In conjunction with our 2024 General Election Manifesto, the Council is releasing a series of blogs which explore the underlying principles and four asks in more depth.
The second blog in the series is by Robyn Cooke, Policy and Research Manager, and Ed Hughes, CEO, Council of Deans of Health.
An ageing population and increasing demands on our healthcare system requires a highly skilled and adaptable workforce, capable of embracing new technologies and approaches. Much of the future NHS workforce therefore depends on education providers – particularly universities and colleges – as the first stage of the workforce pipeline. Moreover, nursing, midwifery and the allied health professions are all degree educated professions, predominantly delivered through universities in partnership with clinical placement providers. Education providers also ensure the continued flow and progression of the pipeline through the development and advancement of the existing healthcare workforce, upskilling through professional development and providing opportunities for progression. Despite the key role education plays in the future of the NHS workforce, the growth in student numbers seen over the last few years has not been matched by a comparable increase in educators. If we continue in this direction, then we will reach a point when it will simply not be possible to deliver the next generation of healthcare professionals in the numbers required.
Blockages in the pipeline
The shortage of healthcare educators is a bottleneck in our ability to train the next generation of healthcare professionals. We know from our members across the UK that staff recruitment is extremely difficult and vacancy rates are high, particularly for certain roles, professions and geographies. The recruitment pool for nursing, midwifery and allied health profession educators and researchers is getting smaller and will continue to deplete with nearly 50% of current educators being over the age of 50 and nearing retirement. Recruitment challenges for educator and research careers are caused by competition with the NHS where salaries are higher and the lack of mobility between practice and academia. This is not helped by poor visibility of the wide variety of career routes and roles within health and social care. The value of roles within education and research are not given the same profile as roles in clinical practice.
Sustaining the whole workforce
Projections of the healthcare workforce numbers needed in the future, and targets for student recruitment set out in the NHS workforce plan, will never be realised if we do not have enough people to educate them. This was emphasised in the recent Health Foundation analysis of the feasibility of the proposals, which noted that, “the LTWP [Long Term Workforce Plan] commitments underline an urgent need for a significant increase in trainer or educator numbers and improved retention of this workforce”. Other parts of the healthcare system have also noted the pressure on educators implied by the plan’s ambitions – with the General Medical Council welcoming the plan, but saying that, “Increasing medical school places also cannot come without a corresponding growth in trainer capacity”.
To continue the flow of the healthcare workforce pipeline then we need to minimise blockages. This means raising awareness of the whole healthcare workforce; roles and careers in education and research need to be widely promoted as well as those clinical practice. This needs to be done in conjunction with improving the mobility between organisations and across sectors. We know that flexibility is a key factor in retaining staff so portfolio careers and increased career fluidity within healthcare will support the sustainability of the whole workforce. This should be complemented by a more creative and collaborative partnership between universities and colleges, including across regions where access to education and training programmes needs to be locally focused, to extend the reach of existing education provision.
The education and healthcare sectors are inextricably linked in many ways, but we do not always see this join up in strategic decision making and workforce planning. To address the growing shortfall in healthcare educators and researchers, the Council is calling for:
- The promotion and signposting of portfolio careers between practice, academia and research to existing NHS staff as well as healthcare students
- A plan to address the obstacles preventing more fluid career routes between healthcare, academia and research
Given the scale of the expansion in healthcare professionals set out in the NHS Long-Term Workforce Plan, we cannot simply scale up what happens now. A different approach is needed to increase the number of educators with both the up-to-date clinical skills and educational training to teach and support students at a time of significant staffing shortages across the health and social care system. Working together, particularly through the Integrated Care Boards, leaders in the health and education sectors must create a positive culture around the role that education and research play both in delivering the future workforce and in retaining existing staff. Through this recognition of the value of the educational element of healthcare professionals’ service, we can collectively address the shortfall in educators which otherwise threatens the delivery of the workforce plan.