Fairer Funding for Student Nurses and Midwives Report

Fairer Funding for Student Midwives and Nurses University of Manchester Results

Endorsed by:

Foreword The progress that has been made so far with this campaign is more than we ever imagined when we first talked about our frustrations at our kitchen table. Approaching the final year of our midwifery degree it seemed so unjust that our maintenance loan would be cut by around a third in the very year that we were required to work more hours than ever before at both placement and university. When contacting student finance to address our concerns, their unsatisfactory response and claim that no other students had raised this issue before did nothing but motivate us to take the matter forward. Though this 'standard policy' is understandable for the majority of degrees, which typically finish around May or June, our course continues until September which leaves us with no funding available throughout the summer months. This situation is replicated for many other healthcare students including but not limited to nursing students, occupational health students and physiotherapy students. After discussing this with our peers it was apparent that we were not alone in our concerns regarding our dwindling finances, which encouraged us further to take the issue to the Students’ Union to investigate the scale of the issue and find out what measures could be taken. Through the help of the dedicated team that we have been fortunate enough to work with, we have been able to collect and collate data regarding the financial difficulties endured by students undertaking healthcare degrees. We are proud to present this report illustrating the impact that this financial cut has on a large number of Nursing and Midwifery students at multiple universities across the country. Hopefully these findings can help influence positive changes in the funding for such students, potentially easing the financial burden for future cohorts.

Thank you for taking the time to read this report.

Victoria and ZoĂŤ

The paper summarises and explains data collected in “Healthcare Students Funding” survey investigating nursing and midwifery finance issues at the University of Manchester. Findings, recommendations and conclusions imply no wrongdoing of any mentioned party and are based upon primary data gathered as part of the investigation.

Students from the University of Manchester School of Nursing, Midwifery and Social Work (NMSW) approached the University Students’ Union in October 2014 complaining of insufficient finance from the NHS and Student Finance. Students’ Union staff and students met a number of times to discuss the problems being faced and potential next steps. Meetings allowed students and staff to identify key funding issues related specifically to their courses. It became clear that problems were systemic, not only in Manchester, but across the country.

Some key factors were identified: -

3rd year Student Finance loan is reduced by 1/3 despite healthcare students remaining at university for a full 12 months.

High numbers of mature students and parents/carers means traditional funding methods are not necessarily suitable Reimbursement for academic travel costs often takes months leaving students without significant funds University of Manchester students are not eligible for multiple bursaries, grants and the hardship fund offered by the institution despite being some those most in need

It was decided that students and staff would conduct some initial exploratory investigations with a view to surveying all undergraduate students in NMWS. This data would be published and used to campaign and lobby Universities, the Higher Education Funding Council for England (HEFCE) and other associated bodies.

Context Finance available for NHS funded courses is different from a traditional undergraduate degree.

Whilst those studying a HEFCE funded course will receive maintenance monies directly from Student Finance, those on NHS courses receive maintenance from a mixture of sources detailed below. Students are entitled to: - An £1000 grant each year - Apply for an additional means-tested bursary of up to £4,395 per year. Students in London will qualify for more (up to £5,460)1 - Receive a reduced maintenance loan from Student Finance. This is less than students receive on the majority of courses at institutions. :2 - £3,263 for students studying in London and living away from the parental home - £2,324 for students studying outside London and away from the parental home 1

http://www.nhscareers.nhs.uk/explore-by-career/nursing/training-to-be-a-nurse/financial-support-for-preregistration-nursing-students/ 2 https://www.gov.uk/nhs-bursaries/what-youll-get

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- £1,744 for students living at the parental home Extra help is available for students who have a disability, long-term health condition, mental health condition, a specific learning difficulty or who have dependants

In-line with other institutions, The University of Manchester (UoM) offers a number of “in-house” bursaries, grants and funds to students to complement monies received from Student Finance.

However, almost all bursaries are not available to students on NHS funded courses, meaning nursing and midwifery students are not eligible to apply for these funds. This includes schemes such as the Manchester bursary which are designed to increase access to students from low participation neighbourhoods.

Nursing and Midwifery students also lack access to hardship funds offered by the university.

The Hardship Fund is not available to all NMSW students - only those from low income households or third year students can apply. Coupled to this, student nurses and midwives at the University of Manchester are not representative of the total student population. As a snapshot in the academic year 13/14: -

14.5% of nursing and midwifery students were from lower-participation neighbourhoods.

By comparison, the university average sits at 7.9% NMSW sees the highest non-continuation rate at UoM - 10.7% (average 6.4%) Nursing and midwifery students are generally less likely to get a 'good degree' (57% in school, average 69%) Students in NMSW are more likely to live at home, be mature or be student parents and carers

Data shows students in NMSW differ markedly from the wider student population and require different funding arrangements.

Results The survey was targeted at two key groups, current second and third year University of Manchester nursing and midwifery students and recent nursing and midwifery graduates from UoM. Results are drawn from an overall sample size of n=365, but non-response/automatic disqualification means this varies. A full breakdown of sample sizes can be provided on request.

Results: Poverty, Pressure and Payday loans Students were asked if their funding was enough to cover all of their expenses. 95% of respondents believe that the combination of their Student Finance Loan and NHS funding are not enough to cover all expenses. Throughout the survey, there were reports of students unable to afford the very basic essentials. One individual stated that they have “lived in poverty for three years” and another stated that they “have spent the last year on a sofa as [they] can no longer pay rent”. The survey also revealed that 19 respondents have had to severely restrict their diet as they could not afford food. One respondent stated that they “hoped they would have toast at

break because there’s no food in at home.” Another revealed that they had “a few weeks where [they] lived off cereal”. This food poverty has led to 16 food bank visits from 8 respondents and a further 7 respondents who stated that they are considering approaching a food bank for help.

