NHS England » NHS Education Funding Agreement 2024-27

Introduction

Following our consultation, which ended on 28 March 2024, NHS England has now published an updated 2024-27 NHS Education Funding Agreement Template.

This document describes the material changes we have made in the NHS Education Funding Agreement in response to stakeholder feedback received during the consultation process.

We have published this updated NHS Education Funding Agreement 2024-27 now, so that NHS England commissioners, education providers and training providers are able to see the proposed NHS Education funding agreement text and can start to complete the Schedules locally, so that, wherever possible, NHS Education Funding Agreement can be agreed in advance of services.

We have also published a supporting guide for the 2024-27 NHS Education Funding agreement on our website. The guide summarises key aspects of the agreement in an easy-to-understand layout for stakeholders reading and reviewing the agreement.

Overall consultation feedback

We received feedback from 142 organisations or individuals in relation to the specific changes we proposed in the draft 2024-27 NHS Education Funding Agreement. Most responses received were from higher education institutions (HEIs), accounting for 38.7% of all responses. A full breakdown of the categories of organisations responding to the consultation is laid out in Table 1.

Table 1 – Breakdown of responses by organisation category

Organisation category	Count of organisation categories	% of organisation categories
Integrated care board (ICB)	3	2.1%
NHS trust or foundation trust	50	35.2%
NHS England	14	9.9%
Higher education institution	55	38.7%
Professional Body	6	4.2%
PIVO	12	8.5%
Local Authority	2	1.4%
Total responses:	142	–

Each of the proposed changes had significant majority support amongst the respondents, with fewer than 14% of respondents disagreeing with any of the individual proposals. In most cases, we have therefore retained the wording proposed in the draft version in the final NHS Education Funding Agreement.

In a small number of cases, consultation feedback has prompted us to make minor changes in the final version of the NHS Education funding agreement. In other cases, the feedback indicates that, while the specific proposed changes to the agreement are supported, further clarification as to their rationale and intent would be helpful. Our detailed response is set out, issue by issue, below.

A quantitative breakdown of the written feedback by section / schedule of the draft NHS Education Funding Agreement is provided in Annex A.

Changes in response to feedback

Changes to the NHS Education Funding Agreement have been agreed with relevant programme leads and NHS England’s legal team and approved by the consultation Oversight Group.

The final changes are summarised in the table below.

