Carry on doctor!

Medicine – alongside other health professions - is one of the few subjects in UK higher education where workforce planning is a significant part of the equation. Medical Schools are capped on how many students - home and overseas - they can admit. This makes the opening of the UK’s first privately funded medical qualifying degree (since the 1940’s) – at the University of Buckingham – a significant occasion.

The Guardian reports that 500 people applied for its 67 places, and that 60% of its students in this first cohort come from the UK. Fees of £35,000 per year (which is within the range for overseas fees at other UK medical schools) did not deter. (The fee may seem eye-watering, but it doesn’t look to me like profiteering: it does cost a lot to train a doctor, and publicly funded medical education continues, for the time being, to attract a significant subsidy in addition to fee income.)

The critical component of a medical degree is clinical experience, and in this instance the University has agreed with the Milton Keynes NHS Trust that students can undertake clinical placements within the hospital. This benefits the hospital too – there’s prestige and money associated with it.

Finding these clinical placements will have been one of the limiting factors in developing the degree programme. Students spend time with qualified clinicians in every different medical specialty: observing procedures, learning from what they see and practising clinical skills. It’s this that ensures that graduate medics don’t only know about the human body, what ails it and how to cure it; they have some actual experience. But there are only so many clinicians to observe, and only so many patients, so the availability of ‘firms’ (the placement possibility for a group of students) is everything. The negotiations here will have been high stake for the University.

Once students graduate with their degree there’s still a while to go before they are fully licensed: two further years of Foundation Study take place, where they work in clinical settings under the continued supervision of senior doctors. (This is what used to be called the Pre-Registration years.) The University of Buckingham website has a telling phrase:

We expect that our graduates will be eligible to apply for UK Foundation Training posts. (My emphasis.)

Should students worry about being able to continue as doctors? I doubt it: it’s five years until it becomes a live issue, so discussions will still be taking place and contracts not yet signed. My guess is that the NHS Trust will be as keen to have foundation doctors as it was to have undergraduates.

So is this all a good thing? On the positive side, it does get the country more doctors, and that is a good thing. It also shows that alternative models for HE provision can work, and that is arguably a good thing. But in the absence of funding available to all, there’s no doubt that the opportunities available are available, like the Ritz, only for those who can afford it. The Charity Commissioners may be as interested in this degree as they are in the charitable status of public schools...

An Alternative point of view

The National Audit Office report on Financial support for students at alternative higher education providers has generated a lot of media coverage in the past couple of weeks – both from industry and social media. Here’s links to the Guardian’s coverage; the BBC and the Times Higher; and also a brief piece by Emily Lupton on Wonkhe. The coverage ranges from £5m mis-spending to a whopping £50m potential risk in your super soar-away Guardian. So what’s really going on?

First up, what are alternative providers? An alternative provider is any college which offers higher education, but is not part of the ‘normal’ state-funded, QAA-regulated, HESA-data-submitting established universities. So the term includes established and well-recognised institutions such as the University of Buckingham or BPP University (relatively new name but a long, long heritage) as well as lots of smaller colleges, some of which have sprung up in the last few years. (I should add for clarity that there are no adverse comments about either Buckingham or BPP in the NAO report.) I blogged a while ago about which institutions use UCAS, and a lot of the entrants and exits from that marketplace are alternative providers.

Alternative providers aren’t all for-profit – the term covers colleges run as charitable trusts too. Courses lead to awards made either through powers that they have gained themselves through the recent more open procedures run by BIS; made by national awarding bodies; or lead to awards validated by universities, or franchised from universities.

The story arises from the opening up of access to Student Loans Company (SLC) funding for students at alternative providers – up to £6k fees, and also for living costs. And this is what the NAO was investigating.

There were four main findings:

“EU students at some alternative providers have claimed or attempted to claim student support they were not entitled to” – this is the £5.4 million mis-spending reported by the media. And 83% of the wrongful claims came from student at just 16 alternative providers.

