1.  The Council of Heads of Medical Schools (CHMS) welcomes this opportunity to submit evidence to the Select Committee. CHMS comprises all of the deans or heads of university medical schools or faculties of medicine in the United Kingdom that provide undergraduate medical education and undertake medical research.

  2.  CHMS would like to emphasise the overwhelming importance of high quality education and research for UK healthcare, as well as for UK Plc. CHMS therefore welcomes the explicit statement of the duty of Foundation Trusts to be involved in education and development, including partnerships with education providers, in the licence agreement of these Trusts. There are a number of opportunities for education and training within the proposals, as well as for working partnerships between new Trusts and higher education institutions, for example in the creation of academic health centres.

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

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

  5.  CHMS therefore has concerns that the critical roles of education and research, lifelong learning, continued professional development, and clinical leadership could be affected by the Foundation Trust status. It would be damaging if these roles are not recognised in the Government's proposals. The important and intimate partnerships between the NHS and universities must continue to be recognised and valued. The lines of responsibility between the Foundation Trusts and Higher Education Institutions, including the universities' answerability to regulatory bodies, quality assurance agencies, and funding councils for the fruits of this partnership, should be defined with this in mind.

  6.  There remains some ambiguity about the position of Higher Education Institutions on the Boards of Foundation Trusts. The absence of a guaranteed place for the universities, which provide teaching and research for the NHS, on the Management Board is of concern to CHMS, particularly with regard to the development of University Clinical Centre partnerships. Medical schools are accountable without the NHS for the quality of healthcare education and must be adequately represented on the Management Board and Board of Governors.

  7.  The devolution of financial control from Whitehall to the local Trust level raises concerns that differential salary scales will be available within Foundation Trusts and may not be available for those employed by the universities but working in the Foundation Trusts. The equality of pay-scales for clinical staff whether employed by universities or by the NHS is vital for recruitment, especially as, in general, university staff do not participate in private practice. There are already critical difficulties in the recruitment and retention of clinical academics in higher education institutions. This is well documented within medicine and is increasingly becoming a problem for nursing and the allied health professions.

  8.  CHMS welcomes the opportunity for Foundation Trusts to have a teaching and research emphasis yet would like to see assurance that funding streams will exist for this. Equally, that the position of teaching and research within other Trusts will not be compromised. There is a question over the management of teaching and research funds with financial control passing to the Foundation Trusts. It is important that those Trusts that achieve Foundation Trust status have a continuing requirement to agree formally with Higher Education Institutions contracts for deployment of R&D funding and for education and training, both clinical placement and facilities support.

  9.  CHMS would be pleased to contribute further to the Committee's Inquiry or give Oral Evidence should that be sought.