What is the Impact of Cutting down Nursing Student Bursary in the Future of Nursing Practice in the UK?

This essay will critically explore the impact of cutting down nursing student bursaries in the practice of nursing in the UK. A brief description of what a student bursary entails will be provided to clarify its contribution to the practice of nursing. The negative effects of cutting down student bursaries will be explored. The new scheme that will replace it will be identified and its rationale provided. Ultimately, the aim of this essay is to provide an analysis on whether cutting down nursing student bursaries is beneficial or detrimental to the future of the nursing profession and the quality of healthcare services in the UK.

The nursing student bursaries form part of the scheme of the NHS Student Bursaries supplied by the NHS Business Services Authority (NHSBSA 2012). It essentially awards an annual payment from the NHS to help students studying medicine, dentistry, nursing, midwifery or other healthcare courses with their study and living costs (Gov UK 2016). As explained by Government UK (2016)

A full-time NHS student can get a bursary from the NHS which depends on the household income (e.g. student’s income, parents’ income or spouse’s income), a 1000 GBP grant from the NHS (for full time students or a reduced amount for part-time students) and a reduced maintenance loan from the Student Finance England.

The NHS pays the tuition fees directly to the university (Gov UK 2016). A student can even receive extra financial help if he/she has a long term disability, a mental health condition, a specific learning disability, children or adult dependents (Gov UK 2016).

From the above given characteristics of a student bursary, it is fair to argue that it is a big help for many students studying healthcare courses like nursing. It is safe to assume that the existence of a bursary helps encourage the entry of students to study nursing, and stabilise those who are already immersed with their nursing study. Ultimately, this helps to secure the future of the nursing workforce in the UK.

In line with the idea that student bursaries help encourage people to study nursing, it can also therefore be said that this same scheme is one strategy that helps combat the problem of nursing shortage. This is because it attracts people to study nursing because of the perceived lower financial burden when compared to studying a non-healthcare related course, and so naturally many more would prefer to study nursing, which would eventually increase the number of professional nurses available. Without the student bursary helping out numerous nursing students, the possibility of many discontinuing their nursing study because of financial constraints is a potential reality. This can ultimately contribute to the existing problem of nursing shortage, as fewer nurses will graduate in the future because students have shifted to another course or halted their studies. This emphasises that exacerbating the current problem of nursing shortage is one potential primary ill effect of cutting down student bursaries for nursing students. In line with this, a study conducted by Buchan and Aiken (2010) showed that one of the major causes of nursing shortage in the world is constrained resources that lead to the undersupply of new nurses. The Truth about Nursing Organization (n.d.) also highlights the inadequate resources for nursing education as one of the causes of nursing shortage.

Nursing shortage, whether local, regional, national or global, has a major impact on nursing practice inasmuch as it can lead to failure to maintain or improve the quality of health care (Buchan and Aiken 2010). In the UK for instance, the latest statistics show that 23,443 nursing vacancies exist which is equivalent to 9% of the entire nursing workforce, and to try to address this, 69% of UK trusts are actively recruiting nurses from abroad (Hughes and Clarke 2016). One reason for this high vacancy rate is that although the number of positions available have elevated, the number of trainees have not increased (Hughes and Clarke 2016). Cutting down the student bursaries available for nursing students will only worsen the problem because it will discourage prospective nursing trainees, and so instead of increasing the number of trainees, which is important to solve the problem of nursing shortage, it will only further reduce the number of people who want to study nursing.

Nursing shortage affects the quality of patient care in many ways. For instance, the lack of nursing staff in a hospital can lead to a heavier workload for the staff nurses present, which in turn can negatively affect nursing job satisfaction and contribute to a higher turnover and again lead to shortage (Duffield and O’Brien-Pallas 2003). This is a logical consequence because fewer staff nurses working in a ward means that each nurse will have to cater to a higher number of patients in order to effectively care for all the inpatients, and perhaps over a longer period of time. This can lead to work-related stress and burnout and therefore degrade the quality of care that they can render, and eventually cause them to quit.

A study by Nevidjon and Erickson (2001) recommended that increasing the funding for nursing education is a good strategy to address the problem of nursing shortage. A study by Keenan (2003) relates that subsidising training is another way to increase the number of registered nurses. It is safe to argue that the concept of student bursaries is a good example of increasing the funds for nursing education, particularly subsidising training of future nurses so that more nurses eventually graduate and enter the nursing workforce. This will ultimately result in more staff nurses working in hospitals. Based on all of the foregoing arguments, it can be declared that the student bursaries actually represent a very good initiative by the government in helping future nurses.

