Funding for Healthcare Education- a view from Scotland

[Mostly focused on nursing, but some more general issues – particularly on price]

A quick race through . . .

Healthcare specific issues:• UG student numbers and unit price• Relationship between qualifications and careers• Mechanisms for contracting beyond UG Pre-Reg• Review of costs of student support

General issues and risks: • Political context and continuing uncertainties• University and College Funding in Scotland• NHS Funding in Scotland

Priorities and areas for future work

UG Student Intakes

• Continuing uncertainty and variability of intake numbers in controlled subjects– 06/07 3325– 09/10 3037– 12/13 2410– 14/15 2678

• Commitment to 3-year rolling plans from SGHD & NES . . . but NHS Boards can barely commit to next month

• Increasing inelasticity of supply in all but adult field of practice, with• Reduced number of providers in LD and Midwifery over recent years,

but intake targets rising and predicted to continue

Price and funded populations

Price• Early to mid-80s: UTR ≅ BMP• Recent years: UTR Subject Price Group (SPG)• Now (13/14): SPG = (BMP - £1000)

Funded population = Target Intake + (previous actual intakes yet to complete x historical attrition co-efficient) ± (non-standard entrants not contributing to target intake) ± . . . = ??

. . . but even SFC don’t know what the answer should be and appear to have got it substantially wrong over recent years.

PG & careers

While a number of models have been developed • Some positive progress around research and CARC, but• Relationship between careers and qualifications remains tenuous at

best• While graduateness at point of registration is established, though not

uncontested, graduateness as a requirement for leadership roles is not well accepted in the UK

Mechanisms for contracting beyond Pre-reg in Scotland are:• Generally unsatisfactory• Over-specified• Short-term funding may be OK, but provision is often unsustainable

General issues and risks:

Political context and continuing uncertainties• Post-referendum fug - and further devolution• UK elections 2015 and Holyrood elections 2016

University and College Funding in Scotland• Significant drop in College Funding, with large drop in number of

students in college sector• University funding less badly hit to date, but probably in the firing line

now, and much more central control over both sectors is being exerted through Outcome Agreements

NHS Funding in Scotland• Never protected to the same extent as in England, and significant

planned cuts were revealed to NHS Health Board Chief Execs just before referendum

Priorities and areas for future work

• Longer term projections for intakes• Career pathways mapped to qualifications• Recognition of the contribution Universities can make to solving some

of the seemingly intractable issues • Transparent Funding, including funding for PG• Risks around number and focus of providers – concentration in Adult

and Mental Health – when MH is not growing and Midwifery and LD are