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Bursary or bust? Bust seems to have won

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The government’s plan to remove the bursary doesn’t really seem to have taken account of the concerns of those who engaged in the consultation

  • The lack of placements could be a real issue for students seeking clinical practice while in training
  • Universities may be happy that they can increase their student numbers, but will there be enough placements
  • If students are paying, haven’t they a right to a high-quality placement experience?

The government’s decision to forge ahead with scrapping the bursary following the “consultation” shows that it isn’t really prepared to consider the views of those who had concerns about it. By the way, the quote marks around “consultation” are intentional because I think it was more of a lip service consultation than a real consideration of people’s views by what I’ve read in the Department of Health’s response yesterday.

”I think it was more of a lip service consultation than a real consideration of people’s views”

One of the main concerns raised was about students’ cost of living while getting to placements, and in fairness, the DH response reassures the profession that the government will cover the initial cost of £303, the threshold students must meet before they can claim travel and expenses.

It has also stated that loans will be available to those undertaking nursing as a second degree, and giving additional funding to students who have children and need help with childcare.

But there are other issues. The government’s major argument in justifying removing the bursary was that it would enable more potential nursing students to train, and therefore fix the nursing shortage.

”Care settings for students to practise their nursing skills are often in short supply”

In the consultation, which received 1,750 responses, some raised the issue of clinical placements. Care settings for students to practise their nursing skills are often in short supply, many students inform us that they experience poor-quality placements, and some struggle to find a placement at all. It was therefore raised as an issue in the consultation that the need to find 10,000 more placements might not be feasible.

The government has said that Health Education England will continue to commission the minimum number of training places for students, and universities are free to organise more placements in addition to that number.

”If these places don’t exist now, then how on earth will we find 10,000 more of them?”

Now that’s all very well, but if these places don’t exist now, then how on earth will we find 10,000 more of them? And if trusts and other care settings are under pressure and short staffed already, can they really afford to take more time out to mentor and train students?

Meanwhile, students, who will be paying for their education rather than being funded, will have an expectation about their placement.

Won’t they feel more justified in complaining if they are having an unsatisfactory placement? With this in mind, is this new system really going to deliver high-quality, experienced nurses to the healthcare sector?

”The ability to offer more nurses a place and cure the staffing shortage wasn’t the objective in removing the bursary”

Let’s not be fooled. The ability to offer more nurses a place and cure the staffing shortage wasn’t the objective in removing the bursary. This was always about a deep-seated desire to do what’s best for the treasury, and not what’s best for the people using the service – or indeed providing it. Once again, it puts profits before patients.

A lot of universities are happy that they can increase training places, and therefore their revenues. Good luck to them, I hope the changes in funding mean they can offer a better-quality and more sustainable business model to train the next generation of nurses. And some potential students are happier that under a loans system they will have more money for their cost of living while training. So I know the plan to move to a loans system doesn’t upset everyone reading this column.

”I know the plan to move to a loans system doesn’t upset everyone reading this column”

But for me it’s another example of an ill-conceived plan that the government pushes ahead with, despite the fact that there may be some serious consequences in terms of quality of both care and student experience.

The training offered by the universities had better be top-notch – to compensate for the fact that in the field, the training for nurses in practice might really suffer.

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Readers' comments (1)

  • I think this has the potential to transform nursing education. Do nursing students really need to spend so much time in placement, for instance? In my experience, placements are often the least satisfactory element of student nurses' experience and, in some instances, actually hampers their development. Perhaps that will need to be re-evaluated by the NMC; perhaps nursing degrees should no longer be 50/50 practice/theory.

    The quality of placements is always an issue, particularly the quality of mentorship. Again, trusts who wish to have students may need to think about the kind of mentorship they provide when students are customers rather than commissions - students will be able to "vote with their feet".

    Also, universities will have to consider the quality of the education they provide and the links they have with local trusts. With the government also committed to liberating higher education provision, perhaps we will see the development of Trust-specific education, with students receiving part of their funding from a Trust in return for an expectation they will work for the Trust for a set period of time on qualifying..

    The bursary system is not working to provide the nurses the country needs. Something needs to happen to shake things up a little.

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