Mental Wealth First

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This week I am announcing ‘Mental Wealth First’: UWE Bristol’s Commitment to put Mental Health and Wellbeing first, for both students and staff. This means adopting the whole university approach of the Universities UK Step Change Framework to ensure we have the right support, systems, training and partnerships in place for optimum mental health and wellbeing. Wellbeing is the key addition here, as we want to create a healthy, productive environment where everyone has what they need to thrive and grow.

What triggered this work was firstly a realisation that, as universities, we have a group of individuals, 18-24 year olds who are going through massive transitions –from home to university and then onto employment. A cohort vulnerable to a range of mental ill-health issues, from anxiety and depression to loneliness, stress about exams, peer pressure or identity issues. The second thing is that data shows that all of us have a continuum of mental health where one in four will experience mental ill-health at some point during our lives.

We are already seeing increasing demands on the NHS in this area. And the demands within universities will continue to increase with people accessing services when they are in crisis with mental ill-health if we don’t rethink our approach. In fact, universities have been reporting a threefold increase in the demand for counselling services since 2007.

Universities should be proud of the work they are already doing to support young people with their mental health and wellbeing needs.

At UWE Bristol, we offer a range of services to support students in ways that suit them individually. For example, the Wellbeing service offers an initial 90 minute Therapeutic Consultation for students seeking support, as well as a daily drop-in service. We have also this term introduced an online platform called Kooth Student, which provides online out of hours access to professional online counsellors, live moderated forums and self-help materials and allows students to seek help anonymously.

We also focus on the transition periods where we know anxiety is often at its greatest for students, such as joining the university, and low times like returning after Christmas and assessment times. Students are encouraged and facilitated to make friends, look after each other, get involved, made aware of the support available and, in the case of our Feelgood February, persuaded to be active.

Throughout the student journey, the University, partnering with the Student Union has run a number of workshops for staff and students. The main aim of the student workshops has been to empower students, improving their emotional resilience, self-belief and esteem and confidence. From the New Year, the SU will operate a new service called Nightline, a phone-based student- to-student support service.

However, we know there is more to be done to address this growing issue. We are one of three universities nationally (alongside Cardiff and York) that will be piloting the Universities UK Step Change Framework. This means auditing our current activity across the university, including our leadership, the data we use, what we provide for staff, our initiatives around prevention and early intervention, how we arrange support particularly around key transition periods and our partnerships.

We will be consulting with staff, students and partners, including Universities UK and leading student mental health charity, Students Minds UK, to identify what works, where there are gaps and what people need in the future. We will then develop our Strategy and five-year Action Plan to begin to implement this new whole university approach.

Our work will be used to help shape the future approach to mental health and wellbeing in universities across the country.

This is not a short term fix but a long term cultural change that we believe will help us create the best environment for people to thrive, getting the most out of their time at university and preparing them for later life.

Find out more about our Mental Wealth First commitment here:

Taking a lead on Brexit

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(An extract from a speech given to the AUA Autumn Conference, Cardiff Nov. 23)


Things considered universities are not in bad shape.  This is compared to 2011 when HEFCE was reporting 1 in 5 of universities in deficit and half below the recommended 3% surplus.

Today the average surplus is 5.2% of income and last year only 10 universities reported deficits.

In parallel Higher Education has been a UK success story. Countries have been investing and skilling up their young people. In 2016 across OECD countries 43% of 25-34 year olds had some tertiary education.  In the US 48%. In Japan some 60%. In the UK 52%. The UK has had to keep up and compete.

Two and half times more young people are now engaged in HE relative to 20 years ago, benefitting them enormously with better income, health and satisfaction prospects never mind additional tax revenue to the treasury.

Importantly with this expansion has come greater social mobility with 9,000 more students in the last 7 years from low participating neighbourhoods being accepted.

This been replicated in international interest from most parts of the world in UK HE. According to HESA, a 21% increase from the EU and the US, about 100% from China and the Middle East between 2006/07 and 2015/16.

