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Corporate Universities: A New Structure for Educational Development Within The UK Health Service

Author: NHSU
First published: 2004

“NHSU must be an influence, a catalyst and a supporter of changing the cultures in health and social care so they become supportive of and promote learning as a normal part of how health and social care is delivered.”

Professor Bob Fryer, Chief Executive, NHSU

The NHS spends a massive £3-4 billion on training each year - roughly 5% of its overall budget, more than the proportion of the country's GDP that is spent on education. As an organisation it is Europe's - and probably the worlds' - biggest spender of work-related learning. However, despite the proportion of NHS budget spent on learning each year, MORI research found that the delivery of education and training across the country is patchy, and some levels of staff have far less access to learning than staff at other levels.

In November 2002 a consultation was launched on the initial plans for a new organisation - NHSU, a 'corporate' university for health and social care. The goal of NHSU sounds simple: to improve patient care through workplace and work-based learning. To achieve this, however, a change is needed in the culture of the NHS. Not only do learning programmes need to reach a much wider range of staff, but there also needs to be a huge investment and innovation in 'work-based' learning, enabling busy staff to develop their skills. In short, as Professor Fryer says, learning needs to become a normal part of working life.

NHSU completed its consultation and has published the findings; the overwhelming majority are fully in support of the idea of a university for the NHS and social care, and NHSU now has the task of ensuring that it is delivered. The focus is now on piloting the first programmes and developing the infrastructure that will enable staff across the NHS to take up the opportunities which are open to them.

The initial plans cover the English regions, but discussions are underway with the devolved administrations in Wales, Northern Ireland and Scotland about the possibility of developing plans that work for each nation.

A university for the NHS?

NHSU will be a unique institution in the range of its offerings and because it will be a university dedicated to the health and social care sectors.

NHSU has stated that it aims to attain university status. Reaching the standards required of an independent university will be an important guarantee of quality to NHSU learners.

Achieving university status will be the clearest possible indication of the Government's determination to put learning and skills development at the heart of the reform programme in health and social care. With a workforce of 1.2 million in the NHS alone, NHSU has the potential to become the biggest university in Europe.

"Anything that allows training to those denied it has to be welcomed by patients and the NHS alike."
Patient Centred Care Magazine

The objective is to improve patient care, so what role can patients play in all of this? NHSU Director Catherine Hastings has taken on the role of patient champion for NHSU. She says: "Throughout all our consultations the same message came through - that patients want to be right in there. They want to be alongside staff from start to finish." For NHSU patients will play a pivotal role in the future of learning for health care; the next step is to find the ways to get genuine patient voices onto the various advisory committees which are working with NHSU as it develops. In outlining its future curriculum, NHSU has placed a group of programmes around improving the patient experience at the forefront of its planning: programmes such as 'Customer Care', 'Patient Safety' and the creation of joint public and staff learning groups are already on their agenda.

The NHS' Patient Czar is Harry Cayton, he too talks about the need for 'triggers for cultural change' in the NHS. Changing the culture of the NHS is not something NHSU can do alone; it cites 'partnership' and 'collaboration' as two central planks in its construction. NHSU has recently placed announcements in the national press calling for expressions of interest from England's educational institutions in formal collaboration with NHSU. This is likely to be the first of a series of calls for collaboration announced by NHSU. The focus of this first call is to establish arrangements with up to 10 higher education institutions from across the country, including a single high-level partner, to support the development of NHSU's core functions.

A number of partnerships, which will deliver the first programmes, are already up and running - from Jobcentre Plus, with whom NHSU have joined forces to create a job guarantee scheme 'Health Learning Works', to City University which is one of the education partners in its first 'Junior Scholarships' pilot. There is also vast scope for collaboration with NHS trusts to ensure that the learning is delivered 'on the ground' at a local level where NHS staff can reach it. Even at this early stage many NHS organisations, including Acute Trusts and PCTs to Mental Health Trusts and Ambulance Trusts, have indicated that they would like to be affiliates in NHSU's initial roll out.

Why does the NHS need NHSU?

As well as ensuring access to learning across all levels in the NHS, NHSU is needed to bring coherence, common standards and relevance to NHS training and development. There are many learning opportunities in the NHS, but these need standardising, extending and signposting to the whole workforce.

Even in its early stages, there is a vital role for NHSU in sign-posting existing courses, and offering support and advice for NHS employees looking for learning opportunities. Working with a team of professional careers advisers, NHSU has developed a service called Ui, an information, advice and guidance service for all those who work for and with the NHS.

'Training boosts morale, it provides a higher level of qualified staff.. It makes you feel as though you are constantly honing your skills and plus it does provide a better level of care'

(Consultation response)

Independent research company MORI has analysed the results of the consultation on NHSU's initial plans - one of the broadest consultations conducted in this sector.

The findings suggest strong support for the NHSU, with 73% of NHS managers supporting the principle of having a single body to co-ordinate and support learning.

'This is the most exciting development in care for a long time'

(Participant, Listening Event)

'.having the confidence to be able to challenge somebody is key and can be delivered through increasing people's training and their sense of own worth.'

