Academics have called for an “urgent” overhaul of the funding system for training nurses and midwives to address both the current workforce crisis facing the NHS and the financial difficulties being experienced by many students.
Student nurses should stop receiving grant funding and instead be provided with loans to pay for their tuition and maintenance fees, with the possibility of having some money repaid once they have secured employment, according to a joint statement issued by the Council of Deans of Health and Universities UK.
The two bodies argued that the current grants-based system was no longer fit for purpose because it tied universities to set numbers of students, resulting in shortages in professions such as nursing.
“We need a more flexible system that will cushion the health service from changes that it cannot anticipate”
Council of Deans and Universities UK
“The resulting staff shortages put the existing workforce under enormous pressure, lead to unsustainable international recruitment and push up agency spending,” said the joint statement.
However, it pointed to the high demand from potential applicants, with nursing being the fifth most popular course in higher education.
“We need a more flexible system that will cushion the health service from changes that it cannot anticipate,” it warned.
At the same time, the bodies said students were losing out from a grants-based system, because the money they received for maintenance costs was not enough.
They noted student nurses, midwives and allied health professionals typically have longer courses than other non-NHS subjects, meaning their money has to be spread further.
In addition, in cases where students received a loan to top up their maintenance grant, this money was reduced in their final year under the false assumption that NHS students completed their degree before the summer along with most other subjects.
Academics said financial hardship for student nurses, midwives and AHPs was now a “key issue”.
They also pointed to the increasing gap – an estimated 8-12% – between the funding provided to universities by the government to cover student tuition fees and the actual cost to provide nursing courses.
“Given the compelling case for change, the government needs to consider urgently whether the current system of NHS-funded grants can be moved to a system of student loans,” said the statement.
“If we want the numbers of health professionals that we know future patients will need, the system must be overhauled”
Any new system should also find ways of attracting newly-qualified staff into the NHS and social care to address workforce pressures currently faced by employers, said the academics.
“This might include scope to offer repayment of part of a student’s loan after a given period of service or the award of a retention bonus, helping employers to reduce their spending on agency staff and retain new registrants,” they added.
Professor Jessica Corner, chair of the Council of Deans of Health, said: “There are no easy decisions on funding reform but with appropriate safeguards, the outstanding record of nursing, midwifery and AHPs in widening participation to higher education can continue.
“There are risks to change but if we want the numbers of health professionals that we know future patients will need, the system must be overhauled,” she said.
A spokeswoman for national workforce planning body Health Education England said its strategy for 2015-16 includes projections to supply an additional 23,000 nurses by 2019.
“This will include newly educated nurses and those who join the NHS through other routes, such as HEE’s Come Back to Nursing campaign. It takes in account nurses who will retire or leave in that time and clearly shows year on year growth in the nursing workforce,” she said.
However, Unison Head of Nursing Gail Adams said: “The current grants-based system isn’t perfect but it does at least enable young people from every background and family income to… study to become nurses, midwives, and other healthcare professionals.
“If grants and the payment of tuition fees disappear and are replaced by loans, we risk burdening nursing and midwifery students with huge debts, just as they are about to start out in the world of work,” she said.
“Even if their employer were to pay off an element of their student loan after several years of employment, the changes could well discourage young people from poorer backgrounds from entering the healthcare professions altogether,” said Ms Adams.
She added: “It’s vital that the nursing and midwifery professions continue to reflect the society they care for. The proposed changes risk it becoming an exclusive career option, simply for those whose families can afford it.”
Last week, the issue of financial concerns among student nurses was raised at the Royal College of Nursing’s annual congress in Bournemouth.
Delegates discussed how the government should attract and retain student nurses.