Collapse In Nursing Course Applicants In Scotland - Nursing Shortages May Get Worse Without Action

15th February 2024

Emergency measures are needed in next month's budget following a ‘collapse' in nursing course applicants, the Royal College of Nursing (RCN) has warned.

The RCN has urged the government to use its spring budget on 6 March to introduce an emergency package of measures to boost nurse recruitment, after figures from the University and Colleges Admissions Service (UCAS) showed a further drop in applicants to nursing courses for the next academic year.

Figures from UCAS released today showed 24,680 nursing applicants to education providers in England this year, compared to 27,370 in 2023 and 33,410 in 2022. This represents a 10% fall in the last year and a 26% fall in the last two years.

The decline is underlined by a drop in the number of mature students from the UK applying for nursing degrees offered by education providers in England, with a 14% drop in applicants between 2023 and 2024 to 11,920.

Applications to nursing decreased across all specialisms, but particularly adult and mental health nursing.

Dr Jo Saxton, chief executive at UCAS, highlighted that while the data showed a decline in applications from mature students, ‘which will be more keenly felt in some subjects such as nursing', these applicants are more likely to apply later in the cycle.

The data is part way through the applications cycle so is an indication rather than full figures on applications to study nursing, representing around 70% of total applicants to nursing for this cycle.

In a letter to health secretary Victoria Atkins, RCN general secretary and chief executive Pat Cullen expressed ‘deep concern' about the ‘rapidly deteriorating state of nurse recruitment’.

She said the situation threatened the sustainability of the NHS and patient safety, considering the 10.3% vacancy rate in nursing positions within the NHS in England. Nursing vacancies across the NHS remain over 42,000.

‘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,’ she said.

‘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.’

In her letter, Ms Cullen urged the UK Government to use the budget to fund nursing student tuition fees, implement a loan forgiveness scheme for NHS nurses, and reintroduce universal living maintenance grants.

‘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,’ she added.

Saffron Cordery, deputy chief executive at NHS Providers, said trust leaders would be ‘extremely worried’ by the drop in applicants.

‘Operational pressures and challenges including wider unresolved industrial disputes impact retention and morale, so there is concern that staffing gaps could widen further,’ she explained.

‘The NHS Long Term Workforce Plan is a welcome blueprint to shore up staff numbers, but without adequate measures to ensure the NHS remains attractive to both future and existing staff, it risks amounting to nothing more than a pipedream.’

The figures also showed that the number of applicants for nursing courses in Scotland was down 8.3% compared to the same point last year.

By the January deadline, 4,650 people had applied to study nursing in Scotland, compared to 5,070 at the same point last year. There are still several months left in this year’s application cycle, but the figures offer a snapshot and follow an 11% fall in acceptances onto undergraduate nursing courses at Scottish universities in 2023 compared to the year before.

In addition, applications to study nursing in Northern Ireland were down 5% - from 2,380 in 2023 to 2,260 in 2024.

However, there was also an 8% rise in applicants to Wales - up from 2,820 in 2023 to 3,050 in 2024.

Eileen McKenna, RCN Scotland associate director, said: ‘That’s now three years in a row that the number of applicants at this time of year has fallen and it’s an extremely worrying trend.

‘Scotland does not have the number of nurses now that it needs to meet the demand for care in health and social care services.’

While citing the more than 3,700 nurse vacancies in the NHS in Scotland alone, she added: ‘This is a desperate situation and it is more important than ever that the Ministerial Nursing and Midwifery Taskforce proposes the right actions to directly address the workforce challenges.

‘The Scottish Government must back the taskforce up by finding the financial resources needed to deliver change and ensure nursing is positioned as a career of choice.’

A Department of Health and Social Care spokesperson said: ‘The number of applicants still continues to outstrip the places on offer.’

They said there were ‘record numbers’ of nurses working in the NHS and that the NHS Long Term Workforce Plan ‘will add 24,000 more nurse and midwifery training places by 2031’.

‘We’re working with UCAS so everyone who wants to pursue a rewarding healthcare career has the support and opportunities to do so,’ the spokesperson added.

This is the second year in a row for a big drop in applications to study nursing in Scotland.

The number of applicants to Scottish programmes is 6,450 as of 30 June 2023, compared to 7,930 in 2022 and 9,010 in 2021. The number of applicants applying to study nursing in Scotland at this point in the UCAS cycle, is below the pre-pandemic number of 7,290 applicants from 2019. The number of applicants was highest in 2021, reflecting an increase in demand for certain courses, including medicine and nursing during the Covid-19 pandemic.

Commenting, Colin Poolman, RCN Scotland Director, said: "This significant drop in applications to nursing courses in Scotland is a real cause for concern amid the stubbornly high registered nurse vacancy rates and ongoing workforce challenges which are compromising patient safety and the wellbeing of staff.

"Our recent report on the costs of becoming a nurse highlighted the significant financial pressures that student nurses are facing. The prospect of starting a degree course during a cost-of-living crisis is bound to be having an impact. Nursing is a hugely diverse profession and relies on attracting people of all ages and all walks of life, often as a second career.

"The Scottish government needs to demonstrate that nursing is valued and a career choice worth pursuing. The Ministerial Nursing and Midwifery Taskforce provides an opportunity to ensure that current and future nursing students get the financial support they need to prioritise their education, cope with the rising cost of living and finish their studies successfully without falling into financial hardship."