Bhardwa (2016) reports that the government has confirmed the removal of the student nurse bursaries, which will be replaced by student loans beginning in 2017. Since it was first announced, it has been opposed by several components of the health sector (Jenkin 2015). In fact, according to Johnston (2016) a coalition of more than 20 charities, medical and professional bodies and trade unions led by the Royal College of Nursing, the British Medical Association, the Royal College of General Practitioners and the Patients’ Association wrote an open letter to the prime minister essentially claiming that the governmental move to end bursaries for nursing and midwifery students is a very risky gamble. It could leave a nursing graduate with 50,000 GBP of debt, and this is enough to discourage people from studying nursing, which is a serious problem, especially now that the NHS is requiring more nurses to fill nursing vacancies (Johnston 2016).

Labour Party leader Jeremy Corbyn suggests that removing the bursaries and replacing it with loans is like punishing students (Merrifield 2016). Abrahams and Nash (2015) boldly relate that students paying for their own tuition fees is a bad idea, and once it is implemented, many students will no longer work on goodwill. Nursing students are a vital component of any ward and it is a rare sight to see a ward function effectively without the help and goodwill of nursing students (Nash and Abrahams 2015). Removing the bursaries will most likely deter prospective nursing students (Abrahams and Nash 2015).

On the other hand, the new scheme involving the replacement of bursaries with loans is expected to save approximately 800 million GBP in funding which is currently used to support the 60,000 student nurses, and which the government then intends to utilise to establish up to 10,000 new training places (Jenkin 2015). This is the primary reason why the Universities UK and the Council of Deans of Health support this governmental action. The change from bursaries to loans will actually remove the limit on the number of nursing students which the government can help support in their studies and therefore the number of prospective nursing students will increase (Jenkin 2015). This is because the presence of the student bursaries puts a cap or limit on the number of students which the government can financially aid (Jenkin 2015).

It is estimated that around 10,000 additional places will be created from 2017 and 2020, which means 3,300 places per year (Watt 2016). It is safe to argue that this increase in places can naturally allow more prospective nursing students. This is good because NHS employers will have a bigger pool of qualified home-grown nurses and therefore the reliance for oversees or agency staff will reduce (Gummer 2016). Dame Professor Jessica Corner, chair of the Council of Deans of Health, says that the replacement of the bursary with loans will not have a negative impact on the number of applicants, and in fact up to 10 applicants are vying for each of the 20,000 training places a year (Jenkin 2015). Aside from this, the change will also help universities to fund courses because currently many schools receive less than it actually costs to deliver training programmes (Jenkin 2015).

It can be declared that the government’s action to change the bursaries into loans does propose an advantage. The advantage is that it can create more training places, which would enable the system to accommodate the high number of people who want to study nursing, which under the current bursary system is limited because the funds for the bursaries can only support a limited number of students. There is however one flaw in this plan, and that is the fact that having more training places for potential nursing students does not immediately mean that prospective students will take advantage of these, because there is the consideration that they will no longer receive financial aid from that government and that they will have to pay for their own training and education. The loans which the government offer cannot be considered as a subsidy, since it is a debt which students will have to pay. This implies that the plan of the government to change bursaries into a loan system will also rely on whether prospective nursing students are willing and financially able to self-finance their studies. The large amount of debt(loan) involved is also not a laughing matter inasmuch as it can reach up to 50,000 GBP for every graduate. Aside from this, there are also other factors which contribute to the desire to study nursing. The Health Foundation (2016) states that factors like the perception of career opportunities after graduation and potential for high level pay are examples of long term factors that greatly affect prospective students’ desire to proceed to nursing.

Conclusion

verall, it can be said that the premise from which the government based its decision to replace bursaries with loans does present a potential advantage, but it is impossible to guarantee that there will still be a high influx of prospective nursing students once it is implemented. There is also the high risk that if the strategy of giving loans instead of bursaries does not work, there will be even less prospective nursing students and even fewer nursing graduates in the future, and this will only contribute to the current problem of nursing shortage in the UK. This in turn can negatively affect the quality of healthcare services. There is also the factor that those who are already studying nursing will be greatly affected once the change has been implemented, and it is logical to argue that some nursing students may even decide to quit or shift to another course because they will be unable to finance their own studies. With these arguments in mind, it can be said that cutting down nursing student bursaries and replacing them with loan grants can either positively or negatively impact nursing practice in the UK; however, the current benefits of the bursaries and the dangers of removing them far outweigh the potential advantage of the proposed loan scheme. Hence, it is no wonder why many sectors of healthcare oppose the new loan system.

References

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Duffield, C. and O’Brien-Pallas, L. (2003). The causes and consequences of nursing shortages: A helicopter view of the research. Australian Health Review. 26(1):186-193.

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