However we know we have to meet some future demands. The notable one of being Brexit which has created uncertainty in student fee and research income, increasing the cost of borrowing and unsettling our EU staff.

We should deal with uncertainty head on. Not sit and watch what is happening in terms of Brexit but tackle its unintended consequences and assist UK productivity and growth.

Universities I believe must be at the forefront of Brexit. Not just in improving the UK’s good research and innovation links with Europe, maintaining great programmes like Erasmus, but if the upside for leaving Europe is about the opening up of the UK economy to the world then we should build on one of the UK’s biggest assets and exports, persuading those from overseas that the UK is tolerant and welcoming.

This means continuing to strengthen our offer to the UK economy and overseas by investing in the UK benchmark in academic quality and approach. This means we enable even greater access to HE, success and employment progression for all students. We embrace the wave of consumerism to ensure students’ rights are protected. We improve on our academic quality and use the digital revolution to enhance the quality of the academic experience. And fourthly we deliver value for money for students by reducing ongoing costs and making sure as much is invested in the student experience as we can.

In fact these are The Office for Students’ new draft objectives.

I am optimistic about the future of higher education and its contribution to the nation. This is based on future demand from both students and employers. We will need to support the next demographic upturn from 2021 onwards with the number of 18-20 year olds expected to rise by 200,000 by 2030. And there will be careers for them. Employers have been saying their recruitment priority is young people with higher skills underlined by last year’s CBI Survey where 80% of business were forecasting vacancies in higher skills, twice that of intermediate skills and more than 10 times that of lower skill vacancies.

But I have other reasons too. Universities have shown they have resilience and can adapt. We have shown that we can improve on the inherent quality of what we provide.

HE can be the change and take a lead on many of the things that have evaded us as a nation for too long – like stubborn youth unemployment with more than 10% of 16-24 year olds out of work or poor educational progression that leads to many other young people not reaching their full potential.

It is imperative that UK HE thrives. Not only does the UK economy rely on it but so does the future livelihoods of many young people whose global outlook, resilience, adaptability and futures depend on having something behind them to meet the future challenges.

Mental Health for Everyone

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Every higher education institution clearly strives to be a place where people can flourish. More than 2.2 million students and over 400,000 staff are engaged in higher education in the UK. However on mental health universities are clearly facing an increasing challenge. Nationally we know around 1 in 4 people in the UK will experience a mental health problem each year and the average age of the first onset of major mental disorders is between 17 to 25 years, the age of many undergraduate students.

Universities have been reporting a greater increase in students declaring a mental health issue and a threefold increase in the demand for counselling services since 2007.
More concerning is a high level of student suicide – with the Office of National Statistics stating the number of student suicides increased from 100 in 2013 to 130 in 2014, the highest since 2007. And the problem that many of these students aren’t known to the student services departments beforehand.

So what can we do about this?

This week I report on the interim findings of the work we have been doing at UniversitiesUK in relation to the development of a Mental Health Framework. The research is due for release later this summer. It builds on UUK’s 2015 Student Mental Wellbeing in HE: Good Practice Guide, as well as a variety of other reports and research that are available.

The case for investment by universities in this area is compelling. The most important reason is of course valuing people – ensuring we support our students, help them thrive, help them manage any potential stigma attached to mental health and most importantly of all ensuring we don’t leave any gaps or leave people behind in the shadows by them not accessing the services often readily available to them.

So what are our interim recommendations?

Time has come for clear leadership. To me this is an obvious area where a Vice-chancellor can pull together areas in the University, and the external bodies we work with. It also calls for leadership at all levels with regards to the evaluation, prioritisation, partnership and resourcing to embed mental health across organisations. Mental health needs to be included in strategy development in planning rounds – set shared and ambitious goals. There are universities like UCLan and York who have done this. The strategy should align policies, procedures and coordinate resources and increase communication across departments.

We need to use more evidence and robust evaluation to find and address gaps in provision. This means monitoring year on year mental health of the population. It means improving current practices by seeking feedback and measuring the quality of services. It means identifying, evaluating, and disseminating promising mental health initiatives and strategies.

