Supporting our future NHS workforce: a consultation on the NHS Bursary Scheme Autumn 2009.

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Supporting our future NHS workforce: a consultation on the NHS Bursary Scheme Autumn 2009

Transcript of Supporting our future NHS workforce: a consultation on the NHS Bursary Scheme Autumn 2009.

Page 1: Supporting our future NHS workforce: a consultation on the NHS Bursary Scheme Autumn 2009.

Supporting our future NHS workforce:a consultation on the NHS Bursary Scheme

Autumn 2009

Page 2: Supporting our future NHS workforce: a consultation on the NHS Bursary Scheme Autumn 2009.

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Background to the NHS Bursary Scheme in England

• £518m spent in 2007/08 on bursaries, allowances and loans:

– £363m on bursaries (to degree and diploma students)

– £88m on allowances (to degree and diploma students)

– £67m on loans (to degree students)

• 90,000 students awarded funding in 2007/08:

– 57,000 nursing students

– 4,000 midwifery students

– 11,000 medical and dental students

– 18,000 students in some of the allied health professions and other students

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eOptional slideBackground to the NHS Bursary Scheme – breakdown of the 18,000 AHP and other students

• 18,000 allied health professional and other students comprised of:– 500 audiology

– 1,000 chiropody / podiatry

– 500 dental hygiene and therapy

– 1,000 dietetics

– 4,000 occupational therapy

– 1,500 operating department practice

– < 500 orthoptics

– 5,000 physiotherapy

– < 500 prosthetic and orthotics

– 3,000 radiography

– 2,000 speech and language therapy

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The current arrangements for healthcare students

• Diploma students are entitled to:

– A non means tested NHS bursary

– Additional allowances to take account of their personal circumstances

• Degree students are entitled to:

– A means tested NHS bursary

– A loan from the Student Loans Company

– Additional means tested bursary for extra weeks they are required to attend university, over 30 weeks

– Additional allowances to take account of their personal circumstances

Location of study/residence

Bursary (2007/08 rates)

London (in lodgings or own home)

£7,443

Elsewhere or with parents

£6,372

Location of study/

residence

Maximum bursary (2007/08

rates)

Loan (2007/08

rates)

London (in lodgings or own

home)£5,425 £3,100

Elsewhere (in lodgings or own

home)£4,388 £2,210

At parental home

£3,375 £1,660

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The review of the NHS Bursary Scheme

• Announced June 2008 in ‘A High Quality Workforce: NHS Next Stage Review’

• Commitment to review the anomaly between diploma and degree nurses

• Opportunity to consider other changes to improve the scheme

• Consider the impact of the move of nursing programmes to degree level

• Led by key stakeholders on a Steering Group with representation from:– Trade unions (UNISON, RCN, BMA, RCM, Society of Radiographers and NUS)– Higher Education– NHS– Department for Business, Innovation and Skills

• Used evaluation criteria to assess options

• Commissioned new research and considered the available evidence

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The scope of the review

Within the scope of the review

• basic bursary award and loans• anomaly between diploma and degree nurses

Not included in the review

• tuition fees (these will continue to be paid)• eligibility for the NHS bursary• other allowances and reimbursments

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Evaluation criteria

• It has been agreed that the proposed scheme should aim to meet the following criteria ……

Legal requirement• Is legally compliant• Will have no adverse impact on equality

Essential/should do

• Removes the anomaly between diploma and degree• Provides a reasonable level of support• Does not create inappropriate student debt• Provides value for money• Is affordable• Has robust administrative and infrastructure costs• Encourages students from a wide range of backgrounds• Is coherent with wider Government policy and funding• Is sufficiently flexible to take account of forecast changes in workforce demand• Attracts and retains students up to the point of qualification

Desirable/would like to do

• Is easy to apply for and understand• Addresses other anomalies – different arrangements for medical and dental students, different arrangements for reimbursing travel expenses and local ‘top-ups’ of the bursary

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The options

• There are five main options:

– Option 1 – retain the current scheme

– Option 2 – provide a means tested bursary and a non-means tested loan to all students

– Option 3 – provide a non-means tested bursary to all students

– Option 4 – move to same scheme as other students (e.g. those taking a degree in Economics)

– Option 5 – employ all students on the minimum wage

• And the options have been further broken down and split into two groups:

– Group 1 (chapter 6) – options that could be implemented within the current bursary budget

– Group 2 (chapter 7) – options that would require additional funding

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The questions

• The consultation asks you to consider:

1Which three options, in priority order, would you support from chapters 6 and 7? (Including at least one options from each of chapter 6 and chapter 7)

2What benefits you would expect to be achieved if your preferred option(s) were implemented?

