By Professor Pauline Walsh, Pro Vice-Chancellor and Executive Dean, Faculty of Medicine and Health Sciences. This article first appeared as a Personally Speaking column in the Stoke Sentinel in July, 2023.

The recently published NHS Plan outlines the case for a long-term strategy to ensure the NHS has appropriate levels of staffing to meet health needs of the future, focusing on three areas of Train Retain and Reform. In essence, this means making sure that we train the right number of people across different programmes and roles ensuring continuing professional development, keeping them within the NHS, and working differently to deliver care. For universities this means engaging with the NHS on several levels to support all these goals.

The most obvious one of these is the initial training of health care professionals and associate professionals as well as ongoing professional training and development for qualified staff. This isn't about just increasing the number of doctors and nurses undertaking degrees at university, although of course this is part of the plan. What is also clear is the need to change thinking about new ways of working, and understanding the skills needed to meet this challenge.

The plan outlines some ambitious targets regarding increased training places for doctors, nurses, and allied health professionals which is a good thing, however there are some nuances to this. Most programmes have open recruitment in terms of the numbers a university can take which is normally outlined at the point a programme is approved, apart from medical student places which are capped by the Government. Applications to health professional programmes are normally high with some programmes having significant numbers of applications per place which requires universities to have robust selection processes to not only ensure students can study the course successfully, but also have the appropriate personal attributes to be a healthcare professional.

One of the ongoing challenges is the need to ensure that local NHS organisations have a pipeline of newly qualified professionals who enter their employment, meaning universities must strike the right balance between recruiting local students and those from across the country. Having strong partnerships with local schools and colleges is crucial to this as it allows local students to see what is possible and to motivate them to consider a career in a health profession. One way of achieving this cited within the plan is the increase in the apprenticeship routes for training with specific targets for different programmes for example, the target of achieving 22 per cent of all adult nurses qualifying via an apprenticeship route by 2028/2029. The registered nurse apprenticeship has been running for some time and has paved the way for other professions to follow suit, including the proposed doctor apprenticeship.

Recent years has seen the development of several 'associate roles' to support qualified health care professionals for example the physician and nursing associate. These roles have standardised education, training, and competency requirements. Universities have embraced this approach with the development of new programmes being seen across England. The alignment of apprenticeship standards to these new roles has enabled NHS organisations to 'grow their own' in collaboration with local universities. A good example of this at Keele University is our Nursing Associate foundation degree, with students and employers positively evaluating the programme and the opportunities they bring. Some of these nursing associates have returned to undertake the top-up programme registered nurse degree apprenticeship.

All of this would seem a positive step in the right direction - having varied routes to qualification and the development of new roles that complement each other which maximise the workforce available to the NHS. However, several things will need to come together for this to be achieved, with the most critical being placement capacity.This means having enough places within clinical practice for students to gain the hands-on experience of the profession to develop the competencies required to practice.

Universities throughout England have identified difficulties in securing enough appropriate clinical placements for the existing number of students, so what will this mean when we have the additional students outlined in the plan? Different approaches to supervision as well as the use of simulated placement experiences are already being implemented to increase placement capacity which will help, and Keele has seen an increase in the facilities on campus with two new health houses, the training ambulance, and a major capital investment of a clinical skills simulation centre due to start shortly.

This is probably the biggest challenge we face and is one that can only be solved by working together through strong partnerships which bring universities, Integrated Care Systems and local NHS and non-NHS organisations together, to work on a plan of action to increase capacity.