As a result, 85% of respondents are forced to look to alternative sources of funding to cover their basic expenses. There are multiple cases where payday loans, credit cards, overdrafts and private loans are a vital source of funding. 15 respondents have used payday loans as a source of income with many students stating that they have relied upon them multiple times. Two respondents stated that as a result of their reliance on payday loan use they are now on monthly repayment plans, one of “£121 per month” and the other “£93 a month”. Within the testimonials, numerous other students discussed the high levels of debt that they had built up as a result of funding their course through these sources. One respondent stated that they “had to borrow £6000 to be able to stay at University”.

There were 42 respondents reliant on their partner and 172 respondents dependent upon loans from their family. This reliance has put a huge strain on many respondents’ relationships with their partners and families with one respondent listing it as “the most difficult [pressure of the course] as it puts a strain on all of my relationships”. Multiple respondents discussed the huge guilt they felt on relying on loans and gifts from family and friends. This feeling of guilt and worthlessness was especially prevalent amongst mature students with many highlighting that they felt like they should be “at an age where [they] can self-support”. The reliance on family members also has added an additional layer of pressure for some respondents. One stated that they were “the only person from [their] entire family who has ever made it to university...they feel like they need to help me, but barely afford to live themselves” Despite the fact that the School of Nursing Midwifery and Social Work, “does not encourage part-time employment” as both undergraduate degrees are full-time courses with 37.5 hours a week of compulsory attendance, 65% of all survey respondents have had to work part-time in order to fund the basic essentials.3 Numerous respondents also stated that due to their placement hours, they are only able to work night shifts and then have to attend lectures the next day. It is perhaps, unsurprising then that 72% of respondents stated that their financial situation had negatively impacted their wellbeing and 136 students stated their financial situation has caused them severe stress, with 30 explicitly stating that they feel exhausted due to their average working week. Testimonials from respondents describe feeling “burnt out”, “constantly exhausted and stressed”, “overwhelmed by everything [they] have to do in a week” and as though they’re undergoing “a huge test to see if [they] can cope under all the stresses of the job”. Furthermore, multiple respondents have stated working 60-70 hours per week and over 15 hours a day.

This extended working week makes it very difficult for nursing and midwifery students to deal with the stresses of the course or to “wind down after a demanding shift at placement”. 80 respondents specifically defined as having a mental health issue and 35% of these respondents 3

Bachelor of Midwifery (Hons) Student Handbook September 2012, p.145.

declared that their financial situation has severely exacerbated their mental health issues. One respondent stated that due to their lack of free time, they “find it very hard to make time for [themselves]” and that their “[mental health] issues may be getting worse”.

Results: Attainment and Retention Nursing and midwifery students have the additional expense of transport costs to placement.

Although, they are later reimbursed and students can receive funding if the distance to placement is further than the distance to University, many students “could not afford transport costs to placement in the first instance.” 33 respondents could not afford to pay the initial cost for transport to placements. One student described that after “a cycling accident”, they had to continue “cycling as [they] could not afford the transport costs to placement [and] did so with slow healing femur fractures”. Others spoke of having to choose between “a bus pass to get you to placement or food”. 17 respondents were so reliant on their part time work that they had to miss lectures or seminars.

Students were also asked if their financial situation had impacted their academic work and one student responded that that felt if they “were more financially sound [they] do think [they] would get better grades”. This response was corroborated by 39% of students who stated that they think their financial situation has negatively impacted their work. 36 students have actually failed or received marks below their average as a result of their financial situation. One respondent said that they “went from getting no grades below 75/100, to failing multiple modules and only attaining a 2:2 overall”. Another respondent noted that they “were falling being on work”, as they “couldn’t pay [their] internet bill so online modules can’t be completed on time.”

As the survey was open to recent graduates and those who had recently interrupted their studies, we received 7 responses from those who had not completed their course. 5 of these respondents cited their financial situation as their reason for leaving the course. One respondents stated that they had worked for “2.5 months without a day off” as “the £230 NHS bursary [they] received is not enough to cover rent”. Another stated that “finance was the most prominent issue on [their] mind at all times throughout [their] University experience” and as a result of their financial hardship they had to drop out.

Further to those who have already left their course, 120 respondents said they’d considered dropping out and 84% of these respondents said that their financial situation played a part in this consideration. 8 of these students were considering interrupting so that they “afford the last 2 years and be more financially stable” for final year due to the drop in funding.

Recommendations Students call upon the University of Manchester to: - Allow full access to bursary schemes and grants currently available to other students.

This includes full access to the Manchester Hardship Fund and Manchester bursary.

- Loan students money to cover travel costs up front prior to work placements commencing.

- Join students and lobby national government to improve the state of funding for student nurses and midwives.

Students call upon Jo Johnson MP, Minister of State for Universities and Science to: - Acknowledge the significant funding gap currently being faced by student nurses and midwives.

- Stop the reduction of the student finance loan in the third and final year of study.

- Increase the grant and bursary levels to reflect the intensity and length of course.

- Cater finance available for larger numbers of mature students and student parents and carers.