Academics are warning that nursing degree and radiography courses could be at risk of closure, which could make the NHS recruitment crisis even worse. The Council of Deans of Health has compiled a list of courses that are struggling to attract and retain students following the removal of student bursaries in 2017. Courses under threat include podiatry, prosthetics, learning disability nursing, orthoptics and mental health nursing, along with radiography. University sources say that there are already significant shortages in these specialisms within the NHS and without an ongoing training pipeline the situation will deteriorate further. Last month, nine out of 10 hospital bosses in England stated that shortages of nurses and doctors within the NHS are now so severe that patient health could be at risk.
Professor Brian Webster-Henderson, chair of the Council of Deans, warned that closure of courses would threaten public health, citing the key role of radiography in providing treatment for the national cancer plan. Courses have already been axed. Portsmouth University has closed its radiotherapy and oncology course for the 2019-20 academic year after attracting only two firm acceptances. The loss of bursaries has made it more difficult for universities to attract considerable numbers of older students – a key market for health subjects. Mature students are reportedly concerned about taking on debt and being placed in a payback regime while having to support dependents. It is also difficult to undertake part-time work around studies and unpaid hospital placements.
There is particular concern over courses such as radiography, which require expensive equipment. Alex Partner, programme leader in radiography at Derby University, said that radiography is one of the most costly courses that a university can run, requiring significant investment in imaging and x-ray technology. Financial pressures are increasing the likelihood of student drop out, with many finding it difficult to combine part-time work and unpaid hospital placements. Despite these issues, Partner argued that radiography training is essential due to the shortage of radiographers in the NHS and the fact that most patients will require some form of imaging.
This year saw a rise of 4% in applications for nursing degrees, following a decline of 31% over the past two years after the end of bursary provision. Nevertheless, universities are claiming that this increase is misleading as recruitment problems in nursing for mental health and learning disabilities still exist, with these two specialisms relying significantly on mature learners.
According to Health Education England, there has been a 50% drop in applications for learning disability nursing training from 2016 to 2018. David Maguire, from the King’s Fund, highlights concerns regarding this trend as there is currently no room for error in the system. A recent analysis from RCN found that learning disability nursing positions have decreased by almost 60% since 2009. It emphasises that specialist skills are crucial in nursing and that, as a rota loses expertise, the increased risk to patients becomes apparent. Furthermore, this issue is more acute with learning disability care, an area in which the NHS offers poor care, compared to services available for the general population.
Many mature students are often drawn to mental health nursing due to personal experiences, but are currently distancing themselves from pursuing it as they feel overwhelmed by large loans. Catherine Gamble, representing mental health nursing at the Royal College of Nursing, explains that one of her students articulated this perfectly; “She was being educated on wellbeing and mental health, but she was too busy to go home for Christmas and found it too expensive to travel between care home placements”. Gamble underlines the fact that mature learners are critical to the NHS as they are an essential reflection of the community they will be serving. She states that while 18-year-olds can be outstanding, they lack the life experience which hospitals expect from their healthcare providers.