Ngaio Crequer talks to four academics about how the National Health Service reforms are affecting their daily work of training students, and finds them largely enthusiastic about the links between practice and higher education.

Nearly three years ago Jane Jacks was director of a school of nursing in the health service, accountable to the health authority.

In April 1992, she moved contractually and physically into the higher education sector and brought 120 academic staff and 40 support staff with her. They were nursing and midwifery tutors. Her new title is director of the school of health care at Liverpool John Moores University.

"My role has changed dramatically. It is culturally very different. They are two quite different organisations and they are both having to adapt and to assess what one can give to the other in terms of support and development.

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"Working in a school of nursing and midwifery in the NHS, our predominant concern was the student in terms of curriculum planning. Academic standards were managed by the professional bodies, not higher education.

"It was not that students were necessarily spoonfed. But the teachers simply input into programmes. Because the students spent a lot of time exposed to the strains of ill people, they demanded a lot of support, whether it was learning support or social learning support.

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"But moving into higher education, you get the impression that the most important part is the academic knowledge, the rigour and the research. That predominates over the needs of the student as an individual.

"In our merger with higher education we need to know what was good about the way we did things before.

"We need not necessarily abandon different views. It is like a revolution or evolution - different approaches can sit with each other."

Professor Jacks was very conscious of moving into an organisation which was much bigger than the one she had been in before.

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She says: "There is an element of pressure to behave in the same way as that organisation, rather than if you had two equals merging together".

She feels that the university background is a great strength when she considers how to develop and extend the curriculum in nursing and midwifery. "Nursing is changing its focus. The care part is still there, but there is also health promotion, and education in health in the broadest sense. We want to develop that side. We want to provide health care courses to people in the community.

"We have lots of different types of courses, but they are predominantly based on nursing and midwifery. In five years' time it will look very different, with much more diversity."

She does not find the funding situation onerous. "We know how many students we have to recruit and so we know how much money we are going to get. In this way we are the same as the rest of the university. Like them we have to manage a budget. All the staff who moved across were appointed on permanent contracts, although there are others working on a fixed-term basis.

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"We know we have to maintain or even increase our level of activity. I have the responsibility, supported by the university, to redirect and develop new activities, and replace others. There is a risk, but this only depends on how the situation is managed. You cannot sit still. I think that is a positive element of the change in culture. The advantage for us now is that we can capitalise on existing organisations within the system. Higher education increases our contacts."