather a lack of them.

As head of workforce planning and education for NHS Plymouth, David Priscott is the first to acknowledge that the NHS needs more resources to train people.

"We need to re-profile the workforce so more support staff are delivering more focussed care. Not only do we need a physiotherapist giving physiotherapy care, but a physiotherapist assistant giving physiotherapy care." It follows, says Priscott, that having better trained support staff, will effectively buy NHS clinical practitioners more time to do their jobs.

Priscott also explains that the constantly changing nature of local health care requirements, coupled with the three to five year lead time to train health professionals, pose a big training headache for the NHS. In Priscott's words, this can lead to "boom and bust" situations, where there are either too few nurses for example, or too many heart surgeons.

Another major factor that determines the training needs throughout the NHS is the demographical and geographical differences across approximately 500 boards or trusts nationwide, which dictate the local skill sets and patient bases.

One former NHS learning and development manager that TrainingZone.co.uk spoke with explained that there can also be "real difficulties for more rural trusts, in accessing clinicians and experts who are able to deliver professional learning within an easily reachable radius. With small training budgets, the transport costs alone can prove prohibitive".

On a more positive note, however, the source also suggested that technology is playing an increasing role in stemming the flow of NHS losses: "A lot of the professional bodies are now able to offer a significant amount of learning online and via video conferencing and podcasts."

This adoption of technology appears to offer a source of real optimism, despite the inherent challenges associated with training in the NHS.

Jane Bodley-Scott, NHS director at Premier IT, a training provider to the NHS, has seen a marked uptake of IT, and in particular elearning-based training. "Although predominantly it is still classroom-based instructor-led training that makes up the larger proportion of training, I think the NHS trusts are progressing significantly in realising the potential of IT training," she explains.

Elearning seems particularly popular in helping clinical staff balance their obligations to keep statutory and mandatory training up to date, with their continuous personal development requirements. By learning online, staff are able to complete the mandatory courses ranging from blood transfusion to infection control, without having to get to a classroom and at a time that fits in with their shift patterns.

Rob Caul, managing director of e2train, providers of learning and performance technologies, has worked with a large number of trusts under the South West Strategic Health Authority (SHA). "Typically two hours of online learning would equate to four hours in a classroom," he says. "It also frees up qualified people to go about their day-to-day jobs, as opposed to carrying out compliance training."

But the use of technology to progress training capabilities is not all that the NHS has up it's surgical sleeve.
www.stepintothenhs.uk is a website designed to help young people aged 14-19 years understand the diversity of the career opportunities available in the health service. The site has been set up by NHS careers, a service managed by NHS Employers (www.nhsemployers.org). The Department of Health (DH) also offers information and advice on training for anyone considering a career within the NHS.

A visit to www.nhscareers.nhs.uk will also provide information on courses ranging from undergraduate and graduate training schemes, through to leadership courses such as the 'Gateway to Leadership' programme, which offers senior managers the chance to use their skills within the NHS. And this is only scratching the surface.

But with over a million employees across the country, how does the NHS ensure consistency of training standards across the organisation?

EQuIP - Enhancing Quality in Partnership - has been developed for the DH by the Sector Skills Council (SSC) as a quality assurance framework for NHS funded education and training. Whilst not compulsory, take up of the framework by SHAs is on the rise. And in addition to EQuIP the individual bodies for clinical training, such as the Royal College of Nursing and the General Medical Council, each have their own training standards which must be complied with.

More generally, to help achieve consistency of quality across all NHS training activities, the ETD standards have been developed. These standards are intended to offer a 'standard way of working for organisations and teams delivering training activity', in conjunction with similar standards that the hundreds of NHS organisations, or trusts, already have in place.

But the key to understanding training within the NHS truly rests with the hundreds of organisations that each have their own training requirements and are all trying to second guess where their budgets will be best spent next year.

As Priscott concludes: "I think things are improving. The long-term strategic planning for health professionals is good. But it could be better if we could visualise the future more."