Applications to the Universities and Colleges Admissions Service (UCAS) for nursing courses in the UK are down (as are applications for midwifery programmes). Scotland has seen the biggest drop, even though nursing students receive the highest student bursary, as well as the profession receiving a better pay award than the rest of the UK. Healthcare staff across Scotland were offered the largest pay package in the history of the NHS.
As of 30 June 2023, the number of applicants to Scottish programmes was 6450, compared with 7930 in 2022 and 9010 in 2021. It was below the pre-pandemic number of 7290 applicants from 2019. The high number in 2021 reflected an increase in demand for certain courses, including nursing and medicine, during the COVID-19 pandemic (Royal College of Nursing, (RCN), 2023a). Data published by UCAS (2023) showed a drop of 19% in applications overall in the 12 months to 30 June 2023. This figure should be a cause for concern not only for Scotland but also for other countries in the UK. This fall in applications is very worrying, it risks creating a staffing flashpoint that will put even more pressure on the NHS. The gap between the number of nurses needed and those entering the workforce is set to widen unless there is rapid action to grow and retain the domestic nursing workforce. The trend observed will be another setback to NHS recovery as it already has record high vacancy rates. The academic year has now commenced and the number of student nurses taking up programmes, overall, shows a decline (RCN, 2023b).
This fall in applications to UCAS should come as no surprise to anyone, particularly after a decade of real-term pay cuts. Although the public may trust and value nurses, it is evident that respect for nursing as a profession is very low. There are ongoing workforce challenges that compromise patient safety and staff wellbeing. Student nurses across the UK are facing serious financial pressures, impacting significantly on their education and financial security as well as their physical and mental health. The prospect of starting a degree course during a cost-of-living crisis is sure to have an impact on student recruitment as well as programme completion. Nursing, an extremely diverse profession, relies on attracting people of all ages and from all spheres of life, often as a second career (RCN, 2023c). UCAS (2023) data showed a significant fall in the number of mature applicants to nursing programmes – cost-of-living factors are making applicants re-evaluate their choice of subject.
The International Council of Nurses (2022) has called on governments to plan and invest in growing their domestic production of nurses to meet the demands on health systems. Expanding our highly skilled and dedicated nursing workforce must involve rapid, sustainable domestic recruitment to alter the trajectory of ever-increasing vacancies. The decline in UCAS applications is not good news for the aspirations in workforce plans to recruit and retain nursing staff.
Nursing is a wonderful career, however, we clearly have an image and identity problem. Not only are we losing outstanding numbers of experienced nurses from the profession, but the issue is also further compounded by deterring the next generation of nurses. Governments need to demonstrate that nurses, todays and tomorrows, are valued and that nursing is a career choice worth pursuing. They have to ensure that current and future students will receive the financial support they need to prioritise their education, manage the rising cost of living and complete their studies without ending up in debt and financial hardship.