We need to change the culture. Engage every department and team of the university in a conversation that reduces stigma and encourages disclosure and appropriate help seeking. Make sure we provide a broad array of information and training for students and staff to increase awareness and compassion. We can create messages to promote ways people can support their own mental health or the health of those they care about, thus, increase the mental health literacy and disclosure.

We need to recognise we all have mental health and engage with determinants of mental health across all aspects of university life. We should give students and staff tools for self-care and stress recovery. Most importantly we should Invest in prevention and early intervention. Ensure that we gain early awareness in the student journey and take up.The narrative we use needs to be much less dominated by mental “illness” and “risk” which, in turn, tends to fuel service-led provision and deficit models, in which only those students who present with difficulty receive support – this is not the right solution to deal with the demand we are facing and the needs of our students and staff. It also serves to reinforce the stigma that we must reduce.

Instead, we all need to drive forward a narrative built around mental “health” in which the HE sector properly recognises mental strength, resilience and confidence as key graduate attributes. After all how many of us has woken up in the middle of the night thinking of something that they have do that might be difficult the next day. An institution’s mainstream curriculum and co-curriculum activity can have apart to play here. For example, through assessment strategies and classroom pedagogy that enhances a sense of engagement and belonging, with strong attendance, which is fundamental to combating isolation, stress and distress.

In terms of supporting the unwell our student services play a vital role and we can take whole population approaches to mental health promotion and self-care with clear messages on distress and support. We can align work on reducing stigma and disclosure with clear signposting, appropriate staff training and peer-to-peer initiatives and support service configuration. There will be a need to configure services for different types of interventions – technology, drop-in, triage systems, telephone, after hours, peer-to-peer. As well as how we reduce the risk of crisis/ suicide situations.

Finally, working partnerships will be key not just between departments, and areas like the student union and sports, but the broader HE sector, the NHS, 3rd sector & charities, schools and graduate employers as well as the town or city, communities and families.

At UWE Bristol, we’ve recognised how important these partnerships and the ‘whole journey approach’ are, linking up with Avon and Wiltshire Mental Health Partnership NHS Trust at an academic and practitioner level, the city councils and charities. We have recognised how important it is that the guidelines and provision we develop for the co-commissioning of services and approaches, should be integrated with feeder schools and colleges, to enhance the preparedness as well as fuel the aspiration of prospective entrants to higher education. Universities are part of a much broader eco-system. To really do the best by our students it is critical that we are as joined up as possible in the approach we take, in order to really maximise the impact we can have for our students.

The note I would like to end on is an important one. Here I believe is the real opportunity to look at this not as a problem of the few but something that impacts many. Where we can look to prevent rather than react to a crisis. And most significantly of all see this as an opportunity to set young people up well for later life. Good mental health should be a strong graduate attribute. This is about shaping a resilient and healthy society for the future – the significance across our public services and the way we live cannot therefore be overstated.

We can and we should adopt NEWS

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Spreading Innovation to Save Lives

Our NHS and social care system are one of the country’s greatest assets. They are a fantastic gift that we give to each other and one that is envied across the globe. However, the world is changing and the need for us to continue to review, reset and reinvent our health and social care system has never been greater. The demands we are placing on it are huge and it is beginning to fail. Whilst this is, in part, a reflection of us all living longer and increased potential through new technologies and new drugs to diagnose and treat more and more conditions and diseases, we have to face up to the challenges that this brings. More people are accessing services and there is often greater demand than we are currently able to meet.

The creation of Academic Health Science Networks by NHS England back in 2013 was an attempt to create partnerships to help us to better collaborate, innovate, disseminate and spread learning and best practice. It was done at a critical time as much of the infrastructure that had formerly been in place to facilitate this kind of learning and sharing had been dismantled in successive reorganisations. The uncomfortable truth was that the system had become fragmented, staff and expertise had been lost, resulting in us facing significant financial, social and staffing challenges.

