Universities are warning that the government is quietly reneging on its promise to provide 10,000 new nursing degree places, intended to relieve pressure on the NHS.
Student nurses must spend 50% of their degree working under supervision, usually in a hospital. But universities have told Education Guardian that not a single extra nursing training place has been funded or allocated for the future. It would cost £15m over five years to fund training placements for 10,000 new nurses, according to the Council of Deans of Health, the body that represents university faculties of nursing.
Applications to study nursing in the new 2017-18 academic year have slumped by 23% compared with last year, after the abolition of bursaries. The government said last year it would free up £800m and pay for an extra 10,000 places by ending bursaries and shifting student nurses to the standard system of £9,000-a-year tuition fees supported by loans. Angry academics now say this was a hollow promise.
Emily Heron, a 22-year-old healthcare assistant who works in a trauma unit in a hospital in Newcastle, says she will have to abandon her dream of becoming a nurse because she cannot afford a degree now. “I first realised I was good at caring for people when my dad became terminally ill and I had to leave college to look after him,” she says.
“I still care for him, and I live on my own with no family to support me. Without a bursary I’d have to take out a big loan on top of paying for my house and car. As a student nurse you basically work a full-time job in a hospital and fit your degree work around that, so there is no chance of doing paid work to help support yourself.” She adds: “I am really committed to nursing and I know I’d be good at it. But I feel like the government is saying to people like me that I’m not worthy of the training.”
Academics are warning that the government must train more nurses as there is no longer a reliable recruitment pipeline from the EU after the Brexit vote. The number of EU nurses registering to practise in the UK has fallen by 96% in less than a year. Only 46 EU nurses came to work in the UK in April compared with 1,304 last July, according to new statistics from the Nursing and Midwifery Council.
David Green, vice-chancellor of Worcester University, one of the leading institutions for nursing, says: “I don’t believe the policy intention with scrapping bursaries was to expand places; I think it was just to save money. The fact the training placements haven’t increased shows there was no plan to increase numbers.”
He explains: “We can give student nurses all the theory, but they need to actually work on a ward. There’s no money for training and we can’t take people on with a false prospectus. That’s the story across the country.”
Prof Steve West, vice-chancellor of the University of the West of England, which also has high-ranking nursing courses, agrees: “At the moment it is not clear how the 10,000 new places for nurses could happen. No new money has been announced so it isn’t clear how you fund an increase in what we currently have.” Universities are already struggling to protect hospital placements for existing students, he says. “As providers are squeezed their number one priority has to be giving care, and education slips down the agenda,” he says.
Nursing degrees have traditionally attracted relatively high numbers of mature female students, often with their own families to support and often from disadvantaged backgrounds. But universities are reporting that these are the candidates who are being frightened off by high fees and loans.
At Worcester, for the first time, nearly half the people selected for interview to study nursing or midwifery this autumn have either not turned up or explained they do not want to proceed because of the new financial arrangements.
“They all say: ‘I’m really sorry but I don’t know how I can manage with this level of debt’,” Green says. “Because we are right at the top of the hierarchy for nursing, we will be able to fill our places: we have about 10 applicants per place, generally. But there will be no expansion. And watch what happens elsewhere. Other places will definitely have a drop. There are nowhere near enough students to meet the shortfall. And the NHS urgently needs this workforce to expand significantly.”
Green is angry that the government now treats nurses and midwives as standard students who should fund their own degrees, when they work 2,100 hours for the NHS free as part of their course, with no promise of a high salary at the end. “They work night shifts, weekends and a 45-week year. They are not ordinary students and everyone knows that,” he says.
“Midwives have to deliver 40 babies as part of their qualification. My wife became a midwife nine years ago. She had one week during her course when she delivered 10 babies in four shifts, all night shifts with no doctor on duty. There is nothing standard about this. It’s really unfair to pretend there is.”
Kevin Crimmons, head of the department of adult nursing at Birmingham City University, agrees: “The environment we are asking our students to go into is unprecedented in terms of the challenges they will face and the pressure the NHS is under. They will be expected to present in a hospital at 7am and face some very physical and emotional challenges. Nurses aren’t like most other students. We hold them to a much higher account.”
He adds: “Our applications from mature students – and we take a lot of mature students – are markedly down when compared to last year. We are now doing outreach work, going out to FE colleges and talking to students about studying nursing to ensure they are making a decision based on the full facts.”
West argues that many student nurses will have access to more funding under the new system, but adds: “They don’t tend to see that: what they see is the £9,000 fees. Either they worry that they have to pay it upfront or they worry about taking on the debt. The government has been lax in engaging with the sector on how to communicate a positive single message.
“The switch to fees and loans has also got caught up in the negative coverage about morale in the NHS,” he says. “We are haemorrhaging staff quite significantly. Put the two things together and I’m not surprised applications to study nursing from certain groups are lower.”
A spokeswoman for the Department of Health said the planned changes would create up to 10,000 more training places for nurses and allied health professionals by the end of this parliament, adding that there was likely to be a bounceback on applications next year. She said that even with a 23% drop in applications the NHS would still be able to fill the required 20,000 student nursing places this year.
