The observation from Richard Murray, who leads the influential King’s Fund, follows Mr Stevens’ admission that the debate over reintroducing a nursing bursary was “back in play”.
“There is a recognition that the current system isn’t really working”
Mr Murray was sat beside Mr Stevens on stage at the King’s Fund leadership and management summit last week when a question and answer session with delegates strayed onto the topic of student nurse funding.
The NHS England chief executive was quoted in the Health Service Journal as saying: “There has been a big debate about bursaries and their removal, which as we look at the way the student loan system is working, that is clearly back in play as a big question we’ve got to answer as a nation.”
He told the conference there needed to be a “much bigger upturn in the pipeline of new nurses” and noted how that would lead to discussions about the financing of undergraduate nurse education.
The comments came as a suprise to organisers and delegates at the conference with Mr Murray describing a “blinking” moment across the room.
He told Nursing Times that he felt Mr Stevens’ remarks meant two things.
“One, that there is a recognition that the current system isn’t really working in order to get the number of nurses in training up,” he said.
“And the broader sense of my interpretation of what Simon said, is that NHS leaders are starting from something closer to a blank sheet of paper and if the analysis and the need in the NHS points in that direction, well then putting back in bursaries might be the right answer.”
He said that the fact that these debates were coming “back into play” underlined the “degree of anxiety” in the NHS about the state of nursing in England, which currently has around 40,000 vacancies.
Although, Mr Murray said he hoped the stern words would translate into positive changes.
“We need to make sure this gets into action now and doesn’t just remain as concerns, but really leads to some pretty brave decisions being taken,” he added.
However, he warned that asking the government to simply reinstate bursaries may be a “difficult pill for them to swallow” and that there may be other avenues to go down to support studying nurses.
“We need to make sure this gets into action now and doesn’t just remain as concerns”
“The bursary is one answer, but it isn’t the only answer and that’s why I think we need things like a cost of living grant or maintenance grant to support them,” he said.
“There isn’t much public money around and so we’ve got to try and make sure that it’s best used to get the biggest increase in nurses that we can get.”
Mr Murray explained how the King’s Fund, with colleagues at Nuffield Trust and The Health Foundation, supported the concept of a maintenance grant to help nurses with their living expenses.
He noted how most student nurses did not have time for part-time jobs like other students due to their clinical placement commitments.
“But we certainly wouldn’t want to rule bursaries out and I think particularly for post-graduate students the tuition fees should be covered,” Mr Murray noted.
“So, I think we should look towards some kind of mixed model that provides some support through bursaries where that is the best way forward, but also willing to provide grants in cases where that is the more appropriate way. It’s about trying to make sure that the full range of financial support is available.”
The government axed the bursary, which covered the cost of training to become a nurse, in 2016 and switched funding to student loans.
Mr Murray described the move as a “slightly poorly designed attempt” to increase student nursing numbers.
Latest figures from the Universities and Colleges Admissions Service show that while applications to study nursing in England have increased by 4% from last year, they are still down more than 15,000 since the bursary was removed.