Mental health care crisis looming because trainee nurses are being driven away by bursary cuts, MPs warn

Specialist training programmes being closed down because of a lack of graduates

Nurses and midwives took to the streets in protest of the bursary's removal (Jack Taylor/Getty Images)

The crisis in mental health services is likely to be made worse because of a collapse in trainee nurses following the Government’s decision to scrap bursaries for nursing students last year, MPs have warned.

In a report on the nursing workforce the Commons Health Select Committee said ministers must be prepared to “respond swiftly” if the policy, intended to allow more nurses to be trained, keeps driving down numbers.

The committee said it was particularly concerned that specialist courses in mental health, learning disabilities and community nursing have been rendered financially unviable because of a lack of applicants.

​Ucas data shows that applicants aged 21 to 25 dropped 13 per cent while those aged over 26 fell 6 per cent last year.

“This is of great concern, given that a significant proportion of trainee nurses are over the age of 25,” the report said.

“Of particular concern is the fact that mature students make up an even larger proportion of students in the shortage areas of mental health nursing and learning disability nursing.”

“We have heard that some universities providing undergraduate courses in mental health and learning disability nursing have struggled to recruit sufficient students this year, threatening the financial viability of these courses.”

This includes London South Bank University, which did not run its learning disabilities course this year, and Sheffield Hallam which recruited just 70 per cent of its target.

Where are nurses most in demand?

Changes in nurse numbers in each sector since 2010:

 
General, elderly and adult nurses
+7% (11,983)

Children’s nurses
+10% (1,468)

Midwifery
+11% (2,056) 

Community services
-11% (-4,985) 

District nurses
-45% (-3,431)

School nurses
-19% (-554)

Learning disabilities settings
-38% (-2,023

Mental health settings
-13% (-5,168) 

Source: Health Committee

These are also the areas that have suffered the biggest declines in nurse numbers in recent years, with an increase claimed by the Government happening almost exclusively in acute NHS hospitals.

Sean Duggan, chief executive of the Mental Health Network, said: “It is important to recognise that in the short term we are seeing increasing vacancy rates, more nurses leaving than joining the profession, and a sharp reduction in applicants to nursing degree places – particularly among the mature students who have traditionally been most attracted to mental health and whose wealth of life experience truly enriches the care they provide.

He said it was also impacting on prospective students with caring responsibilities, from low income groups, and from black or minority ethnic backgrounds, which meant the workforce could become less representative of the community it serves.

The removal of the bursary was intended to usher in a nurse training boom in a hope of filling the 34,000 nurse and midwife vacancies in England.

Under the bursary, student places were limited at each university by the number of places the NHS could afford to fund, and applications have always outstripped availability.

But since 2017 prospective nurses are required to pay £9,000 a year fees or take out student loans for their training, and this resulted 700 fewer nurses starting training, according to Ucas figures.

This could be devastating as qualified nurses are leaving the NHS in droves after eight years of Government-enforced pay restraint and financial pressure in the NHS meaning many services are under significant strain.

NHS figures show 33,000 nurses left the NHS last year, meaning they are leaving faster than new entrants can replace them – a problem made worse by the collapse in EU nurses since the Brexit vote.

Nurses told the committee that the pressures were a risk to their safety, wellbeing, and even their job.

In one interview reported by the committee, a nurse said “every time I walk onto the ward, my PIN (the professional registration number from the Nursing and Midwifery Council that nurses need to practise in the UK) is on the line.”

The Government earmarked more funding for a pay rise for nurses, and other NHS non-medical staff, but this is contingent on contract negotiations in which the Government is demanding even more “productivity gains”.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said the loss of nurses and drought in the pipeline of the next generation, is a “double whammy”.

She said: “The report should make for sober reading inside Government. Ministers must stem the losses by easing the pressure in the NHS and social care, valuing staff with a pay rise above inflation and increasing training places."

Ms Davies added that the RCN welcomed the recommendation “that the Government must now ‘be realistic’ in linking pay to supposed productivity gains".

Unison's head of health, Sara Gorton, said: "The foolishness of abolishing the NHS bursary for healthcare students is laid bare in the report.

"The government needs to reverse this ill-thought-out decision, as well as provide proper funding for nursing apprenticeships, so that young people are encouraged to join the nursing profession.”

Labour Shadow Health Secretary, Jonathan Ashworth, said: “Labour shares the Committee’s concerns about removing the nursing bursaries and the Government’s on-going failure to guarantee the rights of EU healthcare staff.

“The truth is that the Prime Minister has overseen an unprecedented workforce crisis in our NHS, which has culminated in the number of nurses falling for the first time since 2013.”