Section/schedule	Clause	Type of change	Summary of the change needed/agreed wording in final NHS Education Funding Agreement template
Main Body Terms	5.6	Editorial change	The Provider undertakes to fulfil the obligations of its roles and responsibilities set out in the NHS England Education Quality Framework and the terms of this agreement, including demonstrating leadership accountability for educational governance within the organisation such as at board level, senior leadership level *“or equivalent proportionate to organisation size”* that ensures effective accountability for continuous improvement of quality and performance.
Main Body Terms	5.9	Editorial change to make the clause applicable universally.	The Provider shall ensure that there is responsibility for compliance with this agreement at the highest governance level within its organisation for healthcare education and training, this is expected to be either at board level with a nominated director “or equivalent to the organisation size,” responsible for all education and training
Main Body Terms	6.1	Editorial change	*“With the exception of General Practitioner training – where GP schools provide and manage Clinical Educators”*, placement Providers shall identify and appoint sufficient numbers of Clinical Educators to enable the Services to be provided in all respects and at all times in accordance with this agreement. Placement Providers are responsible for the management of Clinical Educators.
Main Body Terms	11.12	Editorial change	The Provider must cooperate with “NHS England, their local Integrated Care Boards or GP school“ in the manner and to the extent they request in planning the provision of, and in providing, education and training for healthcare workers, and must provide them with whatever information they request for such purposes. The Provider must have regard to the NHS England Education Quality Framework and Regulator requirements.
Main Body Terms	16.11 and 16.12 in the draft published template	Deletion of clauses	These clauses are no longer required. The Education and Training guidance and Tariff sets when funding is available. 16.11. NHS England will not fund consecutive training or salary support for Learners on different Programmes without a minimum of twelve (12) months employment in the NHS for the previously funded position unless this is part of a profession pathway development agreed in writing by NHS England. Exceptional circumstances must be agreed by a National Director or Regional Director. This does not include placement tariff funding or workforce development funding which is agreed with NHS England before education and training commences. 16.12. Providers should comply with clause 16.11 for their recruitment activities.
Main Body Terms	23	Inclusion of Lead Employer	23. Safeguarding 23.1 The Provider “or Lead Employer” shall at all times: (a) ensure that all Staff and Learners are subject to a valid enhanced disclosure check for regulated activity undertaken through DBS; (b) monitor the level and validity of the checks under this clause 23 for Staff; and (c) not employ or use the Services of any person who is barred from, or whose previous conduct or records indicate that he or she would present a risk to individuals.
Main Body Terms	28	New sub-clauses to cover IPR for Employed Learners	Clause 28 to change to 28.1. No Party to this agreement shall acquire the Intellectual Property Rights of any other Party “under this agreement.” 28.2. Where an Employed Learner is in a Placement as part of a Programme that is intended to, or in fact does result in the development of Intellectual Property Rights of potential benefit to the NHS, the relevant parties to that Placement shall: (a) If this is anticipated as part of the Placement, use reasonable endeavours to agree a separate agreement in relation to the ownership of the Intellectual Property prior to the commencement of the Placement; or (b) If no agreement is reached under 28.2(a), or the Intellectual Property Rights is an un-anticipated development under the agreement, the relevant parties shall use reasonable endeavours to agree an equitable division of the intellectual property with appropriate licences as between them.
Schedule 1	Activity Box	Inclusion of Training Grants as a service	Inclusion of Training Grants as a service with a “Yes or No” in the box
Schedule 1	5	Editorial change	Title to change to “Knowledge and Library Services”
Schedule 1	5.4	Editorial change	To change the word HEE policies to “NHS England Policies”
Schedule 1	5.9	Inclusion of hyperlink or footnote link	appropriate level of Funding https://library.nhs.uk/wp-content/uploads/sites/4/2022/10/NHS-KLS-Funding-Policy-guidance.-Final-20220706.-Approved.pdf
Schedule 1	9.6.4, in the draft published template	Deletion of clause	The clause is no longer required. The Education and Training guidance and Tariff sets when funding is available. Any additional provision will be set out as part of the offer of service via Change Control Notice. 9.6.4. have not been in receipt of NHS England Funding for the previous years, unless agreed by NHS England in advance.
Schedule 1	Clauses 15-19	Editorial change	The clauses have been updated based on the feedback received and to reflect NHS England priorities. See attached Annex 3 with the changes made in these sections.
Schedule 1	19.7	Editorial change	To change to: “NHS England will provide free access to eLearning for healthcare and other digital learning resources through the Learning Hub. Providers are expected to promote and engage with and promote online and virtual learning to all Staff and Learners“
