In a debate held on 19 June as part of London HE Week, senior representatives from across health education and policy, as well as representatives from the Royal College of Nursing, identified maintenance support and placement tariffs as two key areas of concern in health education funding. Consensus was also reached that a fresh approach was preferable to reverting back to the bursary model and that further investment was needed.

The panel, which in addition to RCN representatives included senior leaders from the NHS, Office for Students, Nuffield Trust, Council of Deans of Health, UCL and London South Bank University, expressed collective concern how past and current funding models contributed to student hardship and attrition.


“Health students are joining at a time when placement capacity is under pressure. Students are often having to undertake placements in such a way that undermines their ability to take on paid work outside of study, particularly if they have caring responsibilities,” explained Amy Fancourt, a panel member and master’s student in nursing at City University London.

“Given the acute workforce shortage, it’s unfair for everyone if health students don’t progress to registration because of financial hardship, and it’s similarly unfair if we exclude whole groups of people because of affordability. Both the past bursary offer and current maintenance loan arrangement are insufficient for many students, particularly in a high-cost city like London, but increasing the debt of those less able to pay is not an appropriate response. Maintenance grants are the only fair way forward.”

Criticism was also voiced over the distribution and level of the placement tariff. Currently, medical students carry a tariff worth 11 times that of a non-medical student. It was felt that this disparity incentivized a system where training availability was at odds with workforce needs and failed to create enough incentive for primary care providers to train non-medical staff.

Concern was also expressed about whether either tariff was sufficient for trusts to dedicate resource for quality placements, even at the higher level made available for medical students. It was agreed that more investment into partner delivery of education was urgently needed, but that a new approach for placement funding, informed by robust workforce planning and stronger outcomes, should be considered.

The debate, titled “Educating London’s Future Health Workforce: When it comes to funding, what’s fair?” was hosted by London South Bank University.