Written evidence submitted by Coventry University Group (RTR0112)

Introduction

The evidence in this submission is presented by Coventry University Group. We are the fifth largest provider of undergraduate education in the UK with over 38 thousand students in 2019-20.

Coventry University Group serves five of the seven NHS regions via the BSc and MSc Blended Nursing Provision. Our School of Nursing, Midwifery and Allied Health currently educates just under 4,700 students in Coventry and the West Midlands, East London, Scarborough and North Yorkshire. We are a sector leader in innovative apprenticeship provision through an integral College. Further details about the Group are provided in Annex 1.

We believe the experience of higher education institutions is uniquely positioned to assist this inquiry because HE is at the forefront of partnership working with the health and social care sector to address the challenges including workforce retention, career progression, and the pressing need to establish integrated care systems. With an ageing population and changing demand on our health and care services, evidence-based planning and academic research are key. Our overarching main recommendations are:

• Simplify and streamline routes into nursing for both students and employers.
• Supplement training with clinical simulation hours to help address capacity issues in accessing clinical placements.
• Ensure partnerships between Higher Education and health and social care employers are consistent between NHS regions and local authority areas
• Empower students to complete their studies by providing financial support for maintenance whilst they are providing services to the NHS.
• Plans for development of Training Hubs in the new structures, such as Integrated Care Systems, should be communicated to HE providers as soon as possible so universities can that joint planning can be set in place and, ideally, coordinated across regions by universities such as Coventry which serves five of the seven NHS regions.
• Increasing access to careers guidance, coaching and mentoring will help retain and train the NHS workforce towards the Governments ambitious targets.
• The Government should be mindful that wider factors that impact retention across all sectors also apply in the NHS including most pressingly, the rising cost of living and regional economic inequalities. Working with employers and training providers could mitigate those factors.
• Apprenticeships should be championed and valued within the sector.
• More widespread, accessible, and supported work experience opportunities within health and social care to enable young people to make informed choices about education and career options.
• HE providers and the NHS can pilot collaborative careers and access programmes with colleges and schools to promote the opportunities and rewards that working in health and social care brings.
• Keeping people within the health and social care sectors should be an overarching goal, particularly when public resources are put into educating the next generation. Having a safe job and a valued career with a clear path to progression is key to achieving better retention.

How Coventry University Group structures courses to meet workforce demand

• Increasing the number of academic starts per year from three and planning for up to nine intakes annually gives students flexibility and enables pattern of training in clinical placements and graduations that are more responsible to year-round NHS need. This is because there are several outturn points of newly qualified nurses into the workforce.
• Blended learning routes enable students to remain in their own communities so they can work in the local health and care sectors. Blended learning mixes online and in person learning to ensure that best use of on campus and placement time is made, allowing the student to effectively manage their own learning journeys with the structures we have put in place.
• We have invested heavily in simulation including Artificial Intelligence patients. Students work collaboratively across professions such as nursing, AHPs and paramedics, to care for virtual patients before going into clinical settings. These are described as virtual simulated placements (VSPs) and are co-created with stakeholders.

Role of HE providers in increasing health and social care workforce numbers

• Partnerships between HE, local government and NHS Trusts enable nurses and allied health professionals to continuously train and develop so their skills and approaches keep pace with changing demand. We have established a Centre for Care Excellence in partnership with University Hospitals Coventry & Warwickshire NHS Foundation Trust.  Part of the remit of this Centre is to promote the development of sustainable clinical academic careers which can benefit patient outcomes, education, research and practice development.  We have seen already that this has begun to attract high calibre clinical staff to the Trust and research active academic staff to the university. These is a vital aspect of fostering a culture of learning, progress and evidence-based practice across the two organisations, which is turn creates a high quality learning environment for students. A similar model of working is being developed with Guys & St Thomas NHS Foundation Trust in London to provide undergraduate programmes tailored to unmet community needs
• All Health Professional courses are a time and resource intensive undertaking for students, whatever their age, but even more so for students with caring responsibilities or children to look after.[1]  61 % of our Health and Life Science students are considered “mature” (over the age of 21). The OfS has identified that Mature undergraduate students are more likely than younger students to be underrepresented in higher education and can face different barriers to accessing and succeeding in their studies[2]. The Government’s announcement of £5,000 p.a. bursary for students beginning in academic year 2021/22 was very much welcomed.[3] 

Ensuring all can be part of the workforce

• Partnership projects with the third sector can also support students from disadvantaged groups to make a success of their employment opportunities. CUG recently joined the Employ Autism Higher Education Network, for example. The Network is run by Santander and the charity Ambitious about Autism. The project ensures access to paid internships and tailored careers advice to autistic students and graduates.[4]
• Barriers to entering the workforce can begin before students begin to seek employment. As an institution committed to widening access through helping students to overcome the common hurdles to completing education such as finance and caring responsibilities we have designed our curriculum with these challenges in mind. At CU Scarborough, we have structured our courses to fit the needs of our students who must earn while they learn. Students receive a set and regular timetable that would enable them to have a job alongside their studies.