“Dropout rates at 9 alternative providers were higher than 20% in 2012/13” and “20% of Higher National students recruited by alternative providers and claiming student support may not have been registered with the qualification awarding body in 2012/13”. The NAO takes this as evidence that some students aren’t really motivated to learn – that is, they may be registering as students only to access loans.

“Between 2012 and 2014, BIS suspended payments to 7 providers and their students owing to concerns that providers had enrolled students onto unapproved courses” and “a lack of clarity has existed within BIS and its partner organisations about which courses were approved for student support.” This points to procedures designed (or at least operated) by BIS and the SLC which didn’t check eligibility before lending money.

“In 3 cases, BIS suspended payments to providers or their students where it had concerns that the providers had supplied incorrect information about student attendance.” The point being that it was the SLC making payments, but without the powers necessary to assure itself of the correctness of the payments.

Does this mean that alternative providers are a Bad Thing? That was certainly the unspoken view behind a lot of the Twittersphere commentary. I don’t think that it does.

It does mean that some of the providers audited almost certainly are doing bad things, and it almost certainly means that some of the people who signed up for courses at some alternative providers were doing it for the wrong reason. But a very few students also enrol at ‘normal’ providers for the wrong reason. And they’re often caught, like these ones, and dealt with. (A quick note about the 83% at 16 providers which the NAO cited: the alternative providers market is very skewed, with a few very large providers and many very small indeed. 83% of students at alternative providers, selected on any basis at all, are mathematically almost certain to come from a small number of providers. Just saying.)

But I do think that there is a problem here, and it’s the failure of regulation which this represents. There wasn’t until September 2014 a single comprehensive list of courses at alternative providers which were approved for access to SLC funds - this makes checking very difficult. There weren’t systems which shared information at the right time between bodies to make it possible to spot and stop problems. There wasn’t the right authority to oversee new providers in a timely fashion. These are all foreseeable problems, the sort of problems which universities have been dealing with for years and which sector groups – Universities UK, the Association of Heads of University Administration (AHUA), the Academic Registrars’ Council (ARC) – are well placed to advise upon.

The reasons for this?  Too little time spent on thinking things through; a government in a hurry; a coalition government, meaning that plans had to be compromised; and a civil service which was distracted by pressure to find savings. And underlying this the great truth that higher education is a long-term process, with outcomes only known sometime after the event. The same is true for higher education policy – act in haste, repent at leisure.

Academic dinosaurs?

A strand of the public discourse around higher education, since the coalition’s funding reforms in 2010, has been about how alternative providers (ie the private sector) will enter the market, compete with established universities and force those ‘academic dinosaurs’ to improve their offer to students, to compete on successful terms.

Two friendly academic dinosaurs

Now no doubt there is a market – you can see some evidence for this in the UCAS data – but I’m not sure that it’s as simple as the ‘more competition = better all round” narrative might have you believe.

Markets are segmented. There are different types of customer; and different types of supplier. This is true for all markets; and hence true for higher education.  Higher education differs in that price is not only about money, but also about entry tariff: you aren’t able to go to some universities unless you have the right qualifications.

On the supplier side (and for simplicity let’s focus on undergraduates only here), you have differentiation by

• length of study (accelerated degrees versus ‘traditional’ degrees; foundation years; part-time study)
• range of subjects (specialist institutions versus multi-faculty)
• mode of study (distance learning versus campus based; daytime versus evening)
• focus on teaching versus focus on research
• qualifications needed to gain entry
• price
• location (near home; another city; a rural location; a different nation)

On the ‘customer’ side, you have differentiation around:

• Price sensitivity (in relation to living costs; total fees; willingness to commit time)
• Confidence (in their own ability)
• Focus (are they looking for ‘the student experience’ or for a qualification?)
• Willingness or ability to travel to university
• Instrumentality (that is, are they focused on the career options open to them, or looking only at the educational aspects)
• Flexibility (that is, how flexible a university must be in the facilities and options it offers the student: think childcare on campus; 24/7 library opening)

This isn’t a simple marketplace. It also strikes me that the alternative providers are seeking out particular niches – a particular subject or a rigorous focus on the learner – and that only one private provider – the University of Buckingham – seeks to play on level terms with other universities.  Not a surprise, but also not a revolution.

