A fundamental rethink of how the NHS trains its future workforce is urgently needed, according to a new paper from the Higher Education Policy Institute ( www.hepi.ac.uk ), Rethinking Placement: Increasing Clinical Placement Efficacy for a Sustainable NHS Future (HEPI Report 194).
The paper, written by senior leaders from the University of East London (UEL), argues that the National Health Service (NHS) cannot achieve its ambitious workforce goals without bold system-wide reform of how students gain real-world experience – the essential bridge between classroom learning and frontline care.
The HEPI Report, which has been published with the support of the Council for Deans of Health, sets out a blueprint for transforming placement provision across the health and care sectors. Drawing on best practice across London through UEL partner organisations, it urges policymakers, universities and NHS providers to move beyond the narrow goal of simply increasing numbers and to focus instead on removing systemic barriers to create placements that are equitable, flexible, digitally enabled and aligned with the future of healthcare delivery.
Authored by Professor Amanda Broderick, Vice-Chancellor and President of the University of East London, and Robert Waterson, Executive Dean of UEL's School of Health, Sport and Bioscience, the report highlights the growing strain on the system, with more than 106,000 vacancies across secondary care and a shortfall of placement opportunities for health students.
It also challenges 'legacy assumptions' and outlines a series of practical interventions to make placements more effective and sustainable. These include greater use of simulation and digital learning, new supervision frameworks that ease pressure on clinical staff and community-based models that widen access to diverse learning environments. It points to pioneering examples across the UK – including UEL's own simulation-based and telehealth placements – as proof that innovation can expand capacity without compromising quality or safety.
Working hand-in-hand with NHS providers, universities can help reimagine supervision models, expand simulation-based training and pilot technology-led learning that mirrors the realities of modern healthcare. The authors warn that without urgent reform, student learning, workforce readiness and patient safety will all be at risk.
Professor Amanda Broderick said: 'Incremental adjustments will not be enough. We need bold, innovative approaches that harness the full potential of simulation, technology and new models of supervision, while deepening partnerships between universities, NHS providers and community organisations. Our goal is to shift the conversation from "more placements" to "better placements": placements that are equitable, flexible, future-facing, and designed around both workforce needs and student success.
'By challenging old assumptions and reimagining what placements can be, we can help build the confident, agile and compassionate workforce the NHS requires to meet the challenges of the next decade and beyond.'
Nick Hillman OBE, HEPI Director, said: 'We all rely on the NHS, but the NHS can only cope with the ageing population if it has a workforce to match.
'This report reveals how to resolve the difficult blockages in the training pipeline to unlock capacity and improve quality.
'I hope Ministers respond constructively.'
In a Foreword to the report, Ed Hughes, Chief Executive of the Council of Deans of Health, writes:
'Clinical placements are the foundation of health and care education. They are where knowledge, skills and professional values come together to shape the workforce our communities need. Yet as this paper makes clear, the placement model that has underpinned education for decades is under significant strain. Capacity is stretched, supervision is challenged, and quality cannot be taken for granted. …
'We cannot simply expand the existing model indefinitely. Changing this will require adaptation from both placement and education providers, including the willingness to take decisions which work in the interests of the system as a whole over addressing issues for particular courses, and which place the student interest at their heart. Placements must be designed to reflect new ways of working, embed simulation and digital learning at scale and develop supervision models that are flexible, safe and resilient. …
'Placements are not a peripheral issue; they are central to the supply, confidence and competence of the future workforce. … As the NHS and the wider health and care sector enter a decisive period of reform, it is imperative that placement transformation is aligned with national strategy and resourced accordingly.'
