Annual Report and Accounts 2020-21 Health Education England (Executive Non-Departmental Public Body) www.hee.nhs.uk We work with partners to plan, recruit, educate and train the health workforce. HC 266 Health Education England (Executive Non-Departmental Public Body) Annual Report and Accounts 2020-21 Presented to Parliament pursuant to Paragraph 26 (4) of Schedule 5 of the Care Act 2014 Ordered by the House of Commons to be printed on 15 July 2021 HC 266 © Crown copyright 2021 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is available at www.gov.uk/official-documents Any enquiries regarding this publication should be sent to us via www.hee.nhs.uk ISBN 978-1-5286-2444-2 CCS0221001382 06/21 Printed on paper containing 75% recycled fibre content minimum Printed in the UK by the APS Group on behalf of the Controller of Her Majesty’s Stationery Office About Health Education England Health Education England exists for one reason only: our vision is to help improve the quality of life and health and care services for the people of England by ensuring the workforce of today and tomorrow has the right skills, values and behaviours, in the right numbers, at the right time and in the right place. Our purpose as part of the NHS, is We serve … to work with partners to plan, recruit, educate and train the health workforce. We are people centred, committed to the NHS Constitution, and driven by our values of responsibility, inclusiveness, fairness and confidence. Our goals are to deliver and reform education to produce the best possible future workforce, to transform the current workforce to meet tomorrow's health and care needs, and ensure the quality of our education and training system. 5. Health Education England - Annual Report and Accounts 2020-21 Contents Foreword from our Chair and Chief Executive 7 About Health Education England 9 Our Strategic Direction 11 Performance Report 15 Statement on Performance from our Chief Executive 15 Overview 16 Performance Analysis 17 Financial Review 43 Accountability Report 47 Corporate Governance Report 47 - Directors’ Report 48 - Statement of Accounting Officer’s Responsibilities 63 - Governance Statement 64 Remuneration and Staff Report 72 Parliamentary Accountability and Audit Report 96 The Certificate and Report of the Comptroller and Auditor General to the Houses of Parliament 97 Annual Accounts 2020-21 102 Notes to the Accounts 106 Annexes 122 Annex 1: Summary of HEE’s delivery against the 63 Commitments 122 Annex 2: Attendance at Board and Committee Meetings 2020-21 128 Annex 3: Corporate Governance in Central Government Departments: Code of Good Practice 2017 Compliance Checklist 132 Annex 4: Information Governance Annual Incident Summary 133 Annex 5: Internal Audit Review Classifications 136 Glossary 138 6. Health Education England - Annual Report and Accounts 2020-21 Foreword from our Chair and Chief Executive As we write this foreword, just at the close of the last financial year, more than 30 million people have received their first COVID-19 vaccine dose. Health Education England (HEE) has played a crucial role in making this possible, from our Chief Nurse leading the workforce preparations, communications supporting the cross-NHS campaign and our Technology Enhanced Learning team delivering e-learning. Whilst responding to the pandemic, we worked closely with partners to continue education and training where possible. We deployed doctors in training flexibly, partnered with ambulance trusts to maintain student placements, ensured student nurses could continue to study, and provided training for the Vaccination Programme. Our Annual Report & Accounts shows how we delivered during 2020-21, a year in which HEE responded to unprecedented challenges with compassion and agility. We supported patients, learners and the NHS with our unique expertise and system responsibilities. Key pandemic responses • supported around 40,000 learners to play key roles including nursing, midwifery, allied health profession (AHP) students and medical student volunteers • created and implemented a foundation interim year so final year medical students could volunteer as foundation doctors ahead of the usual August start date. Around 3,800 doctors were deployed in England • launched COVID-19 free global e-learning, used nearly 4.5 million times • led workforce modelling, providing real time evidence and information about the skills and expertise of learners, enabling matching to NHS need • supported thousands of colleagues to work remotely supporting the NHS, ensuring the education and training of learners, and protecting the pipeline of new professionals for the NHS. We thank all our colleagues for their extraordinary work in this extraordinary year Our ability to invest in learners was hugely impacted by the pandemic, leading to a budget underspend at the end of the financial year. Catching up for