NHS England » NHS Education Funding Agreement 2024-27

1. How to use this guide

This guide is intended to explain the legal terms in the NHS Education Funding Agreement for a lay audience. It will help to clarify NHS England’s position on key clauses and themes within the NHS Education Funding Agreement and should be read in conjunction with the consultation outcome report page on the NHS England website.

This guide is ordered to match the flow of the NHS Education Funding Agreement, for ease of viewing the two documents together.

In order to cover all sections of the NHS Funding Agreement, this document is necessarily lengthy.

2. How to contact us

If you have any questions regarding the NHS Education Funding Agreement, please speak with your local contract manager in the first instance.

If you are unsure who your contract manager is, or if you want to be added onto our mailing list for future updates to the NHS Education Funding Agreement, please email: england.educationfundingagreement.nhs.net

3. Background

NHS England is an executive, non-departmental public body, sponsored by the Department of Health and Social Care, whilst remaining accountable to the Secretary of State for Health and Social Care.

In accordance with the Care Act 2014, NHS England is responsible for the leadership of all healthcare education and training for those employed by the NHS and for those seeking NHS employment. NHS England also has a statutory responsibility for the quality of the services which it funds and for the safety and protection of learners and service users within those services.

The NHS Education Funding Agreement is a formal mechanism for the relationship between NHS England and providers which undertake healthcare education and training activities listed under the agreement. The agreement is designed to run from 1 April 2024 until 31 March 2027 and is strictly limited for use for future workforce funds (and, where appropriate, tuition fees where the training has not been commissioned separately).

The funding agreement supports the education and training of future workforce activities listed as part of the annually published Department of Health and Social Care (DHSC) education and training Tariff and NHS England education funding guide.

4. The purpose of the new NHS Education Funding Agreement

The 2024-27 NHS Education Funding Agreement has been introduced across England to:

achieve a consistent, nationwide approach to and the management of funding for education and training made available under this agreement
make it easier to understand how public funds are used, and to outline the return-on-investment expectations for the funding used in training the healthcare workforce
better accommodate non-NHS education and training partners in training delivery, to encourage a wider selection of training partners to improve training capacity, quality, and student experience
become a key tool for improving the quality of education and training, driving change, and providing funding
better ensure that education investment is spent for the future NHS workforce to deliver outstanding patient care

5. The principles of the NHS Education Funding Agreement

The following points are the principles which have led to the development of the 2024-27 NHS Education Funding Agreement.

The agreement will:

be a multi-professional agreement which is applicable across multiple providers and settings. The agreement can be used between NHS England and any provider of healthcare education and training which receives NHS England education and training funding available under this agreement, regardless of their status or setting
emphasise the roles and responsibilities of each party involved in delivering healthcare education and training, including NHS England’s expectations on the outputs (quality, impact and value) for the public investment received
support systems to understand what healthcare education and training takes place within their footprint
increase transparency and confirm value for money, improve visibility of funding, whilst promote good stewardship of the educational investment made to enable the NHS to play their critical role in training the future health professional workforce
increase system awareness of education funding stewardship, and the roles and responsibilities of each partner in providing this
attain parity with other NHS contracts, making visible the role of educating the current and future workforce as core NHS ‘business’
reflect the emphasis on the NHS England Education Quality Framework for the safety of learners and patients

6. Guidance

6.1. Aim of the NHS Education Funding Agreement

The agreement is strictly limited for use for future workforce funds (including, but not limited to, placement tariff, salary support, and, where appropriate, tuition fees where the training has not been commissioned separately).

The NHS Education Funding Agreement will not be used for competitive education and training programmes. NHS England will collaborate with education and training providers through a commercial process to establish the appropriate contract mechanism for all new competitive education and training programmes.

The aim of the agreement is to be supportive and facilitative to enable the strongest of partnerships and collaborations for all involved in the delivery of healthcare education and training. It is designed to support the needs of local healthcare systems and help to ensure that the workforce has the right numbers, skills, values, and behaviours now and in the future.

