HEPI report urges NHS clinical placement overhaul to secure future workforce in the UK

A recent Higher Education Policy Institute report authored by senior leaders at the University of East London has called for a fundamental rethink of National Health Service clinical placements, arguing that simulation, digital models and community settings must scale to meet acute workforce shortages

A fundamental rethink of how the UK National Health Service (NHS) trains its future workforce is urgently required, according to a recent policy paper from the Higher Education Policy Institute (HEPI): ‘Rethinking placement: increasing clinical placement efficacy for a sustainable NHS future’ (HEPI Report 194).

The report from the University of East London (UEL), argued that the NHS would not meet its ambitious workforce goals without bold, system-wide reform of how its students can gain real-world experience. Clinical placements are presented as the essential bridge between classroom learning and frontline care, yet current arrangements have come under severe strain.

HEPI Report 194 – which has been published with the support of the Council for Deans of Health – set out a blueprint to transform placement provision across the health and care sectors. Drawing on practice across London through UEL partner organisations, the authors urged policymakers, universities and NHS providers to move beyond the narrow objective of simply increasing placement numbers. Instead, they called for the removal of systemic barriers so that placements can become equitable, flexible, and digitally-enabled, and aligned with the future shape of healthcare delivery.

The paper was Authored by Vice-Chancellor and President of the University of East London, Professor Amanda Broderick, and Executive Dean of UEL’s School of Health, Sport and Bioscience, Robert Waterson. It highlighted the growing pressure on the system, with more than 106,000 vacancies across secondary care and a persistent shortfall of placement opportunities for health students. The authors linked these gaps directly to national ambitions to expand the clinical workforce, arguing that placement capacity and quality now represent a critical rate-limiting factor.

The report challenged what it described as ‘legacy assumptions’ about how and where students should train and outlined a series of practical interventions to make placements more effective and sustainable. These included greater use of high-quality simulation and digital learning environments, refreshed supervision frameworks to ease pressure on clinical staff and community-based models that widen access to diverse learning settings.

It also highlighted examples across the UK – including UEL’s own simulation-based and telehealth placements – as evidence that novel methodologies can expand capacity without compromising either quality or safety.

“Incremental adjustments will not be enough. We need bold, innovative approaches that harness the full potential of simulation, technology and novel models of supervision, while deepening partnerships between universities, NHS providers and community organisations,” said Professor Broderick.

She explained that the aim is to shift the debate from a simple emphasis on volume to a focus on the nature of the experience itself, so that: “the conversation moves from ‘more placements’ to ‘better placements’. Placements that are equitable, flexible, future-facing and designed around both workforce needs and student success”.

Professor Broderick added that by questioning long-held assumptions and recasting what placements can deliver, universities and health providers together can create the confident, agile and compassionate workforce that will be required by the NHS to meet the novel kinds of healthcare demands of coming decades.

The report argued that universities – when they work hand in hand with NHS providers – can help to reimagine supervision models, expand simulation-based education and pilot technology-led learning which reflects contemporary clinical practice. Without urgent reform, the authors warned that student learning, workforce readiness and ultimately patient safety would all face greater levels of risk.

“We all rely on the NHS, but the NHS can only cope with the ageing population if it has a workforce to match,” said Nick Hillman OBE, Director of HEPI, as he linked the findings to wider demographic pressures on the NHS.

He stated that the report set out how policymakers and providers could resolve key bottlenecks in the training pipeline, in order to unlock capacity and improve quality for students and patients alike.

In a Foreword to the report, Chief Executive of the Council of Deans of Health, Ed Hughes, underlined that placements sit at the heart of professional preparation.

“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,” wrote Mr Hughes.

Hughes noted that the placement model which has underpinned education for decades now faces intense strain, with capacity stretched, supervision under pressure and quality no longer able to be guaranteed in every setting.

Hughes further stressed that simple expansion of the existing model would not suffice. He argued that meaningful change would require adaptation from both placement providers and education institutions, as well as a willingness to take decisions which favour the interests of the system as a whole rather than isolated courses, and which keep the student experience central.

Placements must reflect contemporary ways of working, embed simulation and digital learning at scale and adopt supervision models that remain flexible, safe and resilient, he wrote.

He concluded that 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 what he described as a decisive period of reform, Hughes wrote that it has become imperative that placement transformation aligns with national strategy and receives appropriate resourcing.

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