My prediction (and it is just that! no value judgments are made here!) would be that private providers will compete mostly with some of the newer universities: attracting students with less familiarity with higher education; focusing on the learner; offering flexible study.  The older universities will continue to be popular with students who have familial experience of university, and for whom ‘going to university’ has been part of their life plan since before they knew it, in short, who come from ‘traditional’ backgrounds..

If this is right, the effects of competition won’t be on the sector as a whole, but on a subset of existing institutions only. And not, noticeably, on those institutions with a strong focus on research, which I’ve heard as a particular bugbear of the alternative providers (why subsidize research with fees? they ask).

Back to the dinosaur metaphor, this is consistent with what know – evolution is a slow process, impacting on particular ecosystems and subspecies; changing a food chain here and there; but passing almost unnoticed from one generation to the next. In the absence of a metaphorical meteorite hitting the UK university sector, the dinosaurs may be successful for some time yet.

Say hello, wave goodbye

UCAS release regular statistics on applications and entry to UK universities, and there’s some really interesting data available to download.  One aspect that caught my eye recently was the growth in the number of institutions which recruit through UCAS:

Year of entry	Institutions
2008-09	307
2009-10	306
2010-11	306
2011-12	302
2012-13	320
2013-14	361

Aha! I thought – that’ll be the growth in alternative providers. But I looked at the data more closely and found that it wasn’t as simple as that.

Firstly, the data show more entry to and exit from the UCAS sector than I’d expected:

	2013-14	2012-13	2011-12	2010-11	2009-10
Total institutions	361	320	302	306	306
Total new this year	45	24	7	12	8
Total gone from year before	4	6	10	12	9

In total, 402 establishments had recruited through UCAS in the period.

Secondly, the new entrants and leavers were quite varied:

	Coming				Going
	Renaming	FE	HE	Alternative	FE	HE	Alternative
2009-10	1	2	3	3	3	2	1
2010-11	6	6	2	1	4	1	1
2011-12	1	2	0	3	5	1	1
2012-13	2	11	0	8	4	0	0
2013-14	2	36	1	6	0	2	0

(The numbers don’t quite tally because some of the changes happened over several academic years, with parallel running in the UCAS lists)

My conclusions? Firstly, the growth in ‘HE in FE’ Colleges having direct entry through UCAS is likely to be connected to the legislative and regulatory changes which came about in 2010-11 as a result of the coalition government’s changes.  But I suspect that it is too early (and the data set here is too small an evidence base) to make any larger prognostications.

Secondly, there is a real growth in alternative providers.  Here is a little more data, showing total UCAS acceptances by providers for the past five sessions, with providers analysed into higher education institutions, further education colleges offering HE, and alternative HE providers:

	2009-10	2010-11	2011-12	2012-13	2013-14
HEIs	451,040	461,305	482,035	428,115	465,380
FECs	18,155	16,735	19,710	18,675	20,235
Alternative	705	1200	2560	2095	3090
Total	469,900	479,240	504,305	448,885	488,705

And in percentages:

	2009-10	2010-11	2011-12	2012-13	2013-14
HEIs	95.99%	96.26%	95.58%	95.37%	95.23%
FECs	3.86%	3.49%	3.91%	4.16%	4.14%
Alternative	0.15%	0.25%	0.51%	0.47%	0.63%
Total	100.00%	100.00%	100.00%	100.00%	100.00%

And my final conclusion? There’s a real opportunity for the Times Higher to run a ‘births, marriages and deaths’ column: only 267 of the 402 establishments hadn’t stopped or started using UCAS during the period.