3 Do any of the options have a significant negative impact on equality?

4 Do any of the options have a significant positive impact on equality?

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eThe options – Group 1, Chapter 6(can be implemented within the existing budget)

• Option 1 – retaining the current scheme

– Diploma students would continue to be eligible for a non-means tested bursary, and degree students for a means tested bursary

Location of study/residence Bursary

London (in lodgings or own home) £7,443

Elsewhere or with parents £6,372

Location of study/residence Maximum bursary Loan

London (in lodgings or own home) £5,425 £3,100

Elsewhere (in lodgings or own home) £4,388 £2,210

At parental home £3,375 £1,660

Diploma students

Degree students

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eThe options – Group 1, Chapter 6(can be implemented within the existing budget)

• Option 2 – providing a means tested bursary and a non-means tested loan

– Option 2a – the loan would be set at the current rate for NHS funded students and the balance of the funding would be used to provide a means tested bursary

– Option 2b – the loan would be set at the current rate for NHS funded students and a non-means tested bursary of £1,000 provided for all students. The remaining balance of the funding would be used to provide a means tested bursary.

– Option 2c – the loan would be set at the current rate for non-NHS funded students and the balance of funding would be used to provide a means tested bursary.

Option 2a Option 2b Option 2c

Location of study/

residenceMax

bursaryLoan

Max bursary*

LoanMax

bursaryLoan

London (in lodgings or own home)

£6,450 £3,100 £5,950 £3,100 £3,950 £6,315

Elsewhere (in lodgings or own home)

£5,250 £2,210 £5,000 £2,210 £3,150 £4,510

At parental home £4,100 £1,660 £4,050 £1,660 £2,350 £3,495

* Includes the £1,000 bursary provided to all students

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• Option 3 – providing a non-means tested bursary to all students

– Option 3a - All students would be eligible to a non-means tested bursary, the rate of which would be set on the basis of the funding available in the existing bursary budget

Location of study/residence Bursary

London (in lodgings or own home) £7,300

Elsewhere (in lodgings or own home) £5,950

At parental home £4,700

The options – Group 1, Chapter 6(can be implemented within the existing budget)

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Group 1, The options so far – case studies

Option 1 Option 2a Option 2b Option 2c Option 3a

Bursary each year £4,325 £5,350 £4,850 £2,850 £6,200

Loan each year £3,100 £3,100 £3,100 £6,315 N/A

Total annual funding £7,425 £8,450 £7,950 £9,165 £6,200

Max. level of student debt at end of course £9,300 £9,300 £9,300 £18,945 N/A

Vivienne is 25 and studying for a nursing degree in London. She is independent of her parents and has no income of her own whilst studying. Her course lasts for 41 weeks.

The table below shows how much funding would be available to Vivienne under each option.

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Option 1 Option 2a Option 2b Option 2c Option 3

Bursary each year £185 £1,063 £1,000 £0 £4,640

Loan each year £2,210 £2,210 £2,210 £4,510 N/A

Total annual funding £2,395 £3,273 £3,210 £4,510 £4,640

Max. level of student debt at end of course £6,630 £6,630 £6,630 £13,530 N/A

Group 1, The options so far – case studies

Simeon is 21 and studying for a physiotherapy degree in Northumbria.He is dependent on his parents who have a combined incomeof £50,000. His course lasts for 35 weeks.

The table below shows how much funding would be availableto Simeon under each option.

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eThe options – Group 2, Chapter 7(would require additional funding)

• Option 2 – providing a means tested bursary and a non-means tested loan

– Option 2d – the loan would be set at the current rate for non-NHS funded students with a maximum means tested bursary to provide sufficient funding to bring student income up to a defined level – additional cost of £220m.

– Option 2e – the loan would be set at the current rate for NHS funded students with a maximum means tested bursary to provide sufficient funding to bring student income up to a defined level – additional cost of £240m.

Option 2d Option 2e

Location of study/

residenceMax bursary Loan Max bursary Loan

London (in lodgings or own home)

£6,900 £6,315 £10,100 £3,100

Elsewhere (in lodgings or own home)

£6,400 £4,510 £8,700 £2,210

At parental home £5,600 £3,495 £7,450 £1,660

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eThe options – Group 2, Chapter 7(would require additional funding)

• Option 3 – providing a non-means tested bursary to all students

– Option 3b – the bursary would be set at the current rate for diploma students – additional cost of £30m.

– Option 3c – the bursary would be set at a level sufficient to bring student income up to a defined level – additional cost of £340m.

Location of study/residenceOption 3b

Bursary

Option 3c

Bursary

London (in lodgings or own home) £7,450 £13,200

Elsewhere (in lodgings or own home) £6,350 £10,950

At parental home £5,300 £9,100

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eThe options – Group 2, Chapter 7(would require additional funding)

• Option 4 – moving all students to the same scheme as other students (e.g. those taking a degree in Economics)

– All students would be treated in the same way as other students in higher education and be eligible for a means tested grant and loan which is partly means tested (28%) – additional cost of £260m.

