Universities fear plans for a new ranking system that accounts for graduate earnings when assessing the quality of teaching for different subjects could disadvantage nursing courses.
The government is looking at expanding a new system that it introduced last summer called the Teaching Excellence and Student Outcomes Framework (TEF).
“Changes to the teaching rankings will be another poorly thought through soundbite policy”
Under the framework, universities are currently given a gold, silver or bronze rating after being assessed on a range of factors that includes looking at data on average graduate earnings.
But under latest government proposals, 35 individual subjects, including nursing, could also be given such ratings based on similar factors, including the salaries students achieve after they graduate.
Subject-level ratings would be based on a range of metrics including assessments and feedback on teaching, the quality of the learning environment and whether graduates successfully go into employment or further study.
The ratings would also draw on the Longitudinal Education Outcomes dataset, which tracks graduates into the workplace using information from different government departments.
“It is time to adopt a more pragmatic, progressive and transparent approach to ranking courses”
The suggestion is that one measure of success for different courses will be whether or not graduates earn above or below the national average for 25 to 29-year-olds – currently £21,000 – a threshold that would be updated annually.
Another approach could be to assess graduate earnings for specific courses against average salaries for related professions. “This would explicitly recognise that graduates’ earning outcomes are likely to systematically differ by subject in a way that is unrelated to teaching quality,” said the document.
However, it stated this would be too complicated and potentially confusing for students. The idea was not to compare different subjects with one another but to assess performance between different higher education providers for the same type of courses, the document explained.
A 10-week public consultation on the proposals, which closes on 21 May, is running alongside a pilot of the scheme involving 50 universities, with an independent review to be carried out next year.
“It also sends out the wrong message to prospective nurse students, whom this country very much needs”
Given that nurses tend to earn less than other professions like law and banking, some academics fear the approach will adversely affect nursing degree courses, which have already been hit by a fall in applications after the removal of the student nurse bursary.
Professor Kevin Crimmons, associate professor in adult nursing at Birmingham City University, said universities were “still reeling from the removal of the nursing bursary” and said subject rankings could make things worse.
“Changes to the teaching rankings will be another poorly thought through soundbite policy that could have grave knock-on effects for nursing,” he said.
“Nursing students are motivated by compassion rather than salary,” he said. “They tell us that they want to do nursing because they want to make a difference in people’s lives.”
Professor Warren Turner, dean of the school of health and social care at London South Bank University, said the proposals “could have serious unintended consequences for nursing, midwifery and allied health courses”.
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“Salaries for these vocations are generally set nationally by the NHS and other employers and earnings are generally not the prime motivator for students in choosing these highly rewarding careers,” he noted.
He said: “Subject-level grading of courses, therefore, on the basis of earnings compared with other completely unrelated courses is a regressive approach to indicating quality of teaching and could serve to further reduce the attractiveness of these courses to potential students.”
Professor Turner highlighted that the NHS had over 40,000 vacant nursing, midwifery and allied health posts and the health sector needed to attract another 140,000 people over the next decade.
“It is time to adopt a more pragmatic, progressive and transparent approach to ranking courses based on those indicators that are truly representative of the quality of teaching and learning support provided to students, which for all of these courses includes substantial partnership with employers and an excellent preparation for future careers,” he said.
“Nursing is still very much a local/regional applicant market”
Dr Steve O’Brien, dean of the health and society faculty at University of Northampton, said: “Whilst salary is important, there are other more significant factors that our health professions students take into account with the choice of their course and career.
“But to give current nursing students the perception their course is lower in quality, based on the rather blunt measure of salaries, insults them and their achievements,” he said. “It also sends out the wrong message to prospective nurse students, whom this country very much needs.”
The Council of Deans of Health – the body representing universities faculties that train nurses, midwives and allied health professionals – said using graduate earnings to rate healthcare courses had limitations.
“The use of graduate earnings to rate universities at subject level will have limitations in the context of healthcare courses where salary bands for graduates working in the NHS are fixed,” said a spokesman for the council.