(NHS Manager)

Despite the overall awareness and support, the consultation highlighted some real areas of concern - and therefore some very real challenges for those. One of the most important questions of the consultation has been 'how will busy staff have time for learning?'. It will need shared and concerted action from leaders and managers in health and social care, active support from Board members, commitment from staff and help from all those involved.

Fundamental to enabling staff to learn is flexibility. NHSU intends to deliver learning through a variety of forms including face-to-face, group learning, workplace learning and through use of information and communications technology.

The funding structure of NHSU was another matter of discussion throughout the consultation. NHSU is being established with new money from the Department of Health. While cost structures for the programmes are still being developed, it is expected that fees will be paid by a combination of employers and learners, depending on the programme type. NHSU will be seeking to use its core funding to 'leverage' funding from elsewhere, for use within the NHS. So, in the longer term additional funding may be attracted from bodies such as, Workforce Development Confederations (WDCs), the Learning and Skills Council for relevant issues, and from the European Union.

Local Delivery

NHSU will not be centralising the delivery of learning to the NHS. Programmes and services need to be delivered locally, where NHS staff can reach them. NHSU has already put into place Regional Heads to lead teams of local learning co-ordinators across all nine English Regions. The regional teams are working with local Trusts, including PCTs, Workforce Development Confederations and Strategic Health Authorities to develop an extensive network of local learning centres that will build on what already exists, forming a central part of NHSU's delivery.

Of course an ambitious project like this will not spring into being fully formed. NHSU will be rolled out nationally over a period of time. There are many details still to be resolved, and it is vital to the success of the first projects that they are assessed and through a pilot phase ahead of being rolled out widely.

Next stage of development

Now that many of the first programmes are being piloted, NHSU has been developing the next stage of its curriculum. This includes a range of programmes relating to patient experience, covering areas such as customer care, patient safety and managing patient complaints. There will also be programmes aimed at career progression, for example progressing Care Assistants to Nursing and Allied Health Professional (AHP) Roles, and programmes for GPs, Nurses and AHPs with special interests.

Talking about NHSU's development from consultation to the beginnings of delivery, Professor Fryer says: "There is tremendous commitment to the idea. People are saying it's long overdue." There has been some initial scepticism or concern from traditional universities, but NHSU has stated clearly that it intends, and needs, to work in close partnership with the higher education sector. There has been growing appreciation from universities, Professor Fryer continues: "Many have asked to work with us on such projects as First Contact Care and Foundation Degrees, which has pleased us enormously. We have moved away from the early misconceptions and now the whole question is on the quality and calibre of our delivery."

AT A GLANCE

NHSU's initial programmes include:

Induction - for everyone, around 130,000 people a year, who joins the NHS

Advanced Communications skills - for staff working with Cancer patients

Skills for life - courses based around language, IT literacy and numeracy skills

First Contact Care - in primary care to help front line staff assess the needs of patients

Health Informatics - developed helping staff manage information more effectively

Managing in Health and Social Care

Foundation Degrees in health and social care subjects

Junior scholars will introduce 14-19 year olds to the range of opportunities in the NHS.

CASE STUDY - NHSU IN ACTION

Junior Scholars

We are all aware of the staff shortages in the NHS at the moment, but what can we do to encourage a new generation take the first steps to careers in health and social care. NHSU's Junior Scholars programme is designed to help young people take their first steps towards careers in health care. It is currently in pilot is being piloted in north London.

The first students to take part, a group of 20 from City and Islington College, are enthusiastic about the opportunities offered by Junior Scholars. The innovative programme combines summer schools, mentoring and work experience and has been developed for young people who want to join health care professions, including nursing, genetics research, general practice, radiography, nutrition, physiotherapy, finance or health care administration.

The City and Islington students have just completed the initial stages, which involves interviewing experienced practitioners in their chosen field. This enables them to ask about their areas of interest or concern and learn about the skills, attitudes and attributes that make a successful practitioner and team member.

Parastoo Babkinejad and Jehanne Baptiste say that the interviews have helped them to develop a much clearer idea of what to expect in their chosen professions.

Parastoo, who is studying A-level Biology, Chemistry, Maths and ICT at the college's Sixth Form Centre, plans to read medicine at university. She interviewed Neil Johnson, a former GP who is now the NHSU's Director of Learning Programmes.

"The GP we spoke to was really good; he was helpful and very honest too. He talked about things in a lot of detail and gave a realistic picture of what it's like to be a doctor."

Jehanne has just completed an AVCE Business Studies course at City and Islington College's Business, Arts and Technology Centre and is going on to a degree in accounting. She has also studied sign language and wants to combine her skills and work with deaf people in a financial role. She interviewed Sue Eggleton, a former NHS finance director.

Jeanne said: "I wanted to find out what role finance has in the health sector and if conflicts ever arise between the finance department and other professionals, like the doctors.I've learned that the finance department is responsible for many of the big decisions. Even though the different departments have different responsibilities, they all share the same main focus - making sure that patients are looked after."

Encouraging and supporting young people into health care professions is vital for the future of the NHS. NHSU's Junior Scholars programme is about ensuring that the workforce of the 21^st century reflects the UK's communities. To achieve that we must work to empower students from all backgrounds to take up opportunities to learn for a health care profession