Whilst the NHS Education Funding Agreement is a legal document, and clauses may appear to be directive, the approach NHS England wishes to take is to be pragmatic, collaborative, supportive, and facilitative.

As part of signing up providers onto the agreement, NHS England commissioners will agree the services available to each provider under the agreement and confirming this as part of the onboarding of providers onto the agreement.

We have retained all clauses in the NHS Education Funding Agreement to ensure there is consistency across the country and that there is transparency on the requirements from NHS England.

6.2. Definitions

The definitions provided in the agreement are important in understanding the context and scope of meaning of the language used throughout the NHS Education Funding Agreement. We recognise that different organisations and geographies may use different language and terms and we have tried to accommodate this within our definitions. If you are unsure of the context to a clause, or the language used is not clear, please refer to the definitions.

Within the agreement, when words begin with a capital letter, this usually indicates there is a definition provided.

6.2.1. Use of the word ‘provider’

Throughout the agreement we use the term ‘Provider’. In the context of this agreement, the term ‘Provider’ applies to the organisation that holds the agreement with NHS England.

In some clauses in the agreement ‘Provider’ is used in a more specific context, for example in the terms ‘Education Provider’ and ‘Placement Provider’. In such clauses these terms are specific to that type of organisation only. This means that if you are an ‘Education Provider’ any clauses which refer to ‘Placement Provider’ only are not applicable to you and vice versa.

There will be occasions where a ‘Provider’ is both an ‘Education Provider’ and a ‘Placement Provider’ and in these circumstances all clauses are applicable and this will be made clear in the clause.

The Term PIVO means a Placement Provider other than a higher education institution (HEI) or an NHS Body (these are usually private, independent, or voluntary organisations).

6.3. Responsibilities

The section covers the responsibilities of each organisation party to the agreement. It is to give clarity to the public and all partners.

6.4. Timelines for response

Within the NHS Education Funding Agreement there are clauses where timelines for responses are specified. These are usually timescales for the acknowledgement of a communication rather than a fixed deadline for a response. Following acknowledgement, NHS England will work in partnership with the Provider to ensure appropriate timescales are set.

There are, however, specific and fixed timelines related to Agreement Management in section 26 of the NHS Education Funding Agreement. These are necessary to ensure good governance and accountability.

6.5. Tri-Partite Agreements (TPAs)

Clause 9 covers Tri-Partite Agreements (TPA) and is a framework agreement between NHS England, a placement provider, and an education provider to set out the scope, roles and responsibilities and funding mechanism for healthcare education and training. The TPA is designed to support the delivery of healthcare education and training and is designed to give NHS England a role in linking organisations together for the benefit of the future NHS workforce.

There are two generic TPA documents included in the agreement; Schedule 4A, Undergraduate Dental Education – TPA, and Schedule 4B, Undergraduate Medical Education – TPA.

They are approved as part of the main signatory process with Providers receiving funding for services covered in the agreement.

Signatories will be agreeing to the terms set out in the TPA by signing the NHS Education Funding Agreement. Additionally, a Letter of Coordination will be the mechanism to enact the Undergraduate Dental Education & Undergraduate Medical Education TPAs where it applies and must be signed by all parties to be eligible for funding targeted under this section.

The Generic Template Placement Agreements have been included in the published guidance is not included as a core section of the agreement. Section 9.2 below provides further clarification on the use of the Generic Template Placement Agreement.

6.6. Co-operation

Clause 10 outlines how all organisations can work together to meet local healthcare system needs to ensure the NHS has a future workforce.

6.7. Uniform

The section in the NHS Education Funding Agreement (Clause 14.8) addresses responsibilities for funding uniforms and clarifies who is accountable under this agreement. Any additional requirements, if necessary, will be outlined in the Schedule 1 services as and when they are needed within this agreement.

6.8. Funding

Clause 16 relates to the Funding NHS England will provide for the services being delivered. Within this section there is a clause which refers to the “…increase or decrease…” and for clarity this is in relation to the funding being provided for the Services being delivered (clause 16.9).