Recent media reports have highlighted yet again just how fragile our health and social care eco-system is. It is difficult to ignore the reports when so many dedicated staff who have committed their whole lives to the service are signaling we have a problem. For those of us in the system it is heart-breaking to watch. We are working hard yet no matter how hard we try we are not gaining enough ground.

This is made worse when you listen to reports that seek to apportion blame in one direction or another. We are one NHS. The problems we face are not just about the funding – it is also about the structures, the interfaces, the mechanisms for collaboration, and the relationship between the government, the professionals and importantly the citizens. We all have a stake in this and it is important that we seek a collective solution to create the integrated and joined-up services that are required 365 days a year, 24 hours a day.

So how can we help, how can we get beyond the current ‘blame, denial and shouting’ culture that is so evident at the moment? How do we come together to really create solutions that are sustainable, affordable and acceptable to all the stakeholders? One of the answers is to look at what currently works. Where have we cracked some of this and can learn and spread this knowledge?

The West of England Academic Health Science Network (AHSN) is one of 15 AHSNs across England that has been innovating and spreading best practice. Each AHSN will have examples of best practice and innovation that have improved services locally. Our challenge now is spreading these beyond our local geography and partnerships.

Recently I read with sadness and frustration reports of critically ill patients dying on trolleys in over-crowded Emergency Departments. Sadly this is not new. But there are things we can, and have done, that is reducing the risks and has even eliminated the problem in some of our hospitals. I want to shout about the National Early Warning Score (NEWS), which the West of England AHSN is supporting all our healthcare providers in the region to adopt and spread. I urge our political and clinical leaders to stop arguing and blaming each other, and to wake up and work with us to spread this approach to every Emergency Department, every Ambulance Service, and every Community and Primary Care setting across the country. No more ‘lost’ critically ill patients need to die on trolleys for lack of basic care. In the Emergency Departments in the West of England we now use NEWS alongside an Emergency Department safety checklist which should be universally adopted too. This means care can be monitored across every handover of care throughout the system. This will ensure time is not wasted, and instead we are saving lives.


As published on the WEAHSN website, 17/01/17.

The impact of social media on the mental health of students

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Steve West recently gave this presentation to MPs and Peers

The use of social media is increasingly pervasive in the UK and across the globe, particularly in the lives of our students. At present, Facebook has the highest number of users – 32m in the UK, with 1bn people across the world using Facebook in a single day.

Clearly social media brings a number of benefits to its users – enabling connections to be maintained or new networks to be built that would not have otherwise been possible. Social media can also help boost young people’s self-confidence and social skills.

At UWE Bristol, like many other universities, we use social media to help support recruitment and transition to university – sharing information and enabling students to build connections with their peers before they arrive. It is also a great tool in facilitating communications, supporting teaching, and of course it provides a valuable means of maintaining alumni networks.

However, research and user experiences are exposing a highly negative side to social media – in particular the link between social media and challenges to mental health and well-being. With 18-19 year olds spending an average of 2.55 hours a day on social networking sites, this is clearly a major concern.

We already know that mental health is a very important challenge facing the health and education sectors, with one in four people experiencing a mental health problem in any one year. We also know that there are particular circumstances that students face that put them at increased risk in relation to mental health. This is something we have been striving to address at UWE Bristol, introducing modes of delivery for our well-being service that provide an improved outcome for users and also allow us to cope with the increased demand that we have seen across the sector.

There are a number of reasons for this increase in referrals and applications for well-being support, which has been in the region of 50% over the past 5 years. One potential factor we cannot ignore is the use of social media.

Indeed, there is a growing body of research exploring the links between social media and mental health covering a number of areas, including bullying, harassment, self-esteem, negative body image and normalising self-harm.

