More than half of the research carried out in universities is healthcare related. Universities also carry out significant research for the NHS and medical and healthcare charities, and the NHS and universities jointly employ many of the lead researchers. The effects of the government's proposals for further concentration of research funding, set out in its recent White Paper, The future of higher education, are therefore likely to stretch beyond universities, to the health service as well as the pharmaceutical and bio-medical science industries.
Research funding is already more concentrated in the UK than in the United States, for example. We believe that there must be a balance between funding top-rated departments to support international excellence; protecting other areas of excellence across the higher education (HE) sector, and encouraging new and developing areas of research through appropriate allocations of public funding.
The concentration of research funding in selected institutions, and the separation of teaching and research as proposed by the white paper are a particular threat to the quality of education for healthcare professionals. Universities play a vital role in training virtually all the UK's dentists, doctors, midwives, nurses and allied health professionals such as radiographers, dieticians and physiotherapists. There were over 154,000 such full time undergraduates in UK universities in 2001/02. Health care professions students benefit directly from contact with research active staff. The higher education experience provides them with the opportunity to develop the skill of using evidence to underpin evidence-based practice - an essential factor in delivering better patient outcomes in the health service.
More extensive research would not only help to embed evidence-based practice among healthcare professionals, but would also help toestablish a knowledge base to underpin directly applicable projects
There are over 5,000 clinical academic and research staff employed in university medical and dental schools, who both teach and care for patients. The recent removal of funding from medical schools rated 4 or below in the Research Assessment Exercise (RAE) means that medical and dental research activities will be cut - despite the fact that they are of national excellence and, according to the RAE definitions, may show "evidence of international excellence" as well. Such research not only feeds into improved patient care - it also underpins the UK's pharmaceutical and bio-medical industries, which generate an income of over £7 billion each year.
Nursing and allied health professions research is still at an early stage of development. Health service reforms have stressed the importance of developing the evidence base in all areas of health and social care. Indicators such as RAE ratings, numbers of research-active staff and research income are improving rapidly from a very low base. However research in these professions is still under-funded relative to their size, and has been skewed towards short-term projects. More extensive research would not only help to embed evidence-based practice among healthcare professionals, but would also help to establish a knowledge base to underpin directly applicable projects. The new funding mechanisms to develop capacity and capability for research in nursing and the allied health professions therefore need to be protected and enhanced.
Universities also offer post qualification education and training opportunities to health professionals and deliver continuing professional development (CPD) programmes. These activities provide another essential link between researchers and practitioners delivering care, and can facilitate research awareness to support evidence-based practice and policy in the service. The benefits of collaborative research have included developing new equipment and dressings, examining the effectiveness of NHS services and enabling specific interventions or approaches to be evaluated. The opportunities that CPD provides to reflect on current practice and re-appraise approaches to patient care can lead to much broader interactions across the health professions, promoting inter-professional understanding and working.
Universities UK recently published Partners in Care, a short report about the higher education/health service partnership. It demonstrated the range of healthcare activities to which universities contribute - from research into how stinging nettles can reduce the pain of arthritis, to the 20 years of research and experimentation needed to perfect keyhole surgery techniques.
So while it is easy to assume that arguments about university research funding are only of interest to those working or studying in higher education, the reality is that changes to the funding system will affect other services and sectors of the economy as well. The white paper recognised the vital contribution that our universities have made to the economy and society - now government needs to show it is willing to fund that contribution.
Paul Turner is a member ofCouncil of Deans and Heads ofUK University Faculties forNursing and Health Professions; Michael Powell is a member of the Council of Heads of Medical Schools and Eve Jagusiewicz is a Policy Adviser at Universities UK
