Intensive care for learning

The National Health Service is setting up a dedicated training arm to give all its staff the chance to fulfil their education dreams. Robert Nurden reports on the ambitions of this would-be university

For years, information technology scared Karen Ellis, an occupational therapist at the North Hampshire Hospital in Basingstoke. Whenever she had to write an appointment letter or a report on her PC, she had to get someone else to do it for her.

"I was petrified of computers, and as my work required me to use them more and more, I thought I'd better find out how they worked. I volunteered for a context course with Basingstoke College of Technology (BCOT)," she says. "Now I'm confident enough to handle the technology myself."

Along with her co-worker Sue Hewitt and the maintenance operative Nigel Jensen, she is one of a number of staff at the hospital to have benefited from Bcot's award-winning basic skills courses for local businesses.

Similarly, at Oxford's Radcliffe Hospital, a scheme known as Stepping Stones, organised in conjunction with Oxford County Council and the South East England Development Agency, has brought English language, literacy, numeracy, communication skills, and IT to more than 175 domestic staff, porters, catering staff and managers.

The success of both these projects is largely due to imaginative partnerships between different organisations in response to local needs. Such small-scale initiatives, which can be flexible and tailor-made to suit a small number of students, are classic examples of how work-based training - that thorny area of adult education - can function best. Now, rising above the further education horizon is a monolithic body - the National Health Service University (NHSU) - that wants to muscle in on such grass-roots schemes. If its plans come to fruition, and with a target student population of more than one million, it promises to become the largest corporate university in the country. Yet few at present know what it is, what it is for - or even what its initials stand for.

A spokesman for this new training arm of the NHS revealed: "The U doesn't actually stand for anything. One day it'll stand for university but we're not allowed to call ourselves that yet." After months of meetings,the NHSU published its draft strategic plan in December, outlining its aims for the next four years. Achieving university status was not one of them.

"I can't say when we will become a university," says Bob Fryer, the NHSU's chief executive. "It'll take a long time to fulfil all the criteria. But we want to have the academic and intellectual independence that being a university brings. We don't want to be just another training organisation. We want to attract the best staff, make awards and be a serious research body, particularly in the field of e-learning."

In a bid to raise the academic stakes, the NHSU is expected to announce the name of "a large, highly regarded university" to which it will cement itself. "Partnership with existing schemes is a vital part of the NHSU," said Fryer. "However, we are already developing our own programmes to enable staff to take up further training." He denied that the new body - operating just in England - would be adopting a top-down approach to training, or that it would duplicate existing training.

Through its "skills escalator", the NHSU aims to give porters the chance to become paediatricians and cleaners, cardiologists. More realistically, it offers "a unique and rich blend of learning that includes work-based experiences, which help to make learning a natural part of everyone's working life, as well as tutorials and one-to-one or group sessions and innovative e-learning opportunities".

By 2010, it hopes to have "made a significant difference to the lives of one million people by improving patient care". It will also have contributed to a learning revolution in the UK and "helped to make the NHS one of the best places to work anywhere in the world". Given the current low morale within the health service, there's clearly a long way to go.

One thing this all-singing, all-dancing super-trainer will not, however, be doing is tampering with, or taking control of, medical degrees, for which the universities are heartily thankful. Natfhe, the university teachers' union, has expressed some doubts about the NHSU's purpose.

But Christine Jude, head of widening participation in the NHSU, says a vital part of the pilot stages would be working alongside existing health service structures, such as the workforce development federations. "What the NHSU will bring is a national framework, quality standards and comparable learning experiences, so that we are all singing from the same hymn sheet," she says. "Training in how to communicate well in emotional situations, writing letters, correct prescribing of drugs and use of cleaning materials, and the proper application of English on the telephone will all enhance the patient's experience."

So far, the NHSU has signed partnership agreements with nearly 50 organisations such as hospital trusts, primary care trusts, social service departments and health authorities. Since December it has operated as a special health authority, governed by a board of executive and non-executive members. Its head office is in London but this is likely to relocate later. Because its campus is a "virtual" one, there are just 200 people employed across its nine regional offices. This will rise to 450 at full capacity.

To ascertain what is needed locally, it is designing a learning needs observatory. So far, it is developing programmes which it sees as the most urgent: an induction scheme for new staff; a course in how to make the first contact with patients; advanced communication skills in cancer care; improving language, literacy and numeracy; an online self-assessment tool to identify learning opportunities; a jobs forum for those outside the NHS; foundation degrees; and junior scholarships for 14- to 19-year-olds. So, how will all this be paid for? The NHSU received core set-up funding from the DoH for 2003-4 of £30m, rising to £80m in 2006-8. In addition, it expects to levy charges for its programmes and services from trusts and, in some cases, students. In future, funding will be sought from the Higher Education Funding Council, the Learning and Skills Council, and regional development agencies.

One of its pilot schemes is in the north-west - itself linked to the workplace basic skills network at Lancaster University - whose learning co-ordinator, Mandee Leese, says: "Activity is around the preparation of learning advisers and the infrastructure to deliver NHSU programmes, and raising awareness of what we have to offer among staff of all levels. We want to ensure that managers understand the issues surrounding essential skills and how they can best assist staff to obtain the learning they need."

NHS staff are giving this new university that dare not speak its name a cautious welcome. Whether, however, it will be capable of responding sensitively to local needs - to the benefit of other people like Karen in Basingstoke - rather than impose a centralised wisdom remains to be seen.