Staffing is the issue keeping NHS leaders awake at night – and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence.
Branded as a disaster by trade unions and the opposition, but cautiously welcomed by others, the removal of the nursing, midwifery and allied health bursary in 2016 was a divisive decision that ignited mass protests and online petitions. The argument was that a removal of the cap on nurse students was needed as the grant system could no longer produce enough nurses to meet the national workforce requirements.
However, the government also stood to save hundreds of millions of pounds by removing the bursary at a time when austerity was in full swing.
Its own consultation, published in 2016, clearly set out warnings from respondents that its plans could adversely affect post-graduate students and those with childcare responsibilities, while small, specialist courses could be at risk of closure.
This decision has been debated ever since. Today, HSJ has revealed there are high-level plans to bring back a package of financial support for nursing students. This may even be announced before the end of the year.
Senior sources close to the discussions confirmed one of the options on the table – a cost of living grant that could be between £3,000 and £5,000 – could be offered to mature students, and those on learning disability, mental health and perhaps other threatened allied health courses. Precisely the groups highlighted as being at risk from disappearing from the nursing landscape in the original consultation.
Another option on the table is a debt cancellation scheme, which would link student debt to the number of years worked in the NHS. My understanding is this is popular among those close to the service, but, in reality, would be really difficult to implement, due to the complicated nature of the student loan system.
As of yet, it is unclear which will be the favoured option – or if, perhaps, there could be more than one option put forward, considering the pressing and immediate need to boost the domestic pipeline of nurses.
Choosing good from good
Dido Harding spoke frankly at this week’s Queen’s Nursing Institute conference about “trade-offs” and the difficulty of choosing “good from good”. Baroness Harding made clear there is data showing there has been an impact on mature students of pulling the bursary – but less so for undergraduate students.
She also voiced her preference to invest in social care rather than nursing, as this sector is on the brink of collapse. Considering today’s revelation, this may have been a red herring.
Another interesting snippet from Baroness Harding’s QNI key note was her frustration at being unable to fill the expanded clinical placements. This, in combination with Universities and Colleges Admissions Service data – which showed, between 2016 and 2018, an almost 50 per cent decrease in nursing applicants – has surely bolstered the argument that financial support for nursing students is desperately needed.
A good news announcement
Despite very senior support for any new proposals – whether a grant, debt cancellation or anything else – the final hurdle will be getting it past the Treasury. Previous iterations of the bursary cost as much as £450m a year. Although the new plans sound like a paired down version, questions remain as to how it will be funded and what else it will be competing with for the money.
Even though Baroness Harding’s comments about the need to invest in social care were said in a room full of nurses, the reaction was of understanding. The social care workforce is often paid little more than the living wage and, without proper remuneration, jobs in other sectors are becoming increasingly attractive.
Boris Johnson is a prime minister who has already thrown the austerity agenda out the window and – going by the summer’s rapid capital spending announcements – likes to have something big to announce.
At a time when his government is under fire, this could be the perfect climate for a good news announcement for the NHS workforce.