“It is important that any system used to rank universities recognises the wider benefits of these courses such as employability, where data shows nursing programmes have the highest proportion of graduates in employment, and the vital contribution they make to the nation’s wellbeing,” he said.
Fellow higher education umbrella body Universities UK said TEF would “stand or fall by whether it can provide accurate and meaningful information to inform student choice”.
The body stressed that the proposals were still up in the air and it was not yet clear precisely how information on graduate salaries might be incorporated into ratings and the weighting given.
However, Universities UK said it would be concerned if salaries were used as the only measure of success in higher education.
“Care must be taken to avoid using graduate salaries as the single measure of success in higher education,” said a spokesman. “Many universities specialise in fields such as the arts, the creative industries, nursing and public sector professions that, despite making an essential contribution to society and the economy, pay less on average.”
Professor Guy Daly, executive dean of the faculty of health and life sciences at Coventry University, said many in the sector felt TEF was “a clumsy tool and the most clumsy bit of it is the reference across the salary”.
However, he said he was not overly worried about it on its own. “I’m not concerned and I don’t think many of my colleagues in the faculty or across higher education in faculties of health educating nursing and allied health professions would be either,” he said.
“A subject league table that discriminates in terms of quality might be useful for applicants, but the salary component I don’t think will affect them,” he told Nursing Times.
“Obviously, in the NHS it is a national salary structure so people will be going in at the same levels of salary whether or not they are going to be employed in Coventry, Northampton or Northumberland, so the salary component isn’t going to be a discriminator in a subject league table,” he said.
While gold, silver and bronze ratings might help prospective nursing students choose between courses, he said other factors – such as location – may well be more important.
“Nursing is still very much a local/regional applicant market,” he said. “For the most part, the people who come to study at Coventry University – approximately 60% – are going to be fairly local if not regional.
“They wouldn’t want to go somewhere that’s a very bad bronze or something like that, but when you consider nursing is a 40-week programme where you have got clinical placements and weekend shifts, people are going to want to study locally,” he said.
He added: “For the system, what we want is to ensure that every provider is a good provider and we should be supporting each other in doing that in the same way you would want that to be the case for the NHS itself in terms of the services it provides.”
However, he acknowledged explicit information about salaries might influence potential nurses if they looked at what they could earn if they studied something else.
“It may put applicants off if they compare the salaries nurses, midwives and allied health professionals are paid in comparison with other degrees and other occupations so that might be a bit of a worry,” he said.
“A combination of removal of bursaries, a stark high profile comparison between nursing salaries and other graduate jobs and the public hammering the NHS is getting at the moment – all of those things together may have a significant detrimental effect on applications and enrolment,” he said.
The Department for Education said fears lower public sector salaries would affect course ratings were unfounded because the £21,000 threshold was “below the starting salary for most modestly paying but socially valuable graduate jobs such as nursing, teaching or midwifery”.
“Students will have more information than ever before, allowing them to drill down and compare universities”
Department for Education
As a result, if the average earnings of graduates from a nursing course exceed the £21,000 threshold then it will be seen as being on a par – when it comes to this particular outcome measure – with courses that turn out graduates like lawyers and bankers who are likely to earn way more.
The NHS pay deal currently on the table would see the starting salary for a nurse rise from around £22,000 now to just under £25,000.
“The TEF takes a range of measures into account when rating providers and it is misleading to suggest they would be affected by the average salaries of a small number of professions, regardless of the level,” said a spokeswoman for the Department for Education.
“Additionally, the average wage in teaching and nursing is above the national average for 25-to-29-year-olds, according to the independent Office of National Statistics,” she said, adding that subject-level ratings would help students make decisions about where to study.
“The TEF will help applicants make better choices, and ensure that more students get the value for money they deserve from higher education,” she said.
“Students will have more information than ever before, allowing them to drill down and compare universities by subject and hold universities to account for the education they provide,” she added.