The challenges and opportunities facing the UK healthcare and higher education sectors

challenges and opportunities facing the UK healthcare and higher education sectors

Rebecca Brandwood, our Healthcare and Education Consultant, discusses how shared challenges and opportunities will impact senior talent acquisition across both sectors

Of all the areas of the public sector, it is higher education and healthcare that are often so closely intertwined. With universities providing the training and education for the UK’s 1.2 million-strong healthcare workforce, it would be hard for them not to be. From an organisational perspective; leadership style, key skills demands and core values are shared by both. They face the similar issues when it comes to pensions, Brexit and leadership pay, whilst major policy changes in education have the potential to cascade through the NHS. At the same time national employment prospects, digital implementation and new approaches to leadership present opportunities for both. This is how it will impact senior talent acquisition across both sectors.


1. Pensions

The £1.1m pension cap has left most senior NHS leaders footing the bill for their own pension contributions. The annual tax charge on higher earnings pension contributions has meant that NHS professionals in leadership roles are either cutting down their working hours or opting for early retirement. Whilst this is creating a growing number of interim appointments in the short-term, it is a symptom of a long-term senior skills deficit.

The higher education sector has faced its own pension challenges. Last year’s dispute over the USS pension scheme saw significant strike action that led to cancelled lectures and seminars and as a result, negatively impacted the student experience. There is a threat of further industrial action taking place this year. With doctors and senior medical professionals cutting down their hours, NHS operations have also been cancelled and waiting times have increased.

When compared with countries such as the US and Australia, salaries in the UK’s higher education sector are relatively low. The pension scheme has traditionally been a powerful recruitment tool in rebalancing the disparity. The market for academics is competitive and there are concerns that any future changes to the HE pension scheme could make employment opportunities in the UK less attractive.

2. Demographic hurdles

The UK is currently experiencing a demographic dip in the number 18 year olds in the country. Domestic student recruitment is expected to be more challenging as a result and there will be a renewed focus on recruiting from the international student cohort. This has already led to a demand for professionals who have experience of recruiting overseas students, whilst other in-demand skills include student experience and marketing expertise, as well as estates management to ensure that universities are attractive to prospective students.

The NHS faces its own demographic issues; the UK has a growing elderly population which is leading to more patients with multiple and complex care issues. This is leading to a need for project managers with experience of service redesign to help meet a complex new area of care. Both sectors are faced with a changing recruitment landscape.

3. Brexit

In the past two years, nearly 5000 nurses and midwives from EU countries have left the NHS, citing Brexit as the primary driver.

The shortfall is also being felt in senior academic and executive positions with the UK being viewed as increasingly less attractive to foreign talent. It means that the UK’s precarious relationship with the EU is creating an even larger skills gap throughout the workforce for chief executives and university vice-chancellors to manage.


1. Technology

Earlier this year, the government launched NHSX, a new joint unit responsible for overseeing the digital transformation of the health and social care system. It is part of the ongoing commitment to introducing new technologies into the NHS in order to reduce the burden on clinicians and to enable staff to provide enhanced levels of care.

At the same, the implementation of digital technology in universities is just as much a priority for the higher education sector. The aim is for universities to reduce costs, improve the student experience, and compete with online learning institutions.

The digital agenda will require significant changes to workforce education and training, and as a result, greater collaboration between the NHS and universities to update curriculums will be critical. Already, both sectors are looking for professionals outside of healthcare and higher education for the necessary digital skills. Importantly, it is creating a growing demand for interim managers who can provide both hands-on implementation and strategic consultation to deliver digital programmes. 

2. Key skills

As a result of the pension cap, Brexit and mounting media scrutiny on senior roles, there are skills gaps across the senior leadership divisions of both universities and NHS Trusts.

We’re now seeing both sectors seek out executives from other industries, especially those in the commercial sector. In particular, the current focus on organisational culture and how leadership style impacts it means that leaders who understand how to build, nurture and maintain a strong culture are in increasingly high demand. With both the higher education and healthcare sectors going through a period of change, leaders that join organisations in these sector now, will to some extent, have a clean slate to work on.

What’s more, the delivery of change in the two sectors will require interim leaders and project managers that have the people management skills to engage academics and clinical consultants in the change journey to realise greater outcomes for their organisations.

3. Systems leadership

A solution to the many challenges facing both sectors is systems leadership; a holistic approach to service delivery that aims to provide the best outcomes for students and patients.

For example, a key focus of the NHS’s long-term plan is to deliver place based care, with Trusts working alongside social care, housing providers, education institutions and employment support to provide more efficient care for patients and alleviate demand on services.

For universities this means working with the further education sector to deliver the widening participation agenda, and employers to identify and address skills deficits before it becomes a larger problem.

Both require a different style of leadership that considers the organisation’s place in society, requires a level of ‘out-of-the-box thinking’ and a collaborative mind-set that will enable them to solve problems with other stakeholders in the sector.

For more information please contact Rebecca Brandwood.


Dr Lisa Mooney at 30/07/2019 16:56 said:

Many thanks for the insightful article Rebecca, and yes we are indeed moving through uncertain times, and as a result, leadership that comes with an innate ability to bring people powerfully along with such changes is critical. Unfortunately in HE there is still reticence around this form of positive leadership, as organisations still seek those who bring rapid change, often at a deep and longstanding cost to workforce development and culture. If we are to really witness leadership that implicates positively on cultures and behaviours for long term sustainability, then we also need insightful Vice Chancellors and governing bodies able to recognise these qualities, and willing to move towards a more innovative, creative, and less risk averse strategy.

Ed Macalister-Smith at 30/07/2019 17:13 said:

Whole system working in health and social care has, in my view from a career over 40 years, ALWAYS been a key attribute of successful service delivery (whatever the current colour of politics)...

...and this requires not just skills in managing across boundaries but also a passionate belief that the whole system is more important than your own organisation...

...and that patients and the public expect us as public servants to operate in that way on their behalf.

Andy Morris at 01/08/2019 09:46 said:

Systems Leadership must include GPs, CCGs and commissioners; and don't forget the third sector. The above infers that the NHS just revolves around Trusts!

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