Within this section there is a requirement for a minimum of 12 months employment in the NHS between programmes, this means that NHS England will not fund consecutive programmes without this break. This has been included to ensure that the NHS benefits from the investment being made in a programme and that learners have an opportunity to consolidate their learning before completing any additional programmes.

The agreement has set out a requirement that NHS England will have access to learners’ email addresses as a condition of Funding (clause 16.13). This is to ensure that NHS England, as the lead organisation across England for healthcare education and training, can obtain feedback from learners which helps to improve healthcare education and training across England, and to ensure we can support learners throughout their career. All of our survey responses are shared publicly through the NHS England website.

6.9. Mandatory training

NHS England has not set a direction on mandatory training as, through our engagement, we identified that it was difficult to determine a national approach to this. The section in the NHS Education Funding Agreement (clause 19) provides a framework for use within a local healthcare system.

6.10. Quality and performance

NHS England use the Quality Framework (formerly HEE quality framework) as our core mechanism to ensure learner and patient safety. This section indicates that we expect compliance with the framework. Key Performance Indicators are also indicated in this section. We are aware that Providers are also monitored to meet regulator quality standards as well, but they are not included in this section as this is specific to NHS England.

Clarity/guidance on what concerns require reporting/escalation, as lots happen, a concern, is not an issue and what is a problem? Who to contact/where to get support via this policy here: Education Quality Escalating Quality Concerns.pdf (hee.nhs.uk)

Self-assessment process, clarify that it is light touch and provide links to quality guidance documents.

6.11. Review meetings

The NHS Education Funding Agreement requires that a review meeting take place annually or by exception. By exception, this includes PIVO organisations, 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.

6.12. Intellectual property rights

The section covering intellectual property rights (IPR) clause (28) ensure no party under this agreement shall acquire IPRs of any other party. With the exception of an Employed Learner 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. Where this applies, the parties shall use reasonable endeavours to agree a separate agreement in relation to the ownership of the Intellectual Prior to the commencement of the Placement.

6.13. Insurances

Clause (34), the section covering insurance, represents the requirements under the agreement. The section outlines the responsibilities, liabilities and protections related to insurance coverage.

Some organisations may already have appropriate insurance for matters such as clinical negligence. For example, GPs are now covered by Clinical Negligence Scheme for General Practice (CNSGP). Liabilities arising out of supervision of clinical decisions and/or the clinical actions of the trainee are covered under that scheme. This is reflected in the language under clause 35 deeming (for the purpose of indemnity provisions only) a Learner as the employee of the Provider- not for employment law purposes. CNSGP would be considered adequate insurance under this agreement in respect of clinical negligence. We would expect providers, including GPs to have in place public liability and employers’ liability insurance as a matter of course.

6.14. Liability

The section covering liability clause (35) is intended to reinforce that NHS England does not accept responsibility for liabilities that may rise delivering the training or secondments.

Should NHS England employees be seconded to Providers, then the deeming provisions noted above are included, with an indemnity to NHS England against costs/claims that may arise in the course of the delivery of the services by that individual.

The indemnity provisions are intended to reflect that the Provider is responsible for the delivery of the training and should have in place insurance to cover losses. In the unlikely event of a claim being brought against NHS England, in place of the relevant provider – or by a provider themselves, these clauses are intended to protect NHS England.

6.15. Terminations

Whilst we recognise that the clause covering Terminations to the agreement clause (37) permits NHS England to terminate on a shorter time frame than Providers. This is designed to be supportive of the needs of the healthcare system, learners and the use of public funds and, ultimately, the needs of a future NHS workforce.

6.16. Sub-contracting

The NHS Education Funding Agreement permits sub-contracting as required. The clauses in the agreement covering sub-contracting clause (41) ensure a roll-down of obligations to the sub-contractor. NHS England will contractually manage only the Provider organisation with whom it has signed the NHS Education Funding Agreement, the expectation being that the Provider organisation would then manage any sub-contracts and provide assurance back to NHS England as required.

