I am a health or social care employer

What’s changing?

New students on nursing, midwifery and most AHP pre-registration courses in England after 1 August 2017 will take out maintenance and tuition loans like other students rather than getting an NHS grant.

You can find out more about the courses affected and the implications of the changes in our briefing Information for Employers.

The rationale for the new system

The Government’s intention is that these reforms will remove the cap on student numbers, with the aim to increase the number of students by ‘up to 10,000’ across the lifetime of the Parliament. On a cumulative basis, this is approximately a 7% increase per year from 2017/18. It is also fewer students than were being educated for these professions in 2010.

Is this just a switch of funding mechanism?

No, this change is a lot more significant. The old model of commissioning places from universities will be replaced over time with a more open market, where universities can set their own intakes, provided that placement agreements are in place. This makes strong partnership working between universities and employers particularly important.

How might the new system help employers with workforce shortages?

Student numbers in nursing, midwifery and most of the AHPs have historically been set regionally (under the Strategic Health Authorities) or centrally under HEE, based on moderated aggregation of local workforce plans. It is widely recognized that the system has been driven by short-term affordability concerns and has contributed significantly to workforce shortages.

Decoupling student numbers for these professions from the DH’s budget should allow universities to grow their courses, particularly where employers are predicting increased workforce needs and can open up additional placement opportunities. Over time, this should allow employers to rely less on agency staff and international recruitment, particularly if plans are put in place to help attract and retain new graduates into the workforce.

If the placement funding is allowed to follow the student, the new system should also allow more employers to engage in health education, including making the most of placement opportunities in social care and private providers.

Partnerships between universities and employers

The removal of the number cap makes effective partnerships between universities and employers more important than ever. Employers and universities will need to think through a number of areas together, including the balance between recruiting students locally and more widely, placement capacity and support for new mentors and how to retain students into the workforce. There are examples of employers starting to plan incentives to attract students, such as repaying part of a student’s loan or sponsoring students through their course, or offering longer term career development opportunities.

Influencing the reform

The Government is currently writing the rules of the new system and has been carrying out a public consultation on how it will work. The consultation covers. The Government’s response to the consultation has now been published and provides more detail around a number of areas that may be of particular interest to employers including:

  • Funding for postgraduate pre-registration courses;
  • Placement funding for employers;
  • Student support – placement expenses and maternity/paternity pay;
  • Fair access.


What role can employers play?

Employers across health and social care and beyond have a crucial part to play in influencing the implementation of these reforms: these students are the whole future domestic supply in these professions, so employer input matters. The reforms also give lots of opportunities for local innovation: new placement opportunities, financial support for students, progression from a final year placement into employment…

Learn more