At UWE Bristol, researchers from our world-leading Centre for Appearance Research have carried out a number of studies in this area, focusing in particular on social comparison theory – where people compare themselves to others to know where they stand. One example, includes investigating the causal effect of Facebook on women’s mood and body image, compared to viewing a body-neutral site. The study found that viewing Facebook had a more negative impact on mood, and for those who had a pre-existing tendency to make more appearance comparisons, ‘spending time on Facebook led to a greater desire to change their face, hair and skin-related features’. Facebook provides a huge range of lifestyle and image social comparison opportunities, and it is different to other sources as the comparison is with direct peers. It is also important to note the significance of reports about the frequency of the ‘comments’ made on Facebook being appearance focused.

Given the huge popularity of Facebook, clearly more research is needed to understand the effect on appearance concerns and mental well-being. And as we increase our understanding of the effects, it is clear that the digital literacy of our students and their ability to manage their interactions with their peers through social media will be critical. Prevention is paramount.

At UWE Bristol the digital literacy of our students is a key part of our graduate attributes and our focus on nurturing ‘ready and able graduates’, which informs the design and delivery of our academic programmes. We are also drawing on our experience introducing high-profile preventative programmes, such as bystander intervention in relation to sexual harassment. And we have worked to embed an ethos of respect in our Welcome Weekend programme for new students. It is important that more continues to done by educators and policy makers to boost social media literacy, and beyond this, to increase awareness among parents that social media is yet another source of influence on perceptions of body image.

Clearly this is a societal issue that spreads far beyond universities and involves the whole education system. The launch of the Mental Health and Wellbeing Project at Universities UK last week was a great step forward, which I am very pleased to be leading on. This involves taking a whole university strategic approach to mental health and well-being, starting with a review of the sector, identifying best practice, and the potential development of tools to support future progress. The importance of working together to tackle the issues and support our young people to flourish couldn’t be clearer.

Clear progression pathways critical to meet demand for higher skills

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Today we see the launch of the Report of the Independent Panel on Technical Education. I was very pleased to be a member of the panel advising ministers on this important agenda and strongly support its conclusions.

As the report states, there are serious problems with our current system for technical education and these problems continue to present us with a productivity gap that is holding the UK back.

We know that, ‘by 2020, the UK is predicted to rank just 28th of 33 OECD countries in terms of developing intermediate skills. Furthermore the size of the post-secondary technical education sector in England is extremely small by international standards.’ This is very worrying.

Indeed, our current system for technical education is over-complex and often fails to support the development of the skills our economy needs for the future. The system fails to open up the opportunities our young people deserve, and instead often does the opposite, by closing doors.

The report notes that without urgent action, the UK will fall even further behind its competitors. We need to take action to reform technical education to ensure it is aligned to the skills that industry needs for the future. But we also need to take critical steps to really break down the false divide between academic and technical/professional education pathways. Whilst both routes are different and need to have clear progression pathways, movement between the two needs to be available and absolutely clear to learners. It is not right to cut off movement to university undergraduate study to those on technical pathways, just as it is not right to cut off direct movement into skilled employment for those taking A-Levels.

The report therefore recommends that the Government incentivises the development of short, flexible bridging provision to enable individuals to move, in either direction, between the academic and technical education options and to support adults returning to study.

Without this, we are putting in additional barriers to the success of individuals and to our broader economy. We cannot afford for this to happen. There are multiple pathways to higher levels skills. Each need to be celebrated and the whole system needs to work together as holistic offer.

All young people need to be prepared to maximise their potential as they contribute to society and the economy. Our job is to make sure the options available are clear, with different pathways that work to the strengths and talents of individuals. Everyone deserves the opportunity to progress to the highest skills levels. The recommendations in this report are a very important step in achieving this goal.

The role of universities is changing – we can’t just focus on academia

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A new wave of students will be graduating over the next few weeks.  They’ll be attending award ceremonies knowing they face a challenging future, entering the workplace at a time of turmoil and upheaval.

But, as the country struggles to resolve its relationship with the EU, one thing we know for sure is that improving UK productivity and competitiveness is now more important than ever.   And that depends on graduates with the right skills and mindset to compete in the high-tech global knowledge economy.

