During these unprecedented times of political and economic uncertainty, organisations need to maintain a balance between continuing to focus on their main purpose, while being agile and flexible enough to absorb constant change at pace. The higher education sector is no different to this: universities must continue to shape their future on an agile model of business, while they continue to deliver a high-quality service to students and local partners. In this context, universities that deliver healthcare programmes must ensure they receive the right student applications, provide a high-quality educational experience that retains those students, and also maintain a focus on the research agenda.
Having evaluated the introduction and impact of the 2017 and 2018 student funding reforms in England, the position of the Council of Deans of Health is that changes to funding support for healthcare students are required to support recruitment and retention in England. These changes should include non-means-tested maintenance grants for students to support their living costs, and the introduction of tuition loan repayment schemes linked to service. Postgraduate pre-registration students should receive dedicated support for maintenance costs and tuition fees, and work is urgently needed to improve timely access to support for placement costs, childcare and hardship.
We welcomed the NHS Long Term Plan's recognition that university-based education is the main source of health professionals and that the growth of this route must be accelerated (NHS, 2019). The recent increase in student placement capacity is an important, but not the only, factor in increasing student numbers.
However, threats to sustainable student applications continue to exist. The single biggest threat to the education required to support the NHS Plan is the partial implementation of recommendations made by the May 2019 review (Augar) of post-18 education and funding (Secretary of State for Education, 2019). The review recommends meeting the reasonable costs of higher education through continued public subsidy but lowering student tuition fees. Added to this is the uncertainty around EU funding for research, mobility and collaboration, making the perfect storm.
Universities' response to the lack of certainty around the future of student funding has been to put additional resources into recruitment and marketing of healthcare programmes, strengthen local partnerships with employers, expand relationships with new placement partners in the private and charity sector, and engage with the apprenticeship agenda. While for some universities, these strategies have been effective in increasing student numbers, for others, getting the right applicants for healthcare programmes remains a challenge. Geography, discipline and demographics all play significant parts in this complex context.
Universities are demonstrating flexibility in operating in an even more challenging environment of student recruitment, but investment of time and resources for recruitment may mean, for some, there is less focus on increasing research capacity. Investment in healthcare research is essential to improving health and social care delivery, and addressing global health challenges. While the Government should guarantee the continuation of EU research partnerships through the Horizon 2020/Europe programmes, it should also commit to its target of 2.4% GDP to be invested in UK research and development by 2027, with the longer-term goal of 3%.
For universities, during these unprecedented times, one thing is certain: their continuous commitment to getting the balance right between their focus on student numbers and their contribution to society through research.