It all starts with attraction: building the nursing workforce

While retention is clearly an issue, attracting new nurses into the profession is also a significant problem.

3 July 2019
Student Nurse Lecture Theatre

Six per cent of places on pre-registration nursing degrees across the UK are going unfilled.

When it comes to managing the nursing workforce the focus is often on retention, with recent figures from the Labour party revealing that more than 160,000 nurses have left the NHS for reasons other than retirement since 2010. This is undoubtedly worrying for industry leaders, with departing staff members adding to the strain on the health service from budget cuts and the ageing population.


While retention is clearly an issue, attracting new nurses into the profession is also a significant problem. The number of EU nurses joining the Nursing and Midwifery Council register since the UK voted to leave fell from 10,000 in 2015/16 to just 800 in 2017/18, which means that NHS trusts need to find nursing talent elsewhere in order to ensure that they can continue to provide excellent and efficient patient care.

Developing homegrown talent presents the most sustainable solution to the nursing numbers crisis, yet new data from The Open University’s Breaking Barriers to Nursing report six per cent of places on pre-registration nursing degrees across the UK are going unfilled – the equivalent of over 1,450 vacancies each year.

Barriers to nursing.

Despite many young people considering nursing as a potential career, there are a number of barriers that are deterring them from pursuing this route – and it is essential that educators and NHS employers work together to ensure that everyone who wants to become a nurse has the opportunity to do so.

The barriers to studying nursing are vast – and for most prospective students there will be two or more of these factors at play. The cost (and associated costs) of study is the most prevalent concern, particularly for those in England, but many are also put off by travel or entry requirements, workload, and even the advice made available at school or college. While some of these barriers are difficult to remove or reduce, there are a number of potential solutions that could help improve both recruitment and retention in the sector.


The removal of the nursing bursary in England has certainly made studying for a nursing degree a greater financial commitment, but the associated costs of studying – course materials, relocating, commuting – are problematic for prospective students across the UK. For many, this makes traditional nursing study prohibitively expensive, especially when the costs are compared to relatively low salary expectations.

One solution that could help to address the cost concerns faced by potential nursing students in England, and bring myriad benefits to the NHS as a whole, is the new Registered Nurse Degree Apprenticeship. The ability to earn while you learn is undoubtedly appealing, but it also provides a new route into the profession, offering a tool for continuous professional development to those already in the NHS workforce.

Technology-enabled learning.

In addition to the cost of relocating and commuting, many prospective students struggle with merely the idea of this. For some, this can be an exciting opportunity, but for others the commitment is too much, especially for mature students, who may have other commitments or roots in an area.

With new technology, there is no longer any need for students to travel in order to study, particularly for the lecture-based portion of their degree. Through technology-enabled learning, educators can make course delivery more flexible, so that students can study wherever, whenever and however suits them. And because they have not had to relocate, fewer nurses will leave their training hospitals to return home upon qualification.


Furthermore, some universities’ entry requirements exclude many would-be nurses from entering the profession. The Nursing and Midwifery Council requires candidates to have just GCSE-level Maths and English (or equivalent) when they begin their course, but as it stands, nine in 10 Higher Education Institutions that offer pre-registration nursing degrees in the UK require the 96 UCAS points (equivalent to three A-levels at or above a C-grade) for entry.  And grade requirement vary depending on where you are in the UK – in Wales all universities require at least 120 UCAS points at A-level (3 ‘B’s), while in Scotland half require only 64-72 points.

Remove unnecessary entry requirements.

These additional entry requirements limit an already diminished pool, and at a time when talent is in short supply, they represent an unnecessary barrier into the profession. These requirements also stand in the way of the NHS goal of widening participation and increasing diversity, as many of those who were not afforded good educational opportunities are effectively excluded, even if they have all of the other qualities required to become a nurse.

For some, it is not the practicalities of studying that presents the issue, but concerns about the career at the end. One in five of those who considered becoming a registered nurse were deterred because they were worried about the working hours and stress they might face. However, those working as registered nurses would argue that the rewards far outweigh any challenges – so it’s crucial that NHS trusts work with local communities and media to promote the benefits and counter any negativity, in order to bring in new recruits.

So, there are a number of barriers preventing prospective nurses from entering the profession, but there are also a number of ways in which industry stakeholders – educators and NHS employers – can start to address them.

By removing unnecessary entry requirements, promoting the positive, embracing technology-enabled learning and opening up new routes to the profession, we can develop a more sustainable pipeline of talent, which is essential for future-proofing the NHS, and ensure that it can continue to provide a safe service for years to come.


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