The number of people studying to become a nurse has fallen in every region in England, potentially putting the government’s 10 Year Health Plan at risk, the Royal College of Nursing (RCN) has found.
Latest regional data from the university admissions service (UCAS) showed that the number of people accepted onto nursing courses fell by up to 40% in parts of England between 2020 and 2023, according to analysis by the RCN.
The nursing union is warning that entire regions are being left behind by a failing nurse education system, sharing their concerns just one week after the government launched it’s 10 Year Health Plan consultation to address a ‘broken NHS.’
The RCN is calling on the government to introduce a ‘loan forgiveness model’ and funding support for living costs for students who commit to working in the NHS following graduation.
In the North East of England, the hardest-hit region, acceptances onto pre-registration nursing courses have dropped by 40%, with the union concerned this could mean fewer nurses for the region going forward.
The fall in acceptances varied across regions, with the West Midlands and London seeing the lowest decline in accepted applications, at 14% and 12% each.
The NHS Long Term Workforce Plan (LTWP) aims to grow the nursing workforce from around 350,000 nurses to around 550,000 in 2036/37.
However, the RCN’s analysis shows that the plan is yet to affect numbers, with only 1,000 extra people a year currently forecast to start nursing courses in 2029 compared with a decade earlier.
There are currently over 31,000 unfilled nursing posts in the NHS in England.
Changes made in 2016 saw bursaries for nurse education scrapped, meaning students now pay over £9,000 each year to join the profession.
The RCN says nursing students need specific funding commitments to encourage more domestic recruitment.
The findings come as the RCN, the Royal College of Physicians and the Royal College of GPs have written to the new chair of the Public Accounts Committee to re-open its inquiry into the LTWP due to ‘significant concerns’ and ‘unrealistic’ assumptions throughout the plan.
RCGP said there were 1,557 fewer full-time fully qualified GPs in England in September 2024 compared to September 2015 and called for a national retention strategy for general practice, including national ringfenced funding, oversight and guidance.
Professor Kamila Hawthorne, chair of the RCGP said: ‘The current Long Term Workforce plan is not fit for purpose – and that signatories representing different sectors of the health service have signed this letter, demonstrates widespread concern that must be addressed. The Public Accounts Committee inquiry would be the ideal vehicle to do this, and its findings should feed into the NHS 10-year plan.
‘Retention of doctors – right across the NHS, but not least in general practice – is the principle missing element. We absolutely need more doctors across the board, but with the new government’s clear ambition to move more care out of hospitals and into the community, it makes no sense that the current LTWP for the NHS contains such stark disparity between the projected increase of GPs to that of hospital consultants.’
She added the profession was in a ‘vicious cycle’. ‘If more is not done to retain our current GP workforce, our already chronically understaffed general practice service will be woefully unprepared for the future,’ she said.
‘We’re in a vicious cycle, with workload pressures rising to unsustainable levels, driving GPs out of the profession, and further putting the pressure on remaining staff.’
On student nursing numbers, RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘The prospect of huge debt and lack of financial support is putting off the nurses of the future, threatening to leave patients without the highly trained nursing professionals they desperately need.
‘Nursing is an incredible career, but to fix a broken NHS, the government must fix a broken nurse education model.’
Professor Ranger said more people need to be encouraged into nursing, to help fill vacancies as demand for nursing services continues to rise.
She added: ‘Ministers are right to want to modernise the NHS and shift care into the community, but to do that you must make nursing an attractive career once again.
‘That means forgiving the tuition fee loans of those who commit to working in the health service and funding their living costs. Investment in nursing is always money well spent.’
Acceptances on pre-registration nursing courses
According to RCN analysis of regional UCAS data, acceptances on pre-registration nursing courses fell by the following between 2020-2023:
- East Midlands: fell from 1,910 to 1,625
- East of England: fell from 2,065 to 1,610
- London: fell from 4,110 to 3,630
- North East: fell from 1,580 to 945
- North West: fell from 4,910 to 4,040
- South East: fell from 2,425 to 1,975
- South West: fell from 1,650 to 1,235
- West Midlands fell from 3,505 to 3,000
- Yorks/Humber: fell from 2,795 to 2,100
A version of this story was first published on our sister title Nursing in Practice.