Schedule 1	20	New clause added	Exemption for the Provision of Doctor’s Training in General Practice from certain terms of the NHS Education Funding Agreement. 20.15. A Placement Provider under part 20 of Schedule 1, shall not, in respect of those Services, be required to comply with the following clauses of the NHS Education Funding Agreement which in ease case are the responsibility of another organisation (the Lead Employer for those Doctors): 20.15.1. Clause 11.14(c)- (appointing Guardians of Safe Working in relation to the 2016 terms and conditions of service); 20.15.2. Clause 12 (Employed Learners); 20.15.3. Clause 13 (Non-Employed Learners); and 20.15.4. Clause 17 (Funding).
Schedule 1	20.4.5	Editorial Change	Ensure that the Doctor has access to a senior colleague for help and advice at all times. There should be at least one senior colleague available at all times to the Doctor who is not a locum “unless agreed upon with the GP school.”
Schedule 1	20.4.14.3	New Clause	20.4.14.3. Ensure that the Doctor is consulted prior to being placed within the Placement provider’s Primary Care Network
Schedule 1	21	New Clause	21. Training Grants 21.1. Training Grants to be paid in line with the agreed and approved finance model for the given financial year, for a specific Programme. 21.2. Details of any controls and KPIs where relevant to be detailed in confirmation of the Training Grant from the relevant NHS England Workforce, Training and Education regional teams. 21.3. Training Grants are only paid where a Learner has been confirmed to have started on the Programme funded by the Training Grant and will be validated through data collected related to Programme.
Schedule 3	Title	Editorial change	To change to Quality and Agreement Performance
Schedule 3	1.2	Editorial change	This Schedule sets out the expectations for Providers in respect of the application and monitoring of education quality through the NHS England Quality Strategy and “NHS England Education Quality” Framework and associated quality and performance requirements.
Schedule 3	1.4	Editorial change	“This Schedule applies to all education and training learning environments to support inclusive language for all learning environments” including online and virtual.
Schedule 3	2.3	Removal – editorial of “as a whole system, and “articulates” to “sets out “	The Education Quality Framework sets out the expectations NHS England requires of the quality of the learning environment, working alongside regulatory and professional frameworks and requirements, where relevant.
Schedule 3	2.4	New clause	The systems used within the learning environment for online and virtual learning are appropriate for all learners and educators when taking part in online or virtual learning
Schedule 3	3	Editorial change	Title to change Agreement Performance Monitoring
Schedule 3	3.1	Editorial change	The Provider is required to assure NHS England that the provision of healthcare education and training meets the expectations and standard” of “the NHS England Education Quality Framework and NHS England Education Strategy.”
Schedule 3	3.2.2	Editorial change	The provider is seeking ways to “will” provide a learning experience for all Learners so that they are supported to complete their courses and to enter the workplace confidently and effectively
Schedule 3	3.2.5	Removal of the hyperlink	In line with the NHS England’s education concerns process, they provide assurance that issues/concerns in relation to the learning environment, learners and educators are reported to NHS England.
Schedule 3	3.4	Removal – Editorial of Engage with the whole system where a learning environment is applicable.	The provider is required to complete an annual education and training self-assessment, demonstrating compliance, by exception, against the Education Quality Framework Standards. Providers should have educational governance arrangements which enable organisational self-assessment of performance against the education quality standards.
Schedule 3	Annex 1 – KPI 4	Editorial change	Has the Provider got “suitable” arrangements for educational governance and leadership, with a named board representative”(s) or equivalent” for education and training
Schedule 4A	10.1.7	Editorial change	University IT services “including technology enhanced learning” and electronic student portfolios.
Schedule 4B	10.1.12	Editorial change	E-learning: technology enhanced learning, encompassing current methods such as “current and emerging methods and technologies that support modern education delivery including hybrid and virtual learning”.
Schedule 4B	15.2.1.	spelling check	The Education Provider’s defined Learner outcomes for each clinical Placement and how the Representative Members can facilitate Learners meeting those objectives, in accordance with paragraph 17 and point 2, paragraph 18 of Annex B of the Guidance;
Published Template – Generic Tri-partite Agreement Template	Annex 1	Signatory section	Change signatory from HEE to NHS England
Published Template – Standard Placement Agreement Template	4.6.1.3	Editorial change	3.2.2/3.2.3- clarified that these obligations apply regards staff; 3.2.4.1 added an “in” to improve sentence structure; 4.2.1 added a “the” prior to Placement Provider to improve sentence structure; 4.4- corrected numbering and indention; 4.5 Corrected a typographical error ”party” and “Party” and improved drafting of the indemnity by adding term “other”; 4.5.2.2 improved drafting with clarifying “or” added, added reference to Placement Provider at the end of the clause as this indemnity cross given; Deletion of Clause 4.6.1.3 “duplication”
The Entire Agreement		Editorial Changes	All references to NHS Education Contract has been changed to NHS Education Funding Agreement or Agreement

