More than 32,000 student nurses could drop out of their courses by the end of the next parliament, enough to fill every nursing vacancy in the NHS in England, new analysis for the Royal College of Nursing (RCN) reveals today [16 December].
Financial pressures, struggling services and worsening pay prospects are to blame, the College says.
The RCN is warning that without action to make the career more attractive, by easing the financial burden on students and raising pay, 32,225 people enrolled on nursing courses in England could quit their degrees by 2029, undermining the government’s plans to reform a ‘broken NHS’.
It comes as the UK government proposes just a 2.8% pay uplift for NHS nurses in England.
Analysing data from the Higher Education Statistics Agency, the RCN was able to calculate the average student dropout rate in England as 21% since the nursing bursary was scrapped in 2016. Applied to the projected number of acceptances onto nursing courses in England each year until 2029, it shows that tens of thousands could leave before graduating.
Nursing students in England pay tuition fees of £9,250 each year, which is set to rise to £9,535 in 2025. There is no universal maintenance grant to support living costs and a recent Nuffield Trust report shows some are unable to afford food and bills. It comes as new data from the universities’ admissions service UCAS shows just 130 extra students started nursing courses in England this year compared with 2023.
An RCN survey of nursing students in England from earlier this year revealed seven in ten are considering quitting due to financial pressures.
To rescue nursing and deliver its NHS reforms, the College says the government must make nursing a more attractive degree and career by introducing a loan forgiveness model for students who commit to working in the NHS and wider public services, alongside universal maintenance grants. Addressing the debt burden and easing cost of living pressures is the best way to reduce the dropout rate, alongside increasing nursing pay to make the career more attractive.
Nursing education is unique, requiring students to complete thousands of clinical hours alongside their academic studies. This leaves them unable to seek paid employment as other students can, causing hardship.
In the health service in England, there are 31,774 nursing posts currently vacant.
RCN General Secretary and Chief Executive Professor Nicola Ranger said:
"The students of today are the nurses of the future. But for tens of thousands, the unbearable weight of graduate debt, lack of support with living costs and prospect of low pay is set to push them out of the profession before they qualify. This is a tragedy for them and patients.
“To deliver the government’s NHS reforms we need to supercharge recruitment into nursing, but we can’t do that with a broken education model or more real terms pay cuts. Ministers should change course and agree a social contract with nursing students that sees pay rise and loans forgiven if they commit to working in public services.
“Transforming care cannot happen without investment to transform nursing. That means changing the way we recruit into the profession and making it a more attractive career by raising pay.”
Ends
Notes to editors
The RCN has calculated that the attrition figure for nursing students is 21%. This figure has been calculated based on actual attrition in 2017/18, 2018/19, and 2020/21. We have excluded the years prior to 2017 due to the impact which the bursary was likely to be having upon students remaining on their courses. We have also excluded the first year of the pandemic (2019/20) due to very high attrition relating to the impact of COVID.
Using actual acceptance figures for the 2022, 23 and 24 cohorts, and RCN projected acceptances (based on NHS Long Term Workforce Plan ambitions) for the 2025, 26, 27, 28 and 29 cohorts, we have calculated the total nursing student cohort during this parliamentary term at 153,454. Using this information, we have projected the student attrition loss to be 32,225 during this parliament.
[Note: this includes a reduced proportion of the 22, 23, 28 and 29 cohorts who are only undertaking part of their study during this parliament].
According to the RCN’s latest student survey, the number one reason for student nurses considering dropping out is financial pressures. Among those who said they are considering leaving their courses, 70% gave financial difficulties as their reason.
Earlier this year, RCN analysis revealed the number of people studying to become nurses has collapsed in every region in England by up to 40% since the pandemic.
As of 28 November 2024, there are 31,774 nursing vacancies in NHS England.