Household income Grant

£17,910 or less £2,765

Between £17,911 and £38,330 Partial grant

Over £38,330 No grant

Location of study/residence Max Loan

London (in lodgings or own home) £7,285

Elsewhere (in lodgings or own home) £6,248

At parental home £4,639

From 1 September 2009, students with a household income of up to £25,000 will receive a maximum

grant and those with an income of between £25,000 and £50,000 a partial grant.

In 2007/08, 25% of the loan was means tested. Students who are awarded a grant will have their loan reduced by

that amount, up to a total reduction of £1,230.

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eThe options – Group2, Chapter 7(would require additional funding)

• Option 5 – employing all students on the minimum wage

– All students would be employed whilst they were studying and paid the minimum wage – additional cost of £840m (reduces to £780m if students under 21 are paid at a lower rate).

Location of study 18 – 21 year old rates Over 21 rates

London (inner) £12,218 £14,660

London (outer) £11,723 £14,066

London (fringe) £9,743 £11,690

Elsewhere in the UK £9,005 £10,805

Salaries are based on the NHS standard 37.5 hour week. From 1 October 2008 the rates increased to £9,337 (national) for 18 – 21 year olds and £11,216 (national) for those over 21.

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The remaining options – Group 2 case studies

Option 2d

Option 2e Option 3b Option 3c Option 4 Option 5

Bursary each year £5,800 £9,000 £6,350 £10,397 £2,765 N/A

Loan each year £6,315 £3,100 N/A N/A £7,415 N/A

Total annual funding £12,115 £12,100 £6,350 £10,397 £10,180 £14,660

Max. level of student debt at end of course £18,945 £9,300 N/A N/A £21,550 £0

Vivienne is 25 and studying for a nursing degree in London. She is independent of her parents and has no income of her own whilst studying. Her course lasts for 41 weeks.

The table below shows how much funding would be available to Vivienne under each option.

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The remaining options – Group 2 case studies

Option 2d

Option 2e Option 3b Option 3c Option 4 Option 5

Bursary each year £2,213 £4,513 £5,040 £7,351 £0 N/A

Loan each year £4,510 £2,210 N/A N/A £3,727 N/A

Total annual funding £6,723 £6,723 £5,040 £7,351 £3,727 £10,805

Max. level of student debt at end of course

£13,530 £6,630 N/A N/A £10,846 £0

Simeon is 21 and studying for a physiotherapy degree in NorthumbriaHe is dependent on his parents who have a combined incomeof £50,000. His course lasts for 35 weeks.The table below shows how much funding would be availableto Simeon under each option.

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Additional issues for consideration

1Should medical and dental students from less well off backgrounds be transferred into the NHS Bursary Scheme for the duration of their degree?

2What should be taken into account when considering whether new professions are added into the scheme?

3Should different levels of support be provided to students depending on where they are studying and living?

4How can the information about financial support that is provided to students be improved?

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eOptional slideIncluding medical and dental students from less well off backgrounds

Current arrangements• Eligible for an NHS bursary from year 5, or year 2 of the accelerated degree. In early years, eligible

for support from the Student Loans Company and are required to pay their tuition fees

Evidence• Students from lower socio-economic classifications are under-represented in medicine and dentistry

• Medical and dental students tend to leave university with higher levels of debt than those reported for other students circa £20,000

• Doctors in their first two years of employment are currently earning, on average, between £31,000 and £42,000 per year

Proposal• Students from lowest socio-economic classifications would be able to access the NHS bursary from

their first year– could reduce the amount of funding available to some students in these classifications but would significantly

reduce the amount of debt for all students included and would pay their tuition fees

• Would initially save £2m - £3m per year but costs would rise to £4m - £9m per year within 9 years as the money received from students repaying loans declines

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eOptional slideMechanism for adding new professions to the NHS Bursary Scheme

• A number of professions are not included within the scheme

• Propose a mechanism is established to assess whether new professions should be accepted

• Proposed that the assessment would normally consider:

– The problems of recruiting students to the profession or role– The costs associated with including the students within the scheme– The availability of support from other sources– Whether there are any particular groups that are likely to be under-represented

within the profession and whether financial reasons are a factor in this– The need for a consistent national approach

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eOptional slideDifferent levels of support depending on where students are studying and living

• In recognition of the different costs associated where students choose to live whilst they are studying, it is proposed that there are three different rates of NHS bursary support for both the maintenance award and the extra weeks’ allowance. They are:

– Students living in London in rented accommodation or their own home (highest rate)

– Students living outside London in rented accommodation or their own home (higher rate)

– Students living with their parents (lowest rate)

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eOptional slideProvision of financial information to students

• Need to improve the information for students so they are better informed about the support available and the rewards they can expect if they choose an NHS career

• Views are sought on:

– What the gaps are in the information currently provided?

– Who should provide the information?

– How and where should the information be made available?

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How to respond

• Read the full consultation document at http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_105110

• Complete the questionnaire that has been published alongside the consultation

• Return the questionnaire to [email protected] by 11 December