By Kim Moore, Senior Lecturer in Nursing – Mental Health

It’s party conference time, and the NHS continues to figure highly in the debates and speeches.  With so much turmoil in the NHS it may seem that Jeremy Hunt’s announcement of an increase in nurse training places may seem like a welcome relief (The Spectator, 2017).  There are however several critical issues that need to be addressed; first the impact of scrapping the nursing bursary and the impact on nursing recruitment and whether this is about preferential promotion of nursing associate training posts to fill the growing gap of qualified nurses in all fields of nursing.  As nurses we need to question how this new announcement impacts the nursing shortage we face today and the future of specialist nursing degrees in the years to come.

The reality for nurse training following the scrapping of nursing bursaries was a significant reduction in applications was noted nationally (UCAS, 2017).  Nurses and student nurses have consistently voiced their views on how this move has damaged the potential for recruiting nursing students, with many stating that without the bursary they would not be able to train (iNews, 2016).  Hunt’s announcement of additional training places seems misplaced, and it is unclear how creating more places every year will help to address this if potential students cannot afford the fees and existing training positions cannot be recruited to at their current numbers?  Surely this is not just a case of increasing the number of training places available, it is also critical that students can afford to enter into the existing programs at their current commissioned numbers.

One of the big questions this announcement raises is the balance between for nurses or nursing associates.  From media reporting, it seems that both these roles are equally targeted for increased recruitment (Sky News, 2017) with slightly more nursing associate training posts being made available.  The difference in these two training programs seems to be that nursing associate training posts attract payments; where the training institution receives funding for each student enrolled on the program from a central grant, and the student receives funding for placement costs much like the bursary did for nursing students (HEE, nd).  In contrast nursing students are now accountable for all financial costs associated with their training program including the University fees (starting at £9,000 per annum) and costs associated with practice placements and the cost of living (Top, 2017).  It seems that there are more financial incentives to complete the nursing associate training in preference to nurse training and this is likely to be a critical feature of attracting potential candidates to the course.  With the first nursing associate graduates anticipated for 2019 there seems to be little evaluation of the pilot programs and their ability to ‘fill the gap’ in nursing.

Within all of the announcements there seems less discussion on whether these new nursing posts link to specific fields of nursing with critical shortages such as district nursing, child, learning disability or mental health nursing (NHS England, nd).  This oversight seems to suggest the focus of nursing is shifting from a specialist to generic training programs that predominantly looks at acute care as ‘the’ issue for nursing (HEE, 2015).  Is this a prelude to introducing generic training programs (Stephenson, 2016) mirroring that of the United States or Australia?

So it remains unclear at this time how increasing training places for nursing associates and nurses will help to address the current nursing shortage in the short term, but it seems likely that loading the programs in favour of nursing associates is a faster way of attempting to address the number gaps in the midterm.  Within the wider long term picture of nursing, there are key issues to be addressed in recruiting and retaining nurses within the all branches of the nursing profession (Imison, 2016).  While more nurses are leaving than joining, this may be a plaster that leads an increase in nursing associates entering (and graduating) to fill what appears to be a growing shortage of nurses with very little guidance on their roles in the healthcare skills mix and a prelude to the introduction of the ‘generic nurse education program’.


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Kim Moore

Kim Moore

Lecturer in Mental Health, Birmingham City University’s Faculty of Health