E-petitions debate: Pay and financial support for healthcare students

E-petition subjects

Petitions 610557 and 619609 are calling for student nurses and other healthcare students to be paid at least minimum wage for their placement hours. Petition 616557 is calling for the 30 hours free childcare offer available to workers who meet the required minimum income level to be extended to student midwives, nurses, and paramedics.

Financial support for nursing, healthcare, and paramedic students

Detailed information on the financial support available to nursing and healthcare students, as well as an overview of the numbers of students over time, is available in the Commons Library briefing Medical, dental, and healthcare students: UK numbers and student support arrangements.

Abolition of the NHS bursary

Since 2017, new undergraduate students starting courses in nursing, midwifery, and allied health profession (AHP) programmes in England have been ineligible for the NHS Bursary. They were previously eligible for free tuition, non-repayable grants and bursaries, and a reduced maintenance loan.

Following a 2016 consultation, the UK Government abolished the NHS bursary for nursing and healthcare students, and students were instead made eligible for the standard student finance package of tuition fee and maintenance loans.

Student finance

Nursing, midwifery, and allied healthcare students in England are now primarily funded by the standard student finance package of:

• a tuition fee loan to cover the cost of fees;
• a maintenance loan to help with living costs;
• additional support for some students depending on their personal circumstances (for example, if they have childcare responsibilities);
• the long courses loan for courses exceeding 30 weeks and 3 days in an academic year.

NHS Learning Support Fund

As part of the 2016 funding reforms for nursing and healthcare students, the Government also introduced the NHS Learning Support Fund (LSF). This currently includes:

• a training grant of £5,000 per academic year;
• a specialist subject payment of £1,000 per academic year for students on degrees that struggle to recruit, including mental health and learning disability nursing;
• parental support of £2,000 per academic year for students who have at least one dependent child under 15 years, or under 17 years if registered with special educational need;
• help towards additional travel and accommodation costs related to clinical placements;
• an exceptional hardship fund of up to £3,000 per academic year

Nursing and healthcare placements

Placements are an important part of nursing and healthcare courses because they provide supervised training that allows students to gain the necessary skills and experience to meet education outcomes and work in clinical settings. There have long been calls for students to be paid while on placement, with many students having to work part time alongside their required 2,300 clinical hours to support themselves.

The UK Government has said student nurses receive financial support to train, and are not treated as paid members of staff (they are considered ‘supernumerary’). This is done to ensure “safe and effective care” for patients. This is also the view of the Nursing and Midwifery Council (the independent regulator for nurses and midwives in the UK), which has said students must be considered supernumerary to ensure protected learning time.

On 1 September 2023, the Department for Health and Social Care announced students studying on nursing, midwifery, and allied health courses (and medical and dental courses) can now claim up to 50% more for travel and accommodation expenses incurred whilst studying, including on placements.

Temporary paid placements during the Covid-19 pandemic

During the Covid-19 pandemic, opt-in paid student nursing placements were introduced in March 2020 and January 2021 as a temporary measure to help with the NHS' emergency response. The Government has said it was always clear this was a temporary arrangement.

Childcare support for nursing and healthcare students Free childcare entitlements

In England, the free childcare offer includes 15 hours of free childcare for all three- and four-year-olds. There is also a 30 hours of free childcare offer but students, including nursing and healthcare students, are generally not eligible because they do not meet the income requirements.

In March 2023, Open Democracy reported some nursing students had considered leaving their courses because of financial pressures related to childcare costs.

Student finance

Full-time undergraduate students with children under 15, or under 17 if the child has special educational needs, may be eligible for a Childcare Grant towards their childcare costs from Student Finance England. The Parents’ Learning Allowance is additional funding for eligible full-time students with children that can be used for everyday costs of study, such as books, study materials, and travel.

NHS Learning Support Fund

Students on certain pre-registration undergraduate or postgraduate healthcare courses, including midwifery and nursing, may be eligible for Parental Support from the NHS Learning Support Fund of £2,000 per academic year.

Students cannot receive both the student finance Childcare Grant and NHS-funded Parental Support at the same time.

Petitions Committee survey

Prior to the debate on pay and childcare for healthcare workers, the Petitions Committee conducted an online survey that asked about the cost of living, placement hours and expenses, second jobs, healthcare students being treated as supernumerary, course workload, and parenting.

Most survey respondents stated they were struggling with the cost of living, with 58% saying it was ‘difficult’ or ‘very difficult’ to afford energy, including gas and electricity, and 19% saying they had visited a food bank. Most survey respondents (85%) disagreed that current financial support was adequate for healthcare students’ courseload and needs.

Regarding the supernumerary status of students on placement, both healthcare professionals (40%) and healthcare students (60%) who responded to the survey said placement students were not treated as supernumerary in practice.

UK comparisons

Higher education, including support for students, is devolved. England is the only part of the UK where nursing and other healthcare students must pay for their own tuition (generally through student loan repayments). The governments of Wales, Scotland, and Northern Ireland fund the tuition fees for eligible students.

Scotland has the most generous living cost support. The Paramedic, Nursing, and Midwifery Student Bursary (PNMSB) includes a £10,000 grant for the first three years of a course and £7,500 for the fourth year, as well as a single parents allowance (£2,303 per year), childcare allowance (£2,466 per year), and dependents allowance (£3,640 for first dependent child, and £557 for each other dependent child per year).

Wales is the only part of the UK that ties eligibility for student support to a commitment to working in the NHS following graduation (for a maximum of two years). Students who cannot make this commitment are eligible for the standard student finance package of tuition fee loans and living cost funding instead.