6.17. Variations

The NHS Education Funding Agreement has been standardised for consistency across England. National Variations may be required by, for example, changes in the law. NHS England may issue a Variation which has automatic effect on three months’ notice. Providers not wishing to continue with the agreement as varied must give notice before the effective date of the variation, and the agreement will then terminate on the effective date of the variation.

Within Schedule 1 a variation process is included to ensure that maximum flexibility and to facilitate a partnership approach amongst the parties.

7. Schedules to the NHS Education Funding Agreement

7.1. Schedule 1 – provider services

This schedule covers the services to be provided by the provider with whom NHS England holds the agreement. These sections are tailored specifically to the requirements of the individual organisation.

Included within Schedule 1 is an activity box table, which must be completed as part of the onboarding process for providers entering the agreement to perform services. Additional services may be introduced later, subject to mutual agreement between both parties. Schedule 6- Change Control Notice template will be used to document any changes to the services.

Clauses 3, 4 and 5 shall apply to providers as applicable receiving funding via this agreement.

Clause 5 – knowledge and library services

Clauses 5.1 to 5.10 shall apply to placement providers other than placement providers that are Private Independent Voluntary Organisations (PIVO).
Clauses 5.11 to 5.13 shall apply solely to PIVO which is a placement provider. Refer to definition of PIVO in the definition section above.

Clause 6 – additions to services

The clause can be referred upon a non-recurrent funding for particular education and service projects or initiatives. When using this clause, expectations and outcome shall be detailed and managed using Schedule 6 – Change Control Notice to the service offer.

Clause 7 – variation and change control

The clause can be referred to by parties (NHS England and provider) to vary the schedules as appropriate to the need of healthcare education and training served under this agreement. The change will need to be completed using Schedule 6 – Change Control Notice Template subject duly signed by both parties.

Clause 8 – pre-registration clinical placements

The clause applies to all pre-registration placement providers receiving tariff payment for clinical placement activities as set out in the DHSC Healthcare education and training tariff guidance published annually.

Clause 9 – clinical salary support

The clause applies to placement providers receiving funding from NHS England for clinical salary support. The clause also sets out at a high-level requirement a provider must adhere to for the funding received.

Clause 10 – Undergraduate Medical Education

The clause applies solely to education and placement providers that accepts Undergraduate Medical students Placement funding.

Additionally, all providers receiving this funding must sign a TPA – UMGE in schedule 4B. of this agreement.

Clause 11 – undergraduate dental education

The clause applies to education and placement providers that accepts undergraduate dental students placement funding.

All providers receiving this funding must sign a TPA – UMGE in schedule 4A of this agreement.

Clause 12 – postgraduate medical and dental placement

The clause applies to Placement Providers that accept Postgraduate Medical & Dental Placements funding.

Clause 13 – apprenticeships

The clause applies to providers receiving Apprenticeship funding under the agreement.

Clause 14 – education wupport

The clause relates to Education Support services for employed individual who carry out faculty support services to NHS England as part of NHS England Postgraduate Education services. The section will be used by parties in relation to the duties and activities detailed in clause 14.

Clause 15 – pharmacy education and training services

The clause applies where the Placement Provider who receives funding for services detailed in clauses 16 to 19 of Schedule 1 – Provider Services.

Clause 16 – master of pharmacy (MPHARM)

The clause applies to placement providers receiving MPHARM funding under the agreement.

Clause 17 – provision of foundation trainee pharmacist (FTP) training

The clause applies to placement providers receiving FTP funding under the agreement.

Clause 18 – pharmacy technician pre-registration trainee (PTPT) training (NHS trusts only)

The clause applies to placement providers (NHS Trusts Only) receiving funding for PTPT training.

Clause 19 – educational supervision for the newly qualified pharmacist programme (NHS trusts only)

The clause applies to placement providers (NHS Trusts Only) receiving this funding under the agreement.

Clause 20 – provision of doctor’s training in general practice

The clause applies to placement providers (General Practice Providers or Primary Care Network acting on behalf of a group of General Practice Providers in a locality) receiving the funding listed in clause 20 under this agreement.

