Extra cash for clinical placements in England released by the government over the summer has been provided too late to make any significant difference to the number of nurses being trained at university this year, an investigation by Nursing Times has indicated.
In August, the government announced funding for up to 1,500 additional nursing, midwifery and allied health professional placements would be made available for courses starting this month and in early 2018.
“The government must start to develop a coherent workforce strategy”
This was part of a £16.4m placement funding boost by the government designed to ensure an extra 10,000 student nurses, midwives and AHPs can train by 2020.
It followed months of warnings from universities who said that they would only be able to increase course sizes if more practice placements were made available.
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Our investigation comes as health secretary Jeremy Hunt announced this week a further 5,170 extra clinical placements for student nurses next academic year, in 2018-19. Some universities have again stressed this funding should be released as soon as possible to avoid the delays seen this year.
Nursing Times asked the 53 universities that were automatically eligible for the funding boost announced in August whether they would be accepting the offer of a 4.6% increase in clinical placements this year.
Among the 27 that responded to the snapshot survey, 20 said they had accepted the increase, two had declined the offer and five were still considering their options.
However, around half of the universities that accepted the funding boost told Nursing Times they would not be taking on more student nurses as a result of the cash injection.
They said the money was announced too late for them to recruit more students and, instead, the funding would be used to cover the costs of placements for extra trainees that they had already planned for this year.
“We cannot expect a significant change in the system to result in growth overnight”
This was a particular problem for universities that only offered courses starting in the autumn – though those that take on a second cohort in the spring may have more time to recruit and enrol students.
“The release of the 4.6% placement tariff funding was too late in the day to result in an immediate uplift of student numbers, even at confirmation and clearing,” said Helen Best, deputy dean of the faculty of health and wellbeing at Sheffield Hallam University.
Before the funding announcement, the university had already planned for an extra 55 student nurses this year. Ms Best warned that boosting placements required careful management due to the need for an adequate number of qualified mentors and a range of learning experiences.
“The release of the 4.6% placement tariff funding was too late in the day to result in an immediate uplift of student numbers”
The University of West London said that it had recruited almost a quarter more student nurses this year compared with 2016, but that this had been decided prior to the cash boost. It also highlighted that the 4.6% increase in money was not enough to reimburse the cost of the 22% extra placements it was offering this year.
“Whilst the additional placement tariff funding is welcomed, it will not provide sufficient funding to support this increase in numbers,” said Professor Anthony Woodman, deputy vice chancellor and provost for health at West London.
“The university is disappointed that the additional placement funding does not match the numbers recruited and the costs to the university of identifying additional placement capacity,” he added.
Just four universities out of the 20 that have accepted the funding boost said it would allow them to take on more trainee nurses than they had planned for before the government announcement.
The University of Wolverhampton said 20 more student nurses had begun on courses this month and an extra 60 would start in early 2018.
“The university is disappointed that the additional placement funding does not match the numbers recruited”
Professor Anthony Woodman
While the University of Worcester had recruited around 15% more students this year compared with 2016, it will now also train a further 11 student nurses and one more midwife as a result of the extra placement money.
In addition, the University of Salford said it would take on additional students in January but was unable to confirm how many. Coventry University said “some” extra nurse training places were offered this month, but because the funding was announced late in the application cycle “significant increases in student numbers had not been planned”.
The Royal College of Nursing accused the government of providing “no information” about how the extra placement funding would create 10,000 extra healthcare students by 2020.
The government made the pledge at the end of 2015, when it controversially announced student nurse bursaries would be removed from August 2017.
It claimed the change to loans would mean course sizes would no longer be constrained by funding budgets, which has so far not been borne out by the latest evidence that shows applicants down on previous years.
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Stephanie Aiken, deputy director of nursing at the Royal College of Nursing, said: “The funding was made available only in August, at a point where potential student nurses had already applied for places.
She said: “The government has provided no information about how it will ensure that the additional placement funding will provide the extra 10,000 healthcare professionals promised by 2020.
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“There is currently no official data on training places and applicant numbers, but we understand that this varies across the country,” she added.
Ms Aiken said that, while the additional funding was welcome, a more “coherent framework” was needed to ensure learning on placements was maximised.
She also warned that the system of placements was “already stretched” and that it was unclear how nurses would be able to supervise students – and also new apprentices – in an effective way.
“The government must start to develop a coherent workforce strategy that considers the demand in the health system and how it can be met through training more nurses,” she said. “With 40,000 vacancies in England already, the government must consider training places beyond the 10,000.”
“The government has provided no information about how it will ensure that the additional placement funding will provide the extra 10,000 healthcare professionals”
The Council of Deans of Health, which represents university nursing departments across the UK, said it would continue to work with the Department of Health to ensure universities had the “certainty” to plan expanded course sizes over the next three years.
“However, it is not just the funding of placements which impacts on growth,” said Dr Katerina Kolyva, executive director at the Council of Deans.
Nursing and Midwifery Council
“The same pool of clinical placements is used for students of graduate degrees leading to registration, apprenticeships and nursing associate pilots. This makes high quality support of students in practice highly complex,” she said.
Dr Kolyva said that, during the first year without bursary funding, it was clear that “we cannot expect a significant change in the system to result in growth overnight, without targeted support and relevant communications”.
She called for additional measures such as a national campaign to promote healthcare careers, more support for mature students and targeted incentives for smaller fields of practice.
According to a letter sent to universities over the summer by government arm’s-length body Health Education England, any remaining funding that is declined following this first round of allocation will be offered to universities who accepted the extra placements. These remaining funds will be targeted at training shortage occupations.
The Department of Health was asked for comment but failed to reply in time before Nursing Times went to press.
Impact of extra clinical placement funding