The surprise election has reignited the debate over the removal of student nurse bursaries, only a few months since the policy was officially confirmed. Student nurses in England currently receive a bursary to fund their study and help with living costs. The current government has removed this funding, effective this year, while Labour this week has announced plans to reintroduce it if the party gains power in June’s general election.
The government said that it removed the bursaries to increase the number of nurse training places, to help deal with the well documented shortfall of nurses, midwives and health visitors. It might seem counterproductive to deal with a shortage of nurses by increasing the amount it costs someone to train as a nurse, so it’s worth revisiting how the bursary system limited the supply of new nurses.
The NHS Bursary Scheme was funded by Health Education England (HEE), which itself is funded by the government. The number of nurse training places available each year was limited to how much they could afford to fund. This number wasn’t enough to supply the quantity of nurses needed by the health service, but it couldn’t be increased because of constraints on government spending (as a result of ongoing government policy to reduce the national budget deficit). The government wanted to increase the number of places available, but was unable to do so with the money available.
As a result, despite nursing being a hugely popular course, receiving applications from 57,000 people in 2015, and despite growing demand for staff, the number of nurse training places remained at just over the 20,000 mark. UCAS data indicates there has been broadly no growth in places since 2010, while demand on the health service has been ever increasing.
But a more affordable training scheme for the government means a transfer of burden to students. And from this year trainee nurses will need to take out maintenance and tuition loans like other students. The removal of bursaries was controversial and many have questioned whether the number of people willing to take on these debts to train as a nurse will be sufficient to fill the promised extra training places.
It’s an important question, and the figures from UCAS in January this year showed that the number of people applying for nursing-related courses was down on the same time in 2016 by 23%. But, as I wrote in a blog last summer, nursing was such a popular course, with more than two applications for every place in 2015, the number of applications would have to fall by more than half for training places to go unfilled.
Of course, it’s not all about the numbers, and there are a few things that should be carefully monitored to ensure the removal of nurse bursaries helps to increase the size and strength of the workforce.
Firstly, nurses aren’t just trained by universities – at least half of their training is through hands-on placements in hospitals and other clinical settings, and some of the savings from removing the bursaries should be spent on providing these additional placements.
Removing central funding of training places is also a risk, as it takes away central control over the number of nurses that are trained. This must be closely monitored to ensure shortages do not appear in certain specialisms or in certain places.
Ultimately it is too early to know for certain the impact of removing the bursary. It is likely to increase the number of training places available, which is not only desirable but necessary to help fill the nursing shortfall, caused by years of undersupply and which is at risk of worsening if Brexit affects international recruitment.
However all this relies on maintaining demand for places, by making sure nursing in the NHS remains an attractive career. The best way to achieve this is a long-term and coordinated workforce strategy, looking at staffing levels, training, recruitment and pay. These are issues which will most likely be debated in this election campaign, but which must be looked at holistically by the next government.
Whether or not an incoming administration reinstates the nurse bursary it will be crucial to monitor the number of training places available and ensure a policy is in place to create an adequate supply of nurses for the NHS.