To succeed, the UK needs a talent revolution.  We are going to need over 100,000 new professional scientists, engineers and technologists each year until 2020. We know that 80 per cent of new jobs are in high-skill areas, placing universities and our graduates at the heart of the future workforce.

This week, the Higher Education Statistical Agency (HESA) brought out its annual UK graduate employability figures. The results revealed that 71 per cent of graduates were employed in professional occupations within sixth months of graduating.

When we look at areas with skills shortages, like allied health professions (nursing) and engineering and technology, the figures are 94 per cent and 84 per cent respectively.

But this only tells half the story. As universities, we must ensure that students have the underpinning knowledge that is then applied in practice.

We have to provide an environment where they can use their knowledge in a way that will help them in a work place setting. It is about developing flexible, creative, well rounded individuals.

Increasingly it’s not good enough just to have the knowledge, you have to be able to apply it in different contexts. We need to equip graduates with the right skills and mindset to drive growth and productivity.  Our role is to teach not just the functional skills, but focus on real world learning experiences that allow them to be adaptable, enterprising and ready for work.

As universities, we can’t do this in isolation.  We need to collaborate with business, the public sector and government to map skill shortages, develop courses and provide internships and work placement opportunities.  Universities need to do more to give students real work place opportunities.

This has led to collaboration with SMEs, industry and the health sector to address the shortage of graduates with specific skills required both nationally and regionally.

Skills mapping has enabled our university to create and expand courses and focus more effectively on particular specialisms.  Over the last four years, we have doubled the number of engineering graduates we train and have introduced subjects such as a new forensic computing course to meet the demand for experts in computer crime and cyber security.

From research and innovation to mapping the skills of the future, it will be progressive, collaborative universities that will fulfill their role as key drivers of our country’s productivity and economic growth.

Whatever the future holds for post-Brexit Britain, graduates will require adaptable, transferable talents such as complex problem-solving, entrepreneurialism and emotional intelligence.

The move should be away from teaching purely functional skills that are outdated almost as soon as they are learned, to focus on real-world learning experiences.

The new generation of graduates need a flexibility of mind that will enable them to cope with uncertainty to make informed decisions and actions.

This way we can we serve the needs of young people and provide great career opportunities, even though many of them would have preferred to stay in the EU. That’s what I think universities are now for.

As published by The Telegraph 2July 2016

To accompany the HESA figures, UWE Bristol has launched ‘The Role Of Progressive Universities In The Global Knowledge Economy’. The report calls on universities to forge closer links with business to bridge the skills gap and increase UK productivity.

Building bridges post EU referendum

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As we have seen, the British public yesterday voted to leave the European Union.

This will make Britain the first country to leave the EU since its formation.

As a University, we will continue to closely monitor the implications of this decision as they unfold.

Universities UK have advised that there will not be any immediate material change to the UK university sector’s participation in EU programmes such as Horizon 2020 and Erasmus+, nor to the immigration status of current and prospective EU students and staff – whose contribution to our University and society we are exceptionally proud of. I want to reassure all that UWE Bristol values their commitment and contribution towards creating a university that is inclusive and forward thinking.

We are also highly aware of the challenges the referendum has surfaced in terms of social cohesion, tolerance and diversity across the UK. As a country, we need to work together through this period of social and political instability, to rebuild and heal the divisions.

For UWE Bristol, we are a strong, diverse and multicultural community, proud to unite around our motto of Light, Liberty and Learning. As we move forward we will stay true to our purpose and values, as the new future for the UK in the global economy emerges.

Building healthy cities: the role of universities

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It is no secret that the National Health Service is under immense pressure. An ageing and expanding population, combined with increases in chronic illness and multiple disorders, is placing strain on services and pushing up costs. There is a gap between spending and demand. Yet to meet the Government’s expectations, NHS England must make savings of £22 billion by 2020. At the same time local authority funding continues to be squeezed, as an area of unprotected spending, with implications for public health and social care. A perfect storm is heading our way unless we can find innovative ways of improving the health of our nation quickly, reducing the demand on our already stretched services.