Clarifications in response to feedback

The following section deals with content that was proposed in the draft NHS Education Funding Agreement and that has been retained in the final version – but where we think it would be helpful to offer further clarifications, based on the feedback received.

To note, feedback regarding tariff rates are outside the scope of the Education Funding Agreement consultation and have therefore been excluded from consideration. For further information on healthcare Education and Training tariff and funding, please contact the NHS England Education Funding Strategy Team via england.wte.frp@nhs.net

Any comments pertaining to an individual learner group will be considered with reference to other learner groups to promote consistency in future iterations of the NHS Education Funding Agreement.

Main body terms

Clause 7.7 (b) The NHS Education Quality Framework was first introduced by Health Education England (HEE) in 2016, to articulate the expectations and standards required of all Providers and learning environments. Following the merger of HEE with NHS England in April 2023, this is now the NHS England Education Quality Framework. The document will be refreshed to reflect this change, incorporating NHS England language and branding.

While the Education Quality Framework articulates the standards that NHS England expects all Providers to meet, NHS England does not perform a regulatory function in this domain. The intention is that the Education Quality Framework compliments the requirements set out by the professional regulators.

The requirement to meet the standards in the Quality Framework applies to both Education Providers and Placement Providers. The Provider self-assessment process is light touch, and the size and context of the self-assessment varies to take account of the size and type of organisation and activity and funding incorporated within the Contract. This is to minimise the burden placed on Providers.

During 2022, the NHS Provider self-assessment was launched, and is now being evaluated prior to any launch to ICBs, HEIs or small providers. Further details and guidance on the self-assessment can be found on the former HEE website.

Schedule 1 – provider services

Clause 5: Library And Knowledge Services (Placement Providers)

Clauses 5.1 to 5.10: The requirements shall apply to Placement Providers other than Placement Providers that are Private Independent Voluntary Organisations (PIVO means a Placement provider other than a HEI or an NHS Body).

Clauses 5.11 to 5.12: The requirements shall apply solely to PIVOs.

Clauses 5.1-5.12 (Provision of knowledge services): The requirement at 5.2 is that “The Placement Provider will ensure that there is a proactive, high-quality knowledge and library service that is available to all Staff and learners, whether this is hosted internally, delivered via a managed service level agreement with another NHS Provider or with a Higher Educational Institute.” This does not specify an onsite library at every hospital site.

There is an expectation that Placement Providers will work together to ensure that all staff, including learners in general practice, benefit from access to evidence, digital knowledge resources and knowledge services.

Clause 5.4 (Strategic alignment): Local strategic alignment to Policy recommendations and the Knowledge for Healthcare strategy is essential. This enables learners and staff to benefit from 1) a comprehensive and coherent service offer that delivers for learners and the workforce, system-wide; and 2) a single interface to NHS funded digital knowledge resources.

Clause 5.9 (Funding knowledge services): The principles that underpin this clause are set out in the Funding NHS Knowledge and Library Services in England policy guidance for employers.

Clauses 10 and 11 (Tri-Partite Agreements)

The Tri-Partite Agreements apply to Undergraduate Medicine (Clause 10) and Undergraduate Dental Education (Clause 11) as this is mandated in the Department of Health and Social Care Education and Training Tariff Guidance, Annexes B and E. The tariff guidance does not require a Tri-Partite Agreement for postgraduate learners, hence this omission from the Education Learning Agreement.

Clause 12 (Postgraduate Medical And Dental Placements)

Clause 12.45 – 46 (Income generation): This clause would not apply to work conducted in primary care by a postgraduate trainee that generates nominal income for the GP practice, if the activity is relevant and has value to the doctor’s training.

Clauses 15 – 19: Provision Of Pharmacy Education And Training Activities

Clause 16.5 states that there must be an agreement between the Education Provider and Placement Provider to cover all essential and statutory requirements to support the Services of the MPharm learner while on clinical placement. While the agreement must be signed by both Providers, direct provision of those Services (e.g. occupational health) will not necessarily be delivered by both Providers in all cases.

As per Clause 18.36, NHS England will not fund any expenses in addition to the contribution to training outlined in Clause 18.34.

