Since the general election, we have witnessed ongoing debates on who pays for higher education.
Brian Webster-Henderson and Jan Draper
For healthcare higher education in England, this coincided with a change in the funding system and the introduction of new policy initiatives on nursing apprenticeships and nursing associates.
Whether we look at this issue through the lens of socio-economics or political ideology, the question we want to answer is one and the same: how do we get the right number of students to become future registered professionals that will care for our population safely and effectively using evidence from the latest research and science?
As the Council of Deans of Health, we have been clear that using a funding mechanism that moves away from the previous method of government-controlled student numbers, ensures the sustainability of healthcare education and leaves universities to work collaboratively and innovatively with their local partners in care provision. It also empowers them to respond to local demand which should eventually lead to growth.
The shift from bursaries to student loans saw an expected dip in university applications of up to 24% in England, which now seems to be translating into a 4% reduction in actual recruited student numbers compared to last year’s figures. Although we are far from having achieved growth in student numbers this year, it would be premature to argue that the reason behind it is simply the shift from bursary to tuition fees.
We should be looking at the issue much more deeply, understanding what is happening strategically – particularly with wider economic factors, demographics and the provision of clinical placements. What we have learned from the first year of the reforms is that we cannot expect a significant change in the system to result in growth overnight, without targeted support and relevant communications.
We see three key issues that universities will want to focus on and as a council, we are keen that we work collaboratively with government to address these.
”Universities, employers and government have a responsibility to monitor this process carefully and use the evidence from the first year of the reforms to inform future action”
First, the same pool of clinical placements is used for students of graduate degrees leading to registration, apprenticeships (numbers of which have been much lower than the government’s intent) and nursing associate pilots. This makes high-quality support of various students in practice complex and, with cuts in CPD, untenable. We want to think strategically about how we support clinical staff in practice and nourish their development as they will be operating in ever more complex environments in the future.
Second, the recent additional funding from government for clinical placements announced in early August is welcome. As are targeted strategic interventions for specific professions and fields of practice – both informed by work led by the Higher Education Funding Council for England in which we have been fully engaged and supported. The mechanism by which the funding is administered needs to enable universities and their partners to grow. In other words, we cannot operate in a market economy of open access and still cap or control specific areas of growth.
Third, universities, employers and government have a responsibility to monitor this process carefully and use the evidence from the first year of the reforms to inform future action.
Early intelligence from our members indicates that certain fields of practice (for example learning disability nursing); geographical variety (a more challenging environment in London); and a change in student profile (decrease in mature applicants) require us to think innovatively, proactively and to work in partnership to find sustainable solutions.
Interventions such as a national campaign to highlight the employability and value of our healthcare professionals, fresh approaches to support mature students and targeted incentives for smaller fields of practice are but a few of the many steps we can all consider, as part of a series of innovations, to address the workforce challenges we face and make our profession strong, visible and attractive.
Professor Brian Webster-Henderson is Chair and Professor Jan Draper is Vice-Chair, Council of Deans of Health