Clause 21- training grants

The clause applies to providers receiving grants for the purpose of training or educating individuals or cohorts of individuals on a specific agreed Programme.

7.2. Schedule 2 – funding

This schedule outlines the funding being given for the delivery of Services. It is linked to the annually published Department of Health and Social Care (DHSC) education and training Tariff and NHS England education funding guide.

Any other specific education and training funding to be provided will be agreed with parties using this schedule.

7.3. Schedule 3 – quality and agreement performance

This schedule outlines the Quality and Agreement Performance requirements. It links to the NHS England Education Quality Framework and draws out key clauses of the NHS Education Funding Agreement, which make up the KPIs. There is also an annex in this Schedule which outlines the reporting requirements as per the requirements set out in the agreement.

7.4. Schedule 4 – tri-partite agreement

This schedule is in two parts:

Part A – Undergraduate Dental Education (UGDE) Tri-Partite Agreement
Part B – Undergraduate Medical Education (UGME) Tri-Partite Agreement

The schedules are standardised for use across England and are designed to be used to provide clarity on expectations between parties and to facilitate a less bureaucratic process for placements. By signing the NHS Education Funding Agreement and accepting the services (Clauses 10,11 or both) in Schedule 1, the provider agreeing to the TPAs as well.

Additionally, a Letter of Coordination will be the mechanism to enact the UGDE & UGME TPAs and must be signed by all parties required to be eligible for funding targeted under this section.

Within this schedule our Data Sharing Agreement outlines what, why and how we operate in collecting and transferring data between NHS England and the organisation signing the Agreement.

Any additional data processing required which are not listed in Schedule 5 will need to be drafted and agreed to support healthcare education and training applicable by parties in line NHS England Data Sharing governance process.

NHS England Commissioners will work with you to develop any additional data if required under this agreement.

7.6. Schedule 6 – change control notice template

This schedule contains a change control notice template for use when a change is to be introduced such as additions to services, new terms or funding needs to be set out after the agreement has been signed by parties.

7.7. Schedule 7 – secondment agreement

The schedule relates solely to Education Support services for employed individual who carry out faculty support services to NHS England as part of NHS England Postgraduate Education services. The schedule template will used in relation to secondment agreement set out in clause 14.1.3 of Schedule 1 – Provider Services of this agreement.

The template form must be completed and agreed between parties as part of the requirement of the services.

8. Published templates

NHS England has provided these templates to assist in utilising the services outlined in the NHS Education Funding Agreement. It is important to note that these templates are not legally binding components that providers need to sign with the NHS Education Funding agreement.

The following sections outline how parties can appropriately utilise these templates according to our intentions.

All the templates are available on the NHS England website.

8.1. Standard placement agreement template

The template is generic form which can be used by holders of the NHS Education Funding Agreement to manage placement agreement where an agreement does not exist between parties.

Parties to note, NHS England is not included as a party to this agreement. Therefore, it is expected that parties ensure they have appropriate agreements in place either as mandated by their regulatory bodies standards and the conditions set out under this agreement.

Parties must thoroughly review, and mutually agreed upon, the applicable terms before utilising this agreement template.

8.2. Generic tri-partite agreement template

The template has been introduced to aid when NHS England, Education Provider and Placement Provider wishes to entire into Tri-partite agreement in connection with the service set out in this agreement.

Parties must thoroughly review and mutually agree upon the applicable terms before utilising this agreement template.

8.3. Letter of coordination template

The template letter shall be used to facilitate the coordination of Schedule 4A – Undergraduate Dental Education Tri-partite Agreement and Schedule 4B – Undergraduate Medical Education Tri-partite Agreement with Medical or Dental schools, Placement organisations and NHS England. The signing of this letter by all parties is crucial to ensure the delivery and governance outlined in the NHS Education Funding Agreement, and the Education and Training Tariff Guide issued annually by Department of Health and Social Care.

Publication reference: PRN1324_ii

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