In response, health leaders are having to work smarter and more creatively, harnessing technology where possible, to achieve efficiency and productivity gains. They are also shifting the focus of services towards prevention, rather than cure, to relieve pressure on services. This means addressing public health challenges like obesity at source instead of dealing with the higher costs of medical and surgical interventions down the line.

How well this is working in practice will vary across the country. But it is possible to observe some good examples of the NHS and local government working effectively with others to promote health and wellbeing. The crucial part about this is the “working with others” – because that is the only way to achieve impact on the scale required. In a new report from University Alliance, the first in our four-part Regional Leadership series, we examine the contribution of universities.

As the main suppliers of doctors, nurses, allied health professionals, health scientists and social workers, universities have long been instrumental in health and social care policy and planning. Collectively, we turn out a vast volume of health relevant research and innovation and are responsible for many of the lifesaving technologies used in clinical settings. But less acknowledged, perhaps, is the contribution universities make as anchor institutions within local health economies.

In this unique role, universities are able to unite the complex array of organisations that make up the ‘health ecosystem’ within a city or city region. They can then help to make health and wellbeing provision more efficient and more responsive to the needs of the surrounding population. In Bristol, where my institution UWE is situated, there are positive signs of this happening. Through Bristol Health Partners, for example, the city’s universities have joined forces with providers and commissioners as well as Bristol City Council to integrate provision and improve health and wellbeing through innovation, research, adoption and spread.

Our report also identifies how the research capacity of universities is being harnessed to produce healthier communities. The scope of this activity is exceptionally broad, covering everything from applied clinical medicine, to studies on improving the urban environment through effective planning, to the development of robots that enhance patient care or assist those with permanent health conditions.

Because of the cross-cutting nature of health and wellbeing challenges, there is a growing volume of interdisciplinary research at UK universities. Many institutions also work closely with non-academic partners including businesses, charities and social enterprises.  Incubation spaces on campus enable entrepreneurs to design products and innovate with the support of specialists at the university. This type of engagement will be further enhanced by the soon-to-be-opened University Enterprise Zones like the one at UWE which will focus around MedTech, Robotics and Autonomous Systems.

Finally, university research and innovation and the funding that enables it has the added benefit of supporting local services. Clinical research, for example, will often involve observing and trialling treatments with patients in a local hospital. From the perspective of providers and commissioners, this represents an investment additional to that coming directly from government. Similarly, university-based health academics are often specialists within a particular field of medicine, surgery or other health-related discipline. Through what is effectively a joint appointment with the NHS, their contribution is essential for maintaining the quality of clinical services in the region.

The health challenges Britain faces are multifarious, and it be would be disingenuous to suggest that universities hold all the answers. However, as this exercise proves, universities can and do make significant contributions to the well-being of surrounding populations. They are also major employers and influencers. Our staff and student populations are significant and many universities are working hard to create healthy working and living environments for staff and students alike.

The Healthy University movement is spearheading work-based health living approaches to improve the physical and mental health and well-being of university communities and importantly playing a part in spurring behavioural change in generations to come through education and action. At a time when the NHS and local government are becoming increasingly overstretched, the significance of universities in this space is likely to grow.

As published on WonkHE 25 February 2016 

Health Education – Managing the Risks

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We have now had two weeks to reflect on the Government’s Green Paper, ‘Fulfilling our Potential: Teaching Excellence, Social Mobility and Student Choice’, published on the 6th November.

The Government’s recognition of the vital role universities play in driving economic growth and boosting productivity in the UK was of course very welcome. As a University that places a strong emphasis on widening participation and the employability of our graduates, the paper’s focus on these key areas was again positively received.

The changes set out for consultation will certainly have a significant impact across the higher education sector over the coming years.

However, it is important to note that much of the detail was not included in the paper. As always, this will be where the interest lies. I look forward to working with the Government over the coming months as this develops.

In contrast to the Green Paper, the Comprehensive Spending Review (CSR) sets out quite specific changes that will have a major impact on nursing and allied health provision.

