Analysis

Training places for nurses: will government’s shock plan work?

The government plan to fund an extra 10,000 training places for nurses, midwives and allied health professionals in England has taken the profession by surprise, but questions remain as to how the numbers will add up.

The government plan to fund an extra 10,000 training places for nurses, midwives and allied health professionals in England has taken the profession by surprise, but questions remain as to how the numbers will add up

student
A nursing student at Aintree University Hospital in Liverpool.
 Picture: Neil O'Connor

The government’s announcement that it will fund an extra 10,000 training places for nurses, midwives and allied health professionals (AHPs) in England has taken the profession by surprise.

Nurses are questioning what it means for the workforce and how the numbers will add up.

The funding is for additional clinical training placements in the NHS, allowing universities to increase their student numbers without a dearth of placements acting as an obstacle.

Some of these places could be available as early as next month, says the Department of Health (DH), although it has a deadline of 2020 to fulfil its pledge.

500 places

An extra 500 medical school places were confirmed for next year by the Department of Health, following on from a previous promise to increase places by up to 1,500 in 2020.

The money is part of a plan to boost the country’s clinical workforce and includes 500 extra medical school places being made available for next year.

A DH spokesperson says an undisclosed sum will be given to NHS organisations, allocated via training agency Health Education England (HEE).

The final proportion of nursing, midwifery and AHP student placements ‘will depend on agreements between HEE, NHS trusts and universities’ taking into account workforce needs and demand in local areas.

‘The money we provide will allow there to be more places for students on those courses,’ the spokesperson says.

‘It’s unclear where extra nursing students will come from, when the removal of student funding is putting many people off entering the profession’

Janet Davies

‘It is for universities to work with local healthcare organisations that provide placements to secure the posts for additional students.’

However, the RCN says investing in training placements for nursing students will do little to solve current nursing shortages at a time when applications to take nursing degrees are down.

11% rise

The extra 10,000 training places for nurses, midwives and allied health professionals represents an 11% increase on current figures, says the Department of Health.

General secretary Janet Davies says: ‘It’s unclear where extra nursing students will come from, when the removal of student funding is putting many people off entering the profession.

‘It’s time for ministers to face facts – they will struggle to build a strong and resilient workforce unless they lift the cap on pay and reinstate student funding.’

The government says demand for training places is always high but capacity has been limited by the finite number of commissioned training places available.

Talent rejected

The DH maintains that recent changes to nursing student funding – from a bursary to a loans and tuition fee model – will help to increase the number of nurses able to be trained.

Health minister Philip Dunne says: ‘For too long, a cap on training places has meant thousands of talented students are rejected from university courses each year.

‘These students will now be able to fulfil their potential.'

Mr Dunne’s department says the latest figures show that more than 45,000 students have applied for 23,000 nurse training places this year.

Queen’s Nursing Institute chief executive Crystal Oldman welcomed the funding but said there needs to be a focus on developing suitable placements.

webster
Brian Webster-Henderson: need to monitor
mature students' applications.

Dr Oldman says: ‘The challenge currently is having the capacity and capability in the existing workforce to deliver the services already required for patients, families and carers.

‘I know how challenging it can be to find suitable clinical environments with sufficient capacity and capability for a good learning experience for the student nurse.

‘Creating a learning environment is never without cost – in terms of the physical environment and resources available to students, as well as the nurses supporting the students in practice having the time and skills to teach them.’

Despite a downturn in applications the Council of Deans of Health, which represents university faculties engaged in educating nursing, midwifery and AHP students, says the quality of applicants to nursing courses is good.

Council of Deans chair Brian Webster-Henderson warns of the need to monitor applications from mature students following a decline in applications.

Professor Webster-Henderson adds: ‘Effective promotion of healthcare careers will be vital to ensure that universities can recruit additional students and educate the healthcare workforce required for the future.’

‘Support for attracting students into the profession and then supporting their clinical experience needs to be far more nuanced if the government has any expectations of achieving this headline target’

Kevin Crimmons

But Birmingham City University department of adult nursing head Kevin Crimmons cautions that the headline promise of 10,000 training places is not as generous as it might seem.

Professor Crimmons asks: ‘How many of these places will be for nurses, and how will they be split across the four fields of nursing?

‘We have seen a significant downturn in the number of applicants this year, due to the removal of the bursary and introduction of tuition fees.

‘Support for attracting students into the profession and then supporting their clinical experience needs to be far more nuanced if the government has any expectations of achieving this headline target.’

£1,500 per student

Clinical placements cost around £1,500 per student per year, depending on location and subject, says the Department of Health.

News of the places has also raised questions among front-line nurses.

Writing on the Nursing Standard Facebook page, Matt Fallon asks: ‘Who is going to mentor all these extra students when universities currently struggle placing students as it is?’

Similarly, Lucy Crayton writes: ‘Clinical placement areas don't have enough staff now for the current level of nursing students in training, so how are they going to manage that on top of staffing issues?

‘Not to mention all the experienced and well-trained nurses seeking employment elsewhere.’

It remains to be seen whether the move will ultimately increase the number of nursing students in the system as the government believes, but the profession sorely needs support from Whitehall.

Snapshot of training and placement costs

According to a study by the Higher Education Funding Council for England this year, it costs universities an average of £9,259 annually to train each nurse they accept.

In a recent report about sustainability in the future healthcare workforce in the UK, the Council of Deans of Health called on future governments to commit to investing in additional clinical placement capacity.

It said £15 million over the lifetime of a parliament would support an extra 10,000 places for clinical practice.

Currently, NHS trusts receive a tariff of £3,112 for a yearly placement, but placement arrangements for next year have yet to be finalised by the government.

The DH says the tariff is enough to fund two nursing student placements each year.


 

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