A 25% rise in placement spaces is to be funded as part of a drive to help fill nursing undergraduate spots, health service leaders in England have announced under their new 10-year plan for the NHS.
They have also revealed a five-year NHS job guarantee after nursing and midwifery students qualify and further strategies for improving vacancy rates among the workforce, including the potential introduction of an “online nursing degree”.
“We will provide funding for clinical placements for as many places as universities fill”
NHS Long Term Plan
The NHS Long Term Plan, published at 12pm today, includes a workforce chapter which outlines details for expanding the number of nurses, midwives and allied healthcare professionals in the health service.
It states that work will focus on “increasing the number of undergraduate nursing degrees, reducing attrition from training and improving retention, with the aim of improving the nursing vacancy rate to 5% by 2028”.
To help aid the government’s aim of increasing nurse undergraduate places by 25%, NHS leaders have said they will fund an extra 5,000 places for clinical placements, which also represents a 25% rise.
“Every nurse or midwife graduating will also be offered a five-year NHS job guarantee”
NHS Long Term Plan
In addition, from 2020-21, further funding for work-based placements will be also be provided for as many places universities can fill, which could go up to a 50% rise. Meanwhile, every new nursing and midwifery graduate will also be offered a five-year job guarantee in their local region.
“To facilitate the Department of Health and Social Care’s intended 25% increase in nurse undergraduate places, clinical placements for an extra 5,000 places will be funded from 2019-20, a 25% increase,” the plan stated.
“From 2020-21, we will provide funding for clinical placements for as many places as universities fill, up to a 50% increase. And every nurse or midwife graduating will also be offered a five-year NHS job guarantee within the region where they qualify,” it added.
The long-term plan also claimed that, against a background of “strong” global demand for nursing professionals, universities in England were not yet training sufficient nurses to meet the needs of the health service.
NHS leaders highlighted in the plan that the main source of new nurses was through undergraduate education, noting that “restoring growth in this route is central to the success” of the plan.
According to the plan, 22,200 applicants were accepted onto English nursing courses in 2018 and, while this was a higher number than in seven of the last 10 years, applications had still fallen. In addition, it highlighted that across the UK 14,000 applicants to nursing were not accepted onto courses.
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The plan claimed: “At a time of staff shortage across the NHS it is – to say the least – paradoxical that many thousands of highly motivated and well-qualified applicants who want to join the health service are being turned away.”
However, the plan made no mention of student bursaries or their reinstatement. The government controversially ended bursaries in England in 2017, which prompted a crash in the number of applications for nursing courses. In contrast, they are still available to students in Wales and Scotland.
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In today’s plan, health service leaders in England acknowledged that they needed to “make training more accessible”. But to do so, they mooted the establishment of a new “online nursing degree” for the NHS.
The online training initiative will be linked to guaranteed placements at NHS trusts and primary care, with the “aim of widening participation”, noted the plan.
The plan states this could be launched in 2020, depending on the speed of regulatory approvals, adding that it will be offered for “substantially less” than the £9,50-a-year cost for current students.
For predominantly mature students, the plan said that “earn and learn” support premiums for those embarking on more flexible undergraduate degrees in mental health or learning disability nursing would be “explored”.
It added that it comes with the “aim of having an additional 4,000 people training by 2023-24, supported by increases funding for clinical placements.
“Clinical placements for an extra 5,000 places will be funded from 2019-20, a 25% increase”
NHS Long Term Plan
In terms of other routes into nursing, such as degree apprenticeships and nursing associate apprenticeships, NHS England said it “will continue to invest in the growth of nursing apprenticeships with 7,500 new nursing associates starting in 2019, a 50% increase on 2018.
“We will also provide the necessary investment in training to create meaningful career ladders for these staff to develop and progress. This means that we will now be investing over half of the £200m levy back into the NHS in 2019-20,” it explained.
It added that the terms of the levy may be required to change if the NHS is to provide opportunities to more clinical staff in the future, highlighting that it will be giving evidence to the government’s review of the operation of the levy in 2020.
“Nursing is a high cost subject and is unlikely to be much cheaper when accessed online”
Meanwhile, the plan stated that the health service will also be seeking to grow wider apprenticeships in clinical and non-clinical jobs, “with an expectation that employers will offer all entry-level jobs as apprenticeships before considering other recruitment options”.
The document also said NHS leaders would continue to discuss a fair pay framework that “balances affordability against the need to grow these roles as quickly as we can and provide greater opportunities for people from less advantaged backgrounds to get a first foot on the NHS career ladder”.
However, the popularity of the degree apprenticeship route into nursing has been questioned. A recent report by the Commons’ education committee warned that the uptake of nursing degree apprenticeships has been far too slow, with no more than 30 people starting training through the scheme.
The MPs on the committee concluded that there was “no evidence” to show how the government intended to meet a target of 400 nursing associates progressing to degree apprenticeships from 2019.
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Responding to the plan, Professor Brian Webster-Henderson, chair of the Council of Deans of Health, said: “We are pleased that the government recognises the importance of placement availability to workforce growth and we welcome the commitment to fund as many clinical placements for nurses and midwives as universities can fill.
But he added: “My main concern about today’s publication is its statement that thousands of highly motivated and well-qualified applicants are being turned away by universities. This is simply not the experience of our members. They often struggle to attract students to mental health, learning disability, adult nursing and some allied health profession courses.”
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In addition, he said “further details” were needed on the potential new online nursing degree. “Nursing is a high cost subject and is unlikely to be much cheaper when accessed online so the government would need to subsidise this route,” he said.
“I am concerned that without careful implementation this option could undermine the important local relationships between employers and universities,” said Professor Webster-Henderson.
The new 10-year plan for the health service was published at 12pm today, after being delayed since the end of last year – reportedly due to the chaos around Brexit.
The blueprint sets out how the £20.5bn annual budget increase for the health service, which was promised last summer by prime minister Theresa May, will be spent.
Ahead of its publication, some of the main aims and innovations to be included in the plan were revealed in a statement by NHS England.
Maternity care, children’s services, cancer care, mental health and heart disease were all highlighted as being set to benefit, along with funding boosts for community care, digital technology and prevention.
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The last time a 10-year strategy document was drawn up covering the whole health service in England was the NHS Plan, which was published in 2000 by the Labour government under Tony Blair.