Applications to nursing degrees have shot up by 27% while pre-registration training places have dropped by a tenth, according to figures seen by Nursing Times.
There are concerns that the combination of a surge in demand and budget cuts will leave thousands of aspirant nurses unable to get onto courses or find suitable jobs once qualified.
The figures also come as the quality of nurse education has been thrown into serious doubt by government advisors in a high profile report published today.
Just two weeks before the 15 January deadline for applying to nursing courses starting in September 2012, 98,428 applications had been received by the Universities and Colleges Application Service – 26.8% up on 2011.
This contrasts with a 6% drop in applications to university courses overall – widely seen as a result of rising tuition fees, which student nurses currently do not pay.
Royal College of Nursing head of policy Howard Catton said part of the increase in applications to nursing courses was due to the rising profile of the profession. “But…there may be a number of people who see this as a cost effective route of securing a degree,” he said.
Post freezes made it more likely in future that newly qualified nurses would have to find work as bank staff or in temporary roles that were less likely to offer support through preceptorships, he warned.
The increase in nursing course applications, which exceeds last year’s 25% rise, is also likely to be linked to the fact that nursing will become an all graduate profession from 2013. Many qualified nurses without degrees have been placed on waiting lists for university courses, as revealed by Nursing Times in November.
However, the Council of Deans of Health has warned MPs that the number of places available on pre-registration nursing courses has fallen by 10% as part of a continuous downward trend.
Council chair Ieuan Ellis told Nursing Times the cuts to places “threaten the sustainability of a high quality current and future nursing workforce”, at the same time as Prime Minister David Cameron has pledged his commitment to support nursing care (see opposite).
As previously highlighted by Nursing Times last May, around two thirds of universities have already raised their entry standards in response to the rising demand.
Swansea University head of nursing department Dave Barton said his organisation was receiving many candidates with three A*s predicted at A Level. There were five applicants for every place on adult nursing courses starting in 2012 and 300 applications for just 15 places to study child nursing.
He said: “We’re massively oversubscribed. We’re turning down lots of very disappointed youngsters.”
However, a report by the NHS Future Forum published today has once again drawn attention to well publicised problems in nurse education, including “significant dropout rates and issues with basic skills such as numeracy”.
The forum, set up to advise the government last year, looked at healthcare education and training as one of its four areas of review. It criticised the provision of community placements for student nurses and an over-reliance on “virtual” training experiences.
Forum chair Steve Field told Nursing Times it was vital the government took notice of the report’s findings. “We want to change so that we go for quality rather than just producing numbers of qualified staff. We want the best people coming out of training in the world,” he said.
The report said there were excellent examples of pre- and post-registration nurse training, but there was also “almost universal concern” about the “huge variation in quality across the country”. In particular, there was a “lack of investment” in preceptorships for newly qualified nurses by trusts.
It said nurses needed to be “empowered” to build leadership skills through a structured framework from undergraduate level throughout their careers. The report said there was “evidence that access to postgraduate training for nurses, particularly in specialist areas such as intensive care and emergency medicine, learning disability and older people’s nursing, is declining significantly”.
Nurses’ post-qualification careers needed to be developed through “properly structured processes”, it said, and the National Quality Board should “urgently” review continuing professional development.
There have been ongoing problems with key parts of the current CPD system, such as roll out of the knowledge and skills framework, and monitoring of post registration education and practice (PREP) portfolios.
The forum recommended introducing a “quality premium” which would withhold funding from trusts until they could prove they had provided staff with adequate training.
In a statement on the forum’s recommendations on education and training, RCN chief executive and general secretary Peter Carter said: “The forum has recognised that nurses must be able to update and develop their practice throughout their careers, and that there is recognition of the importance of protecting education and training budgets. It is crucial that this money is used for its desired purpose.”
He added: “We would also very much welcome the moves to commission training places in partnership with employers and to ensure staff are trained and ready to work in new ways, such as in the community as well as in acute hospitals. These improvements in education must go hand in hand with changes in the regulation of the whole health workforce, and we are disappointed that the RCN’s call for the regulation of healthcare assistants has not been taken forward.”
The DH is expected to respond to the proposals this week. Separately, the Royal College of Nursing is also expected next week to launch a commission on nurse training.
Future Forum report’s recommendations on education and training
- Properly structured processes to support individual nurse and midwife development in post-qualification career pathways, ensuring support for clinical, managerial and specialist development
- National Quality Board should “urgently” review CPD
- Trusts should have training funding withheld unless they hit standards
- Employers to carry out “checks” on HCAs
- More nurse leadership training