The changes announced today are welcome, however given the potential implications on the shape of the future nursing and healthcare workforce, it is absolutely critical that we recognise and mitigate the significant risks that arise whenever there is major reform and change.

Changes to student funding

We learnt today that instead of continuing to be funded to study by the Department for Health, nursing, midwifery and allied health students will, from 2017/18, be treated the same as all other degree students, funding their studies by taking out fee and maintenance loans through the Student Loan Company. The financial rationale for the changes is of course clear and it is positive that the artificial cap on student numbers for nursing will be lifted through this change, increasing the training places available (the change in funding arrangements means student numbers will no-longer be controlled by the NHS). There are, however, very significant risks that will need to be worked through as this major change is implemented.

Maintaining quality 

In particular, as the future nursing and healthcare workforce is opened up to market forces, close attention will need to be paid to ensuring that the profession is sufficiently diverse and attractive to encourage students to want to study in these areas. This is essential if we are to achieve the required increase in workforce numbers forecast by the NHS, whilst maintaining the quality of applicants. The profession needs to attract candidates with the right qualifications, attributes, motivations and values for healthcare practice, supported by high quality education, meeting the standards and requirements for registration through degree award.

In relation to the latter point, as we move to the new arrangements proposed today, it will be essential that a sufficient number of quality work placements are available to support students to develop the skills, knowledge and attributes required of graduate practitioners delivering high quality patient care. In this field real and simulated practice is vital.

Improving retention

We know that the retention of staff has been a big problem for the NHS for some time. The skilled workforce has often been lured away by the private sector or temporary staffing agencies – who are perversely capitalising on shortfalls in NHS staffing. Often this can happen just a few years after graduating. Clearly this places a huge burden on NHS finances – with a limited return on investment. 

In light of the above, there is a major opportunity for the government to support the NHS by offering some sort of incentive on the loans for graduates on condition that they stay and work within the NHS for a defined period of time. This approach would ensure the investment via the Student Loans Company is retained within the NHS and the public sector and would recognise the significant public service and benefit delivered by health and social care practitioners.


Preventing skill shortages

We know from data published by the Higher Education Statistics Agency (HESA) that over the last 10 years the numbers of over 26 year olds studying at university has declined by 23%. The University and Colleges Admissions Service also showed that mature students, were deterred when £9k fees were introduced in 2012; seeing a drop of 5% of over 21s in that year. We also know that four in ten mature students come from disadvantaged or low participation backgrounds. It is these mature students that make up some 60% of the nursing cohort. It is absolutely critical that we don’t accelerate the decline in mature students and lose this talent and numbers from the future workforce. This is a big risk for us all and we must build in appropriate safeguards and explain the changes very carefully to potential students. 

This challenge is particularly pronounced in specialist areas, which are often less attractive to 18 year old students. For example, at the University of the West of England we have been able to meet key skill gaps in vital NHS services where it has traditionally been difficult to recruit – like mental health, radiotherapy and learning disabilities – by appealing to mature students, who may also have caring responsibilities. Yet, past experience shows that these are the potential students who are most likely to be put off by the changes that are emerging.

It is clearly essential that we work together to create the right conditions to recruit and retain the very best students we can for the future nursing and healthcare workforce. We need to ensure prospective students understand the changes and the benefits of the new funding approach. It is clear that if we are to meet the additional 10,000 nurses required over the course of this parliament, universities, healthcare providers, commissioners and government are going to need to work together in innovative and creative ways to recruit, retain and energise the future workforce.

The NHS needs a strong, capable and committed workforce to sustain it through the challenges ahead, as demands for healthcare and cost pressures continue to grow. We need to recognise the public value and public good delivered by the nursing and healthcare profession. Importantly, as these changes are implemented we need to be very alive to the risks, redoubling our efforts to make the profession as attractive as possible so we pull in the talented individuals that make the NHS the celebrated institution that it is – which ultimately serves to benefit us all.