16.13: While models may vary between HEIs, it is a reasonable general expectation that an Education Supervisor for MPharm learners will have the appropriate knowledge, skills, and experience to fulfil the role. The requirements set out in Clause 16.4, parts c) and d) would be agreed with the Education Provider prior to placement.

Clause 20: Provision Of Doctor’s Training In General Practice

Clause 20.4.1: This clause indicates that trainee supervision can be shared with other GPs or “other doctors” in the Placement Provider’s practice – not just the named Clinical Supervisor.

Schedule 3 – quality and contract performance

Education Quality Strategy and Quality Framework

Schedule 3 is largely unchanged and proposes a light touch approach that is proportionate and relevant to the activity within the Agreement. This is a continuation of the requirements and responsibilities within the Education Quality Strategy and Education Quality Framework; first introduced by HEE in 2016 and refreshed in 2021.

The Education Quality Strategy sets out the priorities and principles for continuous quality improvement and innovation in the education and training of the healthcare workforce. The Education Quality Framework describes the domains, standards and our expectations of all Providers when delivering healthcare placements and training – both Education Providers and Placement Providers. These standards apply regardless of funding arrangement, and in line with the NHS Care Act (2014). As such, ‘Learners’ include all those on healthcare training programmes.

Following the merger of HEE with NHS England in April 2023, these are now the NHS England Education Quality Strategy and Framework. These documents will be refreshed to reflect this change, incorporating NHS England language and branding.

The Education Funding Agreement should be read in conjunction with the Education Quality Strategy and Education Quality Framework.

NHS England’s powers to secure high quality education and training.

NHS England has a statutory duty under the NHS Act 2006 and Care Act 2014 to:

secure an effective system for the planning and delivery of education and training to the health service workforce (Section 1F(1), NHS Act 2006);
ensure sufficient skilled health care workers for the health service (Section 98, Care Act 2014); and
secure continuous improvement in the quality of education and training provided for health care workers (Section 99, Care Act 2014).

The Education Funding Agreement provides one of the mechanisms by which NHS England enacts its statutory duties, enabling the quality management of activities commissioned through this agreement.

Self-assessment

The bi-annual report has been replaced by the processes as outlined in Schedule 3, Clause 2.5. This makes clear that all Providers must submit an annual self-assessment report, in line with current processes.

By signing the Education Funding Agreement, Providers are confirming that they will comply with the standards set out in the NHS Education Quality Framework, and that they will provide assurance via the annual self-assessment process and review meetings, as required. The Self Assessment will be used as a guide to review and monitor Provider performance against the KPIs set out in Schedule 3, as required.

The self-assessment process is light touch, and the size and context of the self-assessment varies to take account of the size and type of organisation and activity and funding incorporated within the Contract. This is to minimise the burden placed on Providers. During 2022, the NHS provider self-assessment was launched, and is now being evaluated prior to any launch to ICBs, HEIs or small providers.

The process allows all organisations to carry out their own quality evaluation against a set of standards. Providers are asked to complete the annual self-assessment. Normally, submission is completed by November each year, using an online form, indicating where Providers have or have not met the standards. Information is then triangulated with other evidence gathered through existing quality processes. This combined picture is used to determine how well an organisation is fulfilling the requirements of the Education Agreement and Quality Standards. The threshold for follow-up review meetings will be determined by regional teams as part of their ongoing quality management processes. 

It is NHS England’s responsibility to promote high quality education and training, responsive to the needs of patients and local communities. This assurance is gained via self-assessment and NHS England’s regional quality monitoring review processes.

Review meetings

The NHS Education Funding Agreement requires that a review meeting take place annually or by exception. Review meetings for PIVO organisations will occur by exception and where NHS England commissioners will determine and agree upon the frequency of review meetings as part of the process of onboarding providers and managing the agreement. NHS England will be pragmatic in its approach to these reviews and will triangulate information available to reduce the burden on providers.

The threshold for follow-up review meetings will be determined by regional teams as part of their ongoing quality management processes.

