Almost half of nursing students in England have considered quitting before they graduate amid the worst workforce crisis in NHS history, according to the largest survey of its kind.
Applicant numbers have fallen significantly since the end of a grant to support nursing students in 2017. Now a report by the Royal College of Nursing (RCN), seen by the Guardian, suggests that as many as 46% of those enrolled – about 32,000 students – could walk away.
The cost of living was the top reason for students considering an early exit, with seven in 10 (70%) citing “financial difficulties” as a factor. Nursing students have to pay university fees of more than £9,000 a year.
“I had a realisation that when I qualify and get paid, after I pay off my percentage of tuition I am left with the same pay I was earning at McDonald’s at age 18,” said a third-year undergraduate in Lancashire.
“I wasted so much time and put my sweat, blood and tears into something that is burning me out before I start and isn’t even paying enough. It makes me sad for myself that this is the profession I chose.”
Nearly six in 10 respondents (58%) said witnessing low morale and burnout among qualified nurses had also prompted them to consider ditching their nursing degree.
Prof Nicola Ranger, the acting general secretary and chief executive of the RCN, said: “Nursing is a highly skilled and amazing profession, but the next generation of nurses are considering walking away before they have graduated.”
She said immediate action was necessary from the next government to prevent a mass exodus of nursing students.
The NHS long-term workforce plan, published a year ago, aims to increase the nursing workforce in England from about 350,000 to about 550,000 by 2036-37. But the number of people starting nursing courses has declined, and if those already at university quit in large numbers then the NHS could be left tens of thousands of nurses short.
Of the 1,528 nursing students involved in the survey, 46% said they had considered withdrawing from their degree programme. There are about 68,000 student nurses at university, according to the RCN, which suggests 32,000 have thought about dropping out.
Ranger said the next government should fund tuition fees for nursing students and reintroduce universal maintenance support.
“Government-funded nurse education, proper maintenance support and loan forgiveness for those working in the NHS would be money well spent. Building a nursing workforce fit for the future is the best investment a government can make, benefiting our vital services and wider society,” she said.
“Nursing students are the future of our health and care services but they need support from the next government. It cannot be right that people choosing to dedicate their lives to patient care are incurring huge debts and struggling with the cost of living.
“For the long-term workforce plan to get back on track, we need urgent action. The retention and recruitment of nursing staff will be key to driving down NHS waiting times and getting health and care services back on their feet.”
The introduction of nursing degree apprenticeships was intended to broaden the appeal of nursing degrees to those wanting to earn an income while studying. However, data analysed by the RCN shows take-up is falling on these courses, down 20% in the last year.
In England, 3,420 people began nursing degree apprenticeships in 2021-22, falling to 2,720 in 2022-23, the most recent year for which complete figures are available.
Courses are also under threat from the financial crisis gripping universities. In an RCN survey of more than 500 nurse educators in England, three in five reported being directly affected by redundancy, a staffing restructure or recruitment freeze.
Saffron Cordery, the deputy chief executive of NHS Providers, which represents NHS trusts in England, said the next government must resolve the NHS workforce crisis if it was to cut waiting times.
“It’s hard to recruit and retain the staff the NHS needs in today’s economic climate. We can’t afford to lose people training to be tomorrow’s nurses,” she said. “An NHS fit for the future needs a thriving health and care workforce with more, meaningful investment in nursing education.”
To recruit and retain nurses, action was also required on NHS pay, Cordery said.
Wes Streeting, the shadow health secretary, said: “Nurses are the backbone of our NHS and it is worrying that nearly half of nursing students are considering quitting their degrees. Staffing levels are already in crisis and it is paramount that the next generation of nurses feel excited by joining the profession so they can help the patients of tomorrow.”
Daisy Cooper, the Liberal Democrats’ health spokesperson, said: “The NHS is on its knees and it’s no surprise that nursing students are considering quitting in such large numbers. This is the legacy of years of Conservative neglect.”
The Conservative party did not respond to a request for comment.
