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Limits on nurse training numbers should be scrapped

Central rationing of nursing degrees is exacerbating chronic shortage of NHS nurses and over-reliance on expensive agency workers

A new funding system is needed to create thousands more nurse training places every year, Civitas report argues

Proposal would increase the number of UK-trained nurses and and incentivise them to make a long-term commitment to the NHS

Despite high unemployment among young people, the NHS has for years deliberately trained fewer nurses than it needs.

The result has been a reliance on expensive overseas recruitment and to put the NHS in a weak bargaining position with agencies that supply nurses. They are able to charge well above the going rate for permanent staff.

Excess expenditure on agency nurses is one of the causes of the NHS’s failure to meet the rising demands of a growing population.

The annual limit on nurse training places should be scrapped to allow as many young people to study for a career in nursing as wish to do so, a new report by the cross-party think tank Civitas argues.

It calls for a more flexible funding system for nursing degrees that would help the NHS overcome a serious shortage of UK-trained nurses and save it more than £2 billion in the first three years.

The plan would also reduce the ‘brain drain’ of expensively-trained nurses moving abroad and reduce the current reliance on overseas and agency nurses who are more expensive and can be less reliable.

Every year tens of thousands of young people are denied the chance to study nursing at university because of the limit imposed on training numbers by Health Education England (HEE), which covers tuition fees and some living costs up front.

In today’s report, Civitas healthcare researcher Edmund Stubbs outlines a sweeping overhaul of this system that would end the HEE’s centrally-imposed rationing of nurse training by:

Ending the upfront payment of nurses’ tuition fees and living costs bursaries and allowing them to take out student loans like most other undergraduates; and

  • Trained nurses who opt to work for the NHS will have their loan repayments made for them.
  • For those nurses who go on to work for the NHS after receiving their training, there will be no additional cost.

But the cost of nurse education funding would no longer be an upfront expense for the NHS, instead it would appear on the student loans book, and then be paid off by the HEE on behalf of the Department of Health over a number of years.

This would release substantial funds for the NHS of up to £685 million a year, and more than £2 billion across the three-year window between the scheme being implemented and the first loan repayments being made by the HEE.

The proposal would increase the number of newly-qualified nurses leaving university every year while also incentivising them to work in the NHS long-term rather than quitting the profession or finding work overseas.

It would also exert pressure on the independent sector to offer a similar scheme (in order to compete for staff with the NHS) meaning that the private sector would effectively meet the training costs of those nurses who leave the NHS.

Edmund Stubbs writes: ‘Every year, substantial numbers of nurses are recruited from overseas despite nursing courses in the UK being vastly over-subscribed and our heavy dependency on agency staff.

‘This proves that such strict, centralised control of nurse numbers has little benefit. It also leaves the NHS in a weak position when hiring and retaining staff as agencies, knowing nurses are in short supply, charge substantially higher fees to supply the public sector with much-needed staff.’

An estimated 54,000 people apply to study nursing each year, yet only 21,769 of these were accepted last year, and only 22,638 are expected to be accepted in 2015/16.

This means many British applicants are denied the opportunity to train to become a nurse despite a chronic shortage of trained nurses available to the NHS.

A move to open up nurse training would also consolidate the Conservative government’s commitment to ending long-term youth unemployment and creating two million jobs over the course of the parliament.

‘To limit nurse training places to a level below that required for an adequately functioning NHS makes little sense either economically or politically,’ Stubbs says.

‘The morality of expensively recruiting nurses trained overseas to the probable detriment of the health services of those countries is also highly questionable. What is needed is a more flexible method of funding nurse training.

‘In the rest of the higher education sector we do not limit other university course admission numbers. It is nonsensical that we are still obliged to limit nurse university places, as well those for other allied health professional roles, simply due to a lack of NHS funding.’

The proposed reform of nurse education funding could also be applied to other NHS-funded degree courses such as for allied health professional roles, including radiographers, podiatrists and speech therapists. This could bring the total saving over the transitional three years to as much as £2.72 billion.

Supplying the Demand for Nurses: The need to end the rationing of nurse training places

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