Escalation of concerns

The Escalating Education Quality Concerns policy provides the overarching approach and principles for escalating, de-escalating, and sharing issues, risks and concerns relating to the quality of education and training and to the clinical or practice learning environment.

Placement providers, education institutions and those responsible for the management of approved training programmes are required to report concerns to NHS England, particularly where an issue affects the clinical learning environment or where the concern may pose a risk to patient and/or learner safety. Reporting to NHS England should take place where there is a risk of, or evidence that, one or more of the Education Quality Framework standards for education quality are not being met.

Promoting equality, diversity and inclusion

Additional support for Providers to make any reasonable adjustments required to comply with Schedule 3, Clause 2.4.6 can be accessed via the Disabled Student Allowance, which is the responsibility of Student Finance England (SFE). This operates under a separate process to the NHS Education Funding Agreement governance and is therefore not within the scope of this consultation. Further information, including feedback routes, is published on the Government website.

Schedule 4 – tri-partite agreement (TPA)

Schedule 4 Part B Undergraduate Medical Tri-Partite Agreement

Background clause (b): Information on the appropriate funding agreement mechanisms for GP and private, independent and voluntary organisation (PIVO) placements is provided in the DHSC Education and training tariff guidance. Annex C, paragraph 2.5 of the aforementioned document outlines the funding mechanism for undergraduate primary care clinical teaching, and Annex D provides guidance for PIVO placements.

Clause 5.1.3: The requirement that clinical Placements be a minimum of one week in duration is an established eligibility criterion for education and training tariff funding. This is set out in paragraph 2.15, bullet 4 of the Department of Health and Social Care’s Education and Training tariff guidance: “A placement at any type of provider organisation in England that attracts a tariff payment must … be direct clinical training (including time for clinical exams and study leave) with an agreed programme, being a minimum of one week”.

Please note that special category data (i.e. sensitive personal data) is not within the scope of the NHS Education Funding Agreement.

While Paragraph 8C of the Data Sharing Agreement asks whether any information is being transferred outside the UK to ensure compliance with Article 30 of the UK GDPR, no data within the scope of the Education Funding Agreement will be transferred outside of the UK.

Annex 1: statistics

Breakdown of respondents by category

Organisation category	Count of organisation categories	% of organisation categories
Integrated care board (ICB)	3	2.1%
NHS trust or foundation trust	50	35.2%
NHS England	14	9.9%
Higher education institution	55	38.7%
Professional Body	6	4.2%
PIVO	12	8.5%
Local Authority	2	1.4%
Total Responses:	142	–

Quantitative breakdown of comments by section/schedule

Section/schedule	Count
General Feedback	1
Main Body Terms	216
Main Body Terms and Schedule 1	1
Schedule 1 – Services	94
Schedule 2 – Funding	22
Schedule 3 – Quality Contract and Performance Management	133
Schedule 4 – Tri-Partite Agreement (TPA)	12
Schedule 4 Part A – UGD TPA	5
schedule 4 Part B – UGM TPA	6
Schedule 5 – Data Sharing Agreement	35
Schedule 6 – Change Control Notice	4
Schedule 7 – Secondment Agreement	6
Published template – Generic Tri-partite Agreement (Old Schedule 4A)	7
Published template – Standard Placement agreement template	8
Other Queries	16
Grand Total	566

Annex 2: stakeholder email enquiries

Date received	Stakeholder type	Nature of enquiry	Response
22 March 2024	HEI	Request for most up to date version of the NHS England Education and Quality Framework	Shared link to most recent version of NHSE Education and Quality Framework
21 March 2024	HEI	Request to know who the consultation reminder email had been shared with.	Directed the enquiry back to the regional commissioning team which provided this stakeholders’ details relating to the consultation.
	NHS Community Hospital	Request for the Data Protection Impact Assessment for education funding.

Annex 3: editorial changes to schedule 1, clauses 15-19 (pharmacy education and training services)

See the word document: Editorial changes to schedule 1, clauses 15-19

Publication reference: PRN01324i

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