Community nurses and NHS trusts are the latest groups to raise further concerns over the government’s plans to axe bursaries for student nurses and switch to a loans system next year.
Nurses warned it was already difficult for some leading universities to secure enough trainees and reiterated that the reforms risked leading to fewer trained nurses, while London trusts recommended that the government consider delaying the plans.
In its submission to the government’s consultation, the Queen’s Nursing Institute, which represents community nurses, said it was “extremely concerned” about the reforms.
“The lasting impact on the NHS will be immense if insufficient students enter training for several years running”
It warned that fewer mature students would apply to pre-registration nursing degrees under the changes, which would hit community and general practice nursing in particular because these settings recruit more mature students than others.
The QNI challenged the government’s claim that the high numbers of applicants to nursing degrees – three for every course place – meant universities would be able to recruit more students in the future.
“The proposed changes, in their current form, run the risk of adversely affecting recruitment into nursing, midwifery and AHP courses”
King’s Health Partners
It noted that not all of these applicants would necessarily meet the entry criteria for the courses, which now includes a requirement to have the right values following the Francis inquiry into care failings at Mid Staffordshire Foundation Trust.
Universities already found it difficult to recruit students to adult and mental health nursing and to find high quality placements and mentors, said the QNI.
It warned that, as universities attempted to attract more students following the switch to a loans system, there was a risk of nursing courses entering the clearing process and lowering their entry requirements.
The QNI accused the government’s plans of being “potentially discriminatory” against nursing, midwifery and allied health professional students – all of whom will be affected by the changes.
It said that, while the reforms appear to bring funding for tuition fees into line with medical students, in reality trainee nurses would end up paying for a far greater proportion of their training.
The QNI noted that the £9,000 annual loan for trainee nurses, midwives and AHPs would pay for the majority of the cost of their training, but the same yearly loan for medical students accounted for only a small proportion of their costs which were also supported with a bursary.
Meanwhile it reiterated concerns that all government funding for post registration nursing programmes – to train in roles such as district nurses, health visitors and school nurses – could also be removed from September 2017.
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It said that such a change would risk an “immediate reduction in nurses undertaking post-registration specialist and advanced programmes”.
“The lasting impact on the NHS will be immense if insufficient students enter training for several years running and the student pipeline is put at risk. This applies equally to both pre-registration education and post-registration specialist and advanced practice programmes,” said the QNI.
It called for the government to look at alternative funding arrangements for training nurses, midwives and AHPs.
In a separate response to the bursary consultation, King’s College London and a group of foundation trusts raised fears that the recruitment of students – in particular postgraduate – could be “adversely affected” in the short term.
King’s Health Partners – which represents KCL, Guy’s and St Thomas’ FT, King’s College Hospital FT and South London and Maudsley FT – said that, while it welcomed the potential opportunity to increase the number of course places for trainee healthcare professionals, the risks of the reform must be mitigated.
“We believe that the proposed changes, in their current form, run the risk of adversely affecting recruitment into nursing, midwifery and AHP courses in the short term. In particular, they could adversely affect recruitment of postgraduate students into these professions, with a negative impact on the potential contribution of these professions to healthcare,” said the group.
It called for the government to monitor the impact of the reforms across different types of courses and groups and for it to develop “a contingency plan to safeguard healthcare staffing demands in the event of a collapse in applications”.
The group also recommended the government consider delaying the introduction of the proposals. It said the short timeframe that had been proposed risked the government not achieving its ambition of allowing more students to study under the plans.
The group warned that more time was needed for trusts and universities to provide more clinical placements – which were already difficult to secure – and also to recruit more lecturers.
In addition, it recommended students in London should only be required to start paying their loans back when they reached a higher level of salary due the city’s expensive living costs.
The group also said it was “crucial” to have a sustained publicity campaign informing students the reforms meant they would not be in a worse financial situation while studying or would have unaffordable repayments after graduation.
The government announced the bursary removal plans in November as part of the comprehensive spending review, claiming it would create up to 10,000 extra training places for student nurses, midwives and AHPs by 2020.
It said the move to loans also meant students would be able to access around 25% more financial support for their day-to-day costs.
Around two thirds of people who apply for nursing courses are not accepted for training and the changes mean more will be able to become nurses, according to the DH.