Letter to the Secretary of State on the nursing recruitment crisis

Dear Secretary of State,

RE: Urgent action needed to address nursing recruitment crisis in upcoming budget

I'm writing to express my deep concern about the rapidly deteriorating state of nurse recruitment. New data from UCAS reveals a 10% decline in nursing degree applicants to universities in England compared to 2023. This represents a 26% decrease in just two years, marking the lowest number of applicants since 2019.

Failure to address these critical issues will make the ambitions set out in the NHS Long Term Workforce Plan unattainable, leaving the health care system dangerously understaffed and unable to meet the growing demands of patients.

These latest figures expose a widening gap between the aspirations of the plan and the level of political effort required to make them a reality. This needs immediate intervention and corrective action to protect patients now and in the future.

This matters. A decline in applicants risks causing a cascading effect, with fewer students accepted onto nursing courses leading to diminished course cohorts and eventually lower numbers graduating and becoming registered nurses. The latest data suggests that the number of acceptances to nursing degrees in England fell by 11% between 2022 and 2023.

This alarming trend is further compounded by the 11% drop in mature student applicants compared to last year and directly conflicts with the plan for a 32,000 increase in nursing and midwifery training intakes by 2031-32.

The UK government must recognise the severity of this emergency and take immediate action to prevent further decline in nursing recruitment. We believe the current situation poses a direct threat to the sustainability of the NHS and patient safety, considering the existing 10.3% vacancy rate in nursing positions within the NHS in England.

In this context, we urge the UK government to introduce the following emergency package of measures in the upcoming budget:

1. Fund nursing student tuition fees: eliminate the financial burden associated with nursing education, thereby attracting a wider pool of potential candidates, and promoting social mobility within the profession.
2. Implement a loan forgiveness scheme for NHS nurses: relieve financial pressure on registered nurses working in the NHS, incentivising them to remain in the public health care system and contribute to long-term workforce stability.
3. Reintroduce universal living maintenance grants: maintenance grants need to reflect actual student need in terms of living costs so students can focus on their studies without experiencing financial or emotional hardship. This is a crucial step in addressing the issues around student retention, which are exacerbating the NHS workforce crisis.

While the RCN recognises the potential of nursing apprenticeships, the three-year degree programme and expanded postgraduate pathways remain the quickest ways to educate registered nurses. Removing the burden of fees to encourage people through this route is within the government’s control and would be a more efficient and effective way to grow the registered nurse workforce at pace.

It is well evidenced that nursing numbers directly impact patient outcomes; higher ratios of registered nurses to patients on shift leads to reduced lengths of stay and improved mortality. The consistent decline in the number of nursing students marks a pressing patient safety concern.

We urge you to tackle this issue head on and work with the RCN and other stakeholders to develop a comprehensive plan that effectively addresses the nursing recruitment crisis. We stand ready to work collaboratively to ensure a sustainable and robust nursing workforce for the future.

Yours sincerely,

Pat Cullen

General Secretary & Chief Executive