Professor Orla Sheils:

I thank the Chair and members of the committee for the opportunity to contribute to their discussion today. I represent the Irish Universities Association, IUA, the eight members of which play a key role in educating and training students for the full range of healthcare and social care professions in Ireland. We work closely with the providers in clinical and community settings and we rely on them for the essential practical patient-focused training of our students. We also work closely with the relevant professional and regulatory bodies, which are our partners in ensuring the quality of education and standards in health and social care professions meet national and international requirements. Education in the clinical and healthcare setting is quite different from other forms of education insofar as the costs incurred are high as the curricula are costly to deliver; require low staff-student ratios, specialised infrastructure; and substantial running costs which are not incurred by non-clinical programmes.

The IUA believes there are opportunities to address skill shortages within the sector but also to streamline processes within. The alignment among relevant Departments that fund education and training in class and in practice settings and that control the numbers of entrants to healthcare courses could be better. We need a more cohesive system for long-term planning for sustainable growth among health and social care practitioners. Transforming healthcare education requires a stronger alignment between the institutions and systems that are responsible for service delivery to ensure there is more joined-up thinking across policy and funding mechanisms. More streamlining and efficiencies can be made within the regulatory and accreditation bodies which ensure that the education and healthcare standards are being met.

There are efficiencies to be made regarding accreditation of new courses. My colleague from QQI already referred to the fact that in some instances, accrediting bodies will only review a programme when it is actually running. This means accreditation is not secured for the first intake of students to a course. We would suggest, as Dr. Walsh has done, that temporary or additional approval based on a review of the planned curriculum and site for the year 1 intake could be considered with a full review then when the programme is up and running. The same quality standards could be maintained that way but there is less risk to that first cohort.

Notwithstanding the principles for professional engagements with education statement that QQI published in 2021, we also believe there still remain some efficiencies that could be made in areas where duplication occurs. For some professions, monitoring and accreditation is undertaken by both the regulatory body and relevant professional body. In these settings, the remits often overlap but the quite distinct and separate processes place a very heavy burden on the programme providers. Moreover, CORU’s remit whereby each profession has a separate board can be troublesome because each board runs its own full accreditation process. This results in some schools within institutions preparing duplicate material, thereby requiring the same staff to attend up to three accreditation visits per year. This has a high hidden cost for HEIs.

Another issue I would like to highlight is the tension between the health and social care providers that rely on a steady supply of qualified graduates, and the lack of engagement or perhaps difficulty in securing clinical placements. Institutions typically establish long-term commitments with partner healthcare providers to provide meaningful, practical training to students. However, there is not a unified network or national framework for practice education. That can lead to ad hocor competitive environments in which HEIs negotiate with service providers to secure student placements. Some more thinking in that area would be helpful.

The universities can be more flexible, particularly for people who wish to change career midstream or students from other disciplines who wish to transfer towards health professional careers. We in the institutions need to be alive and create more flexible pathways to make that happen. Further flexibility could also be achieved be expanding the role our universities play in supporting continual professional development through new courses, masterclasses or micro-credentials. These are meant to meet the needs of practitioners who want to upskill, reskill or change direction.

We believe much can be done to ensure better alignment, co-ordination and effectiveness, including in the regulation and accreditation of higher education courses, to meet the country’s skills needs across health and social care provision. The IUA and partner universities are committed to playing their part in ensuring long-term sustainable solutions that are planned and can be sustained. I thank members of the IUA and a number of relevant ministerial appointments to CORU, the NMBI, the Medical Council of Ireland, etc., who have contributed their thoughts to this paper.