Retention and progression in work

• Research carried out by Skills for Care found recruitment and retention is now more difficult than before the pandemic. Skills for care research on the workforce shows employers that have training and professional development opportunities have better outcomes (lower staff turnover and/or high CQC ratings) than others.  Finding pathways into postgraduate studies is often left to the individual as opposed to planned at a sector level, often with a lack of support for health professionals to access CPD. A standardised, structured career pathway for different health professions would vastly improve planning for growth in CPD provision and to adapt programmes reflexively to challenges faced by professionals in practice. Employers often struggle to find the funding to release staff, but it has been found consistently that one of the most significant reasons for nurses leaving the profession or for moving employers is lack of access to CPD.
• More broadly, ensuring the health and social care sector is a valued career is essential in ensuring that the workforce can grow to meet the demands of the population. The Youth Futures Foundation told the Lords Committee on youth unemployment that health and social care is “widely low paid with low progression”.[5] This is borne out by comparative vacancy figures across sectors. Before the pandemic, there was a vacancy rate of around 8 percent for both the NHS and adult social care, compared to just under 3 percent for jobs across the economy.[6]

Addressing local skills needs

• Coventry University has been responsive to the local needs of all our campuses across England. Identifying a local skills gap, we recently invested in the development of a Radiography discipline at our Coventry campus, recruiting 22 entrants in the first cohort in September 2021 following a request by University Hospitals Coventry & Warwickshire.
• At our Scarborough campus, which had been previously identified as a higher education “cold spot” by the Social Mobility Foundation, we are working to develop a new generation of healthcare professionals, the majority of whom go on to work at local NHS organisations whose vacancies stand at 12,390.[7] As well as delivering the Nursing Associate course at our Scarborough campus, in response to a high demand for the nursing associate role, the university offers a route onto this course at the Coventry, and London campuses, where it is delivered in partnership with (amongst others) Guy’s and St Thomas’ NHS Foundation Trust. Our Nursing Associate programme was shortlisted for a Student Nursing Times and Apprenticeship award in 2019 and over 10% of students who completed the first programme have secured places on the prestigious Florence Nightingale Leadership course.
• We are working with 28 employers across health and social care in London to train a new generation of apprentices in Occupational Therapy, Physiotherapy and Public Health to help address the Capital’s workforce shortage areas. 

International student recruitment

• Our courses are currently oversubscribed with our post popular courses receiving more than 10 applicants for every place that we offer, including BSc Children and Young People’s Nursing, BSc Mental Health Nursing and BSc Midwifery. We could increase training numbers significantly if challenges to increasing placement capacity within the NHS were addressed. There needs to be a centralised approach to tackling placement capacity as a barrier to training. Such capacity pressures on placement also hinder the recruitment of international students onto NHS training placements with priority given to UK candidates first. International students are currently an underutilised workforce resource and Government consideration to remove immigration barriers needs to be given to attract the best and brightest to study and work with the NHS. Preferential treatment both in the Tier Four and Postgraduate Student Visas categories should be considered.
• Registered nurses of all employment types were included in the Migration Advisory Committee’s Shortage Occupation List (SOL) since 2013 because of the shortage of resident workers available to fill these roles. The vacancy rate for registered nurses in adult social care is 9.9%, It was noted in the May 2019 review of the SOL that numbers of registered nurses have continued to fall, with recommendations from the committee that nursing roles remain on the SOL due to ongoing difficulties in the recruitment of nurses across health and social care.[8]

Apprenticeships

• The apprenticeship route, although excellent for both the student and employers, has not been enacted at scale by health and social care employers.  This is largely because employers must find the backfill salary costs. If this was resolved, the uptake in apprenticeships would be significant, not just to the employer but the prospective student. Experience from Coventry University Group suggests that apprenticeships could be key to addressing workforce issues within health and social care settings. Apprenticeships enable our students to earn while they learn but the public sector cannot afford apprenticeships at scale as the levy only covers the costs of education. A flexible part-time apprenticeship programme could unlock potential for the workforce and unlock the biggest block for getting more people registered as healthcare workers.

Annex 1

Coventry University is the fifth largest provider of undergraduate education in the UK with 38,430 students in 2019-20. We trace our origins to Coventry College of Design in 1843, which was intended to provide the necessary education and innovation for the future workforce. Our institution has changed, expanded, and developed over time but that founding purpose remains the same.

Now with locations in Coventry Scarborough, London and local regional partnerships with links to employers, we are continually developing to suit the needs of our learners. Coventry University Group prides itself on pioneering innovative education in line with our commitment to equal opportunities and our ambition for flexible learning pathways that empower students to think critically. UK HE has been evolving for hundreds of years. This is a strength of our sector, which exported £23.3 bn in 2018, an increase of 8.9 percent on the previous year.[9] CUG is a leading UK institution for Transnational Education, providing a valued UK education product across 20 different countries.[10]

Learning is a collaborative and long-term process, and we build equally long-term relationships with students, colleagues and alumni for continued engagement in education. Our comments in this response are about ensuring we take learners, young people, parents and employers with us on that journey. The people we care about have undergone a huge period of uncertainty, with changing expectations for their lives and careers and it's important to have regard for that in policymaking.

Jan 2022