Press release

Reform nursing training placements to help tackle the recruitment crisis, says MillionPlus

22 Feb 2023

The latest policy briefing from MillionPlus, the Association for Modern Universities, calls for the UK and Scottish governments to urgently reform the clinical training placements system to ensure a healthy supply of nurses across the NHS.

The NHS faces a recruitment crisis. With around 10% of nursing vacancies currently unfilled in NHS England and Scotland and global pressures meaning international recruitment is less viable than during previous crises, there is a need to train significantly more nurses domestically.

Increased uptake of nursing courses during the pandemic has since tailed off, with applications down 18.1% in England and 24.2% in Scotland between 2022 and 2023. The situation is exacerbated by record numbers of experienced nurses leaving the sector and a stubbornly high attrition rate of student nurses. Added to increased demand for nurses before the end of the decade, MillionPlus estimates that 160,000 student nurses will need to be recruited, trained and enter NHS England between now and 2031 and 28,000 for NHS Scotland. This represents an increase on forecast numbers of around 20%.

While universities could accommodate these increases, the requirement for student nurses to undertake 2,300 hours of clinical placement presents a much larger barrier, one which change could help to tackle.

Among others, the briefing recommends the following reforms:

  • Greater involvement of higher education institutes in long-term NHS workforce planning. Allowing for knowledge transfer, a more stable placements landscape and collaboration between universities over competition.
  • Allow the tariff to follow the student in their placements rather than be allocated to NHS Trusts and Boards, allowing for a closer system focused on the education of students.
  • Formalise the relationship between education and placement providers and funders through the NHS Education Contract. This would ensure all integrated care systems fall within the Tri-Partite Agreement in NHS England
  • Provide universities with stable and longer-term funding streams with the flexibility to innovate. Celebrate the diversity of regional healthcare providers while allowing universities to plan for the longer term.
  • Government investment in simulation infrastructure that is open-source. Recognise the additional capital costs arising from the NMC’s decision to double the amount of simulation student nurses can undertake and allow for universities to invest in freeing up clinical placements.
  • Government to establish a study to explore reducing the number of hours student nurses are legally required to undertake a training placement. This would bring the UK in line with other international developed healthcare systems. 

Professor Graham Baldwin, Chair of MillionPlus and Vice-Chancellor of the University of Central Lancashire, said:

“Demand for nurses coming into the NHS within England and Scotland is ever growing. Modern universities, which collectively train around two-thirds of all student nurses, are up for this challenge. However, increasing the recruitment of student nurses is only half the solution; the requirement for student nurses to undertake training through a clinical placement before qualifying presents a clear barrier for growth in a system already creaking at the seams.

“This briefing highlights the innovative approaches modern universities have taken to expand placement capacity, the mentoring and monitoring of students while on placement and improvements to working hand in hand with their partner NHS Trusts, care homes and other placement facilities.

“Reform of clinical placements is required to keep a vital and noble profession in rude health. Now is the time for governments in both Westminster and Holyrood to invest in the education of nurses to ensure the NHS meets the increased demand for its services.”


Notes to editors

  1. For further information or to arrange an interview, please contact Dan Blows on 020 3927 2916 or email:
  2. Who trains the nurses? Universities and the placements shortfall is attached to this email and is available online here
  3. MillionPlus is the Association for Modern Universities in the UK, and the voice of 21st century higher education. We champion, promote and raise awareness of the essential role and impact of modern universities in the UK’s world-leading higher education sector. More information can be found at
  4. What are modern universities? Modern universities are long established centres of higher education in their communities with roots that stretch back decades, if not centuries. Many gained university title following legislation agreed by parliament in 1992. They make up almost half of the UK university sector with over a million students studying at modern universities every year.
  5. Modern universities: facts and stats 2022