Last year we warned the government that scrapping student funding would lead to a drop in applications. You will have seen that our worst fears have been realised - the most recent UCAS figures show a 23% fall in nursing applicants compared to 2016.
This means thousands of potentially brilliant nurses have not felt able to achieve their ambition and pursue a challenging, yet wonderful career. For many, taking on a large debt is simply not an option. This is particularly true of mature candidates, with a 29% drop in applications from over 25s. These are people with life experience, who would benefit so much from university.
But many may already have significant household debt; a previous student loan, children to support, bills to pay, and food to put on the table. For people like this, student funding was a way they could enter nursing while continuing to provide for their families – in England, this is no longer the case.
“Nurses’ pay simply doesn’t reflect the level of knowledge and skill they use”
Just think of all that wasted potential – we will never know what we’ve lost.
And the keen school leaver must now weigh up the prospect of saddling themselves with thousands of pounds’ worth of debt. For many would-be graduates, this consideration still comes out in favour of a degree – if they enter a profession where they can expect their earnings to reflect their level of expertise. But for nurses, the government’s 1% cap keeps salaries unrealistically low. Nurses’ pay simply doesn’t reflect the level of knowledge and skill they use on a daily basis, let alone the level of responsibility entrusted to them in caring for people who are often at their most vulnerable.
This makes the decision to take on debt that much harder to justify.
The drop in applications adds just one more pressure to a nursing workforce that is being stretched ever-more thinly. What this means for staffing levels is the stuff of nightmares. Unsurprisingly, according to NHS data almost every hospital in the country is dangerously short of nurses, so a drop in applicants – the nurses of the future – is something we can ill afford.
“Almost every hospital in the country is dangerously short of nurses”
By 2020 nearly half the workforce will be eligible for retirement - it is essential we replace them.
The proposed solution comes in the form of nursing associates and apprenticeships, but attractive as these models may appear, we must be cautious. They are not without their pitfalls and it’s important we learn from the past. Nurse associates will provide valuable support to registered nurses, and give our healthcare support workers a great opportunity. But we must not return to the days of the state enrolled nurses who undertook the same tasks with less pay and with no prospects of promotion.
A system of APEL to enable associates to attend university and graduate as a registered nurse is essential, but it isn’t a quick fix, and must be sustained, unlike previous schemes.
I worry about the apprentice model. We are training nurses for the future, who will hopefully have long, rewarding careers in our health and care services. They will need to be flexible, with wide experience and in-depth knowledge and skills. They will need to have the ability to work in different settings, take on leadership roles and most significantly, be research literate, able to use evidence and challenge the status quo.
“We fought hard to achieve supernumerary status for nursing students”
We fought hard to achieve supernumerary status for nursing students, and in December the NMC rightly said supernumerary status should be extended to apprentices. Apprenticeships may offer the chance to earn and learn, but it’s the quality of that learning that matters both to aspiring nurses and their patients.
It is hard to imagine apprentices getting the input and education they need in today’s high pressure clinical settings without supernumerary status, a nurturing environment, and good quality teaching and simulation facilities. And for the increasingly complex healthcare of the future, good quality education is vital. Supernumerary status protects apprentices’ clinical experience, the quality of their education, the supervision they get and, most importantly of all, it protects patients.
“We should not forget that nursing is still a great profession”
I’m concerned that in many cases the overstretched workplaces our members describe are hardly an ideal learning environment, but we should not forget that nursing is still a great profession, and one that offers rewards few others can.
Nurses are essential for good quality health care, and the recent APPG report “Triple Impact” points out that universal health coverage cannot possibly be achieved without strengthening nursing globally.
So rather than raiding the funding for the education of our future nurses, we should be making significant investment to ensure the future provision of health and care.
Janet Davies, RCN chief executive and general secretary