The Open University is calling on higher education institutions (HEIs) and NHS employers to address barriers to the nursing profession that are contributing to the UK’s chronic shortage of nurses.
This comes as data secured by The Open University under the Freedom of Information (FOI) Act 2000[i], reveals that one in 20 (6%) places available to study nursing at university across the UK were vacant at the start of the current academic year – the equivalent of 1,450 potential nurses – despite three in 10 (30%) young people seriously considering the profession.
Analysis included in the university’s Breaking Barriers to Nursing report suggests that, if key stakeholders focus on removing the barriers faced by prospective students and ensure that all places to study nursing are filled each year, an additional 10,100 nurses could be fully qualified in 10 years time, with a further 4,340 additional students still studying. This would fill 13 per cent of the forecasted nursing deficit[ii].
Money, specifically the cost of study or living away from home as well as concerns about paying back student loans among those studying in England, was the most significant barrier experienced by those interested in becoming a registered nurse, deterring a third (33%) of those interested in the profession. However, there are also a number of other important issues to consider, such as, travel (13%), entry requirements (11%) and workload (17%).
These issues are also affecting many of those currently studying, which may go some way to explaining low retention on nursing degrees across the UK. On average, one in four (24%) students drops out before completing their study – 6,740 from each intake[iii]. Currently, one in three (32%) of those studying are unsure if they still want to become a nurse, which raises concerns about the stability of the existing talent pipeline.
These findings come at a time when the NHS has advertised 11,000 vacancies for full-time nursing staff in England[iv], and new registrations from the EU have fallen from more than 10,000 in 2015/16 to just 800 in 2017/18[v]. In order to address shortages and develop the nursing workforce of the future in a more sustainable way, The Open University is suggesting a number of ways to remove barriers those thinking of pursuing a career as a registered nurse:
- Embrace technology enabled learning
In today’s digital era, HEIs can take advantage of new technology that allows them to deliver high quality lectures, materials and support digitally. The additional flexibility this can bring enables students to learn when, how and where they want, which can therefore remove barriers for those who struggle to fit studying around personal commitments or who would prefer to stay in their home locality without having to travel long distances to attend lectures.
- Open up access to the profession
The vast majority of universities set entry requirements above those set out by the Nursing and Midwifery Council (NMC), with nine in 10 (91%) UK universities requiring 96 UCAS points, the equivalent of at least three English A-levels at C-grade or above. This is a significant blocker to widening participation in nursing as it immediately excludes those who may not have been afforded the educational opportunities to achieve these qualifications.
- Promote flexibility and positive nursing stories
With many potential applicants to nursing concerned about working hours and perceived pressure, there is a role for NHS employers and professional bodies in continuing to promote nursing as a career while addressing these negative perceptions. This could be achieved through local outreach and partnerships with schools, colleges and communities.
- Give nurses the opportunity to earn while they learn
The new Registered Nurse Degree Apprenticeship could help to remove some of the financial barriers faced by would-be nurses in England. It could relieve the financial strain for those who do not want to take out a student loan or those who need to start earning right away. More than three quarters (77%) of those currently studying would be interested in a degree apprenticeship if they were applying to study now, and it would also help the NHS England to secure return on its £200m apprenticeship levy investment.
Sally Boyle, Head of School in the Faculty of Health, Wellbeing and Social Care at The Open University, responded to the findings:
“It is devastating that at a time when the healthcare sector is under enormous pressure there are so many people who are being deterred from pursuing a nursing career. Something must be done to overcome the issues of under-subscription and trainee attrition, so that the NHS and other healthcare providers can continue to provide safe patient care.
“There are a number of barriers to studying nursing that can be easily addressed if Higher Education Institutions and healthcare employers work together to take advantage of available technologies and initiatives, such as flexible technology-enabled learning, and the apprenticeships available in England. By ensuring that the maximum possible number of nurses are training and registering each year, the sector will have better access to the nurses it urgently needs.”
[i] The Open University issued requests to 77 Higher Education Institutions in the UK in March 2019 under the Freedom of Information Act 2000. 55 per cent of these organisations responded to The Open University’s request for information.
[ii] The King’s Fund NHS Vacancy Report (2019) forecasts that there will be a deficit of 108,000 nurses in the UK in 10 years time. If all places to study nursing were filled each year, there would be a total of 13,800 additional nurses – which is 13 per cent of the total deficit
[iii] Data from The Health Foundation (A critical moment: NHS staffing trends, retention and attrition, 2019) reveals that the average attrition rate on pre-registration nursing degrees in 24 per cent. According to UCAS (Acceptances by detailed subject group and domicile, 2017) 28,091 people accepted places to study nursing, which means that 6,742 people would have dropped out
[iv] NHS Digital (2019) NHS Vacancy Statistics England – February 2015-September 2018
[v] Nursing and Midwifery Council (2019) The big picture
Further details on the barriers faced by prospective and current nursing students, along with solutions to the issues can be found in The Open University’s new report Breaking Barriers to Nursing.