Introduction

The Department of Health consulted in April 2016 on proposed changes to the funding available to those individuals training to be nurses, midwives and allied health professionals in England. Reforming healthcare education funding: creating a sustainable future workforce set out plans to move from the current bursary-based system to a loan-based system.

Following this consultation from 01 August 2017 new students in England on most nursing, midwifery and allied health professional pre-registration courses will have access to the standard student support package of tuition fee loans and support for living costs, rather than receiving an NHS grant.

Information on the funding reforms

If you would like more information on the funding reforms the Council of Deans of Health have created a comprehensive guide called The Funding Clinic. This guide can be found here.

London Medicine & Healthcare and the funding reforms

The Healthcare Education Group responded to the Department of Health’s consultation, jointly with the London Deans of Health group. Key points raised in our response included:

  • Removal of the cap on student numbers London HEIs have worked collaboratively over many years with both London employers/placement providers and Health Education England (HEE) to ensure efficient use and provision of clinical placements. We have developed shared systems and support (including common practice assessment documentation) to ensure that students receive the best possible education and support on placement. We are concerned that the removal of the cap on student numbers and the emergence of multiple new providers in London could destabilise existing provision through a failure to build on existing collaborative structures and processes and that this could lead to inefficiency, poor student experience and risk patient safety.
  • Small and specialist subject provision Smaller and specialist courses are a significant concern to London HEIs. There is a risk that HEIs will exit the market where small and specialist courses become non-viable. This could leave the NHS with a workforce crisis in these fields. We believe that the only realistic way to secure these courses is to maintain central oversight and where necessary to offer financial incentives to both students/ trainees and to HEIs to ensure that costs of running these course are met. Many of these small courses are operating under the existing system at the very margins of viability and are at significant risk of closure under the new arrangements. If graduates from these courses are valued and needed we would propose that financial incentives are put in place to ensure that courses are retained and protected from closure.
  • The funding and support available for postgraduate healthcare students. London has a high number of students undertaking postgraduate courses leading to pre-registration in nursing, midwifery and the allied health professions. The current maximum postgraduate loan of £10,000 is insufficient to meet the cost of tuition fees and costs of living. Students undertaking these courses will often already have student loan debts accrued from their first degrees. We are concerned that students will be deterred from undertaking these postgraduate health courses if this means sustaining significant increases in loan debt, or personal financial hardship during their training.
  • Student diversity We are concerned that these reforms may significantly reduce the diversity of the student population. London health and social care courses attract higher numbers of mature students and students from the full range of socio-economic backgrounds than from the rest of England. The funding reforms will need to take account of the challenges many of these students face in terms of managing their lives, finances and combining work and study.

The Healthcare Education Group continues to engage with these ongoing healthcare education funding reforms, and their implementation. Most recently we have been in dialogue with the Department of Health and HEFCE, to highlight our concerns that there are still some outstanding issues which have not yet been addressed. These issues include decisions on postgraduate funding, clinical placement commissioning and small & specialist courses.

We are also monitoring how recruitment to healthcare courses for courses starting in Autumn 2017 is progressing for members of the Healthcare Education Group, in the context of these changes to healthcare funding.