learners who were disrupted is a significant issue and cost for 2021-22. Supporting the future workforce Whilst we played our part in dealing with the crisis, we remained focused on our key priority: ensuring future NHS workforce supply. Investment has been made to increase clinical placements and grow nursing, midwifery, and allied health professions, through our Clinical Placement Expansion Programme. During 2020-21 we also saw a record increase in applications to become nurse students with 32% growth in year. We recruited record numbers of GP trainees, with 3,793 posts, 500 more than our target. We also expanded training places for clinical psychologists and child and adolescent psychotherapists by 25%. Making HEE the Best Place to Work Last year the Board identified HEE becoming the Best Place to Work as their key priority, recognising that supported, involved, and engaged colleagues deliver better results. We ensured the pandemic did not marginalise this goal. In many ways the pandemic forced us to move faster towards improving our ways of working and our culture. We continued to implement recommendations from our staff engagement programmes and co-created our values: responsible, fair, confident, and inclusive. As we embed these values, we will also explore what the future of work should look like. We will gather information, evidence, and intelligence about the possibilities for delivering our priorities in more flexible, agile, sustainable and family friendly ways by harnessing technology and the lessons of the pandemic. 7. Health Education England - Annual Report and Accounts 2020-21 Foreword from our Chair and Chief Executive Making HEE a Digital First organisation The NHS further embracing digital technology is vital and preparing a digital ready workforce is key to its success therefore we are committed to building a Digital First HEE; walking our talk. Our Topol Fellows for Digital Healthcare continued with the second cohort, making over 50 fellows to date. We played a key role in creating and implementing the inaugural blended learning nursing degree using current and emerging digital and innovative technologies. Our Digital Boards programme, with NHS Providers, is helping Boards understand the potential and implications of the digital agenda and increasing their confidence and capability to harness it. The future We have continued to build on our commitment to cooperation and collaboration with partners such as NHS England and NHS Improvement (NHSE/I), the Department of Health and Social Care (DHSC), Royal Colleges, professional regulators, and providers of NHS services. We worked closely with DHSC to inform the contents of the recent white paper for the Health and Care Bill. We look forward to working with new Integrated Care Services (ICSs) as they develop. We will also work with partners to refresh our strategic workforce planning framework. Next year will have its own challenges, including recovering from the pandemic and embedding its lessons, but we remain focused on ensuring the NHS has the workforce it needs including key commitments around 6,000 extra doctors in primary care, 26,000 extra primary care professionals, and 50,000 additional nurses. None of HEE’s achievements are possible without our people, our advisory committees, and our partners. We are grateful to them all. In particular we would like to offer our sincere thanks to Professor Wendy Reid for her excellent leadership of HEE as Interim Chief Executive, before Dr Navina Evans started in post. Sir David Behan CBE Dr Navina Evans CBE Chair Chief Executive 8. Health Education England - Annual Report and Accounts 2020-21 About Health Education England HEE is part of the NHS and works with partners to plan, recruit, educate and train the NHS workforce. HEE was established by Parliament in 2012 as a Special Health Authority, and in 2015 became a Non-Departmental Public Body through the Care Act 20141. The Care Act 2014 sets out HEE’s remit, roles and responsibilities, including its duty to ensure an effective system of education and training for the NHS and public health. The Care Act 2014 also places a duty on HEE to have regard to the NHS Constitution 2. The NHS Constitution establishes the principles and values of the NHS in England and unites patients, the public and staff in a shared ambition for health and high-quality care for all, now and for future generations. We are committed to putting patients at the heart of everything we do, promoting transparency and equity and ensuring the efficient use of public money. In 2020-21 Parliament and government entrusted HEE with £4.341bn, to plan, recruit, educate and train the health workforce. The government’s annual mandate to HEE is a requirement of the Care Act 2014 and it sets out the government’s strategic objectives for HEE in the following areas: • workforce planning • education • training.