Nurses would stay in the NHS for up to 10 extra years if their student loans were ‘forgiven’, major report finds

The economic value of the extra work done could be over £1 billion, researchers say. 

NHS nurses would stay in their jobs for between 7-10 extra years if the government forgave their student debt, new research has found. 

Independent analysis, carried out by London Economics, found that forgiving nurses' student loans would retain over 14,000 nurses working in the NHS over ten years – enough to fill over half the current vacancies in England and give a major boost to the standard of patient care. The findings were published in an extensive report by the Royal College of Nursing (RCN) today (FRIDAY 21 MARCH). 

The new analysis comes as the government takes direct control of the NHS in England, with the College calling for the government to be accountable for workforce supply.  

A loan forgiveness scheme would see nurses have their loans ‘forgiven' by government in return for working in the NHS and wider public services for a period of time, following the completion of their degree. The RCN says it would be a highly effective way to ease the nurse retention crisis, improving patient care and paving the way for successful government health service reforms, in a series of recommendations.

Independent researchers calculated that the economic value of the additional work as a result of retaining more nursing staff is worth the equivalent of £1.162 billion a year, in a boost for productivity. If implemented now, the measure would result in the equivalent to an additional 65,000 nurse-years worked in the NHS per graduating cohort.

Latest figures show there has been a huge rise in nursing staff quitting the profession early since the pandemic, with a staggering 67% increase in the number leaving the Nursing and Midwifery Council (NMC) register within just five years of joining, between 2021-2024. The number walking away within 10 years increased by 43% during the same period.

If this trend continues, 11,000 nurses will have left the profession by the end of the next parliament without spending a decade in the job, the research found.

As part of the report, London Economics surveyed hundreds of nurses in England, presenting them with job roles with different benefits, including loan forgiveness, to measure their impact on retention. Nurses told the researchers they would be willing to commit to between 7-10 more years in roles that offered student loan forgiveness than roles that did not.

The report looked in detail at the domestic supply of nurses in England. It found that services are not only being hit by the failure to retain staff when in employment, but also by collapsing student recruitment and high levels of attrition during study.

There has been a 35% drop in applications to nursing courses in England since 2021 and a 19% decrease in acceptances, whilst 21% of nursing students will drop out before completing their studies. Of those currently considering quitting, 70% gave financial difficulties as their reason. 

In 2016, the government scrapped bursaries for student nurses and midwives, meaning tuition fees are now charged for these courses. Nursing degrees will now cost students £9,535 a year, from academic year 2025-2026. 

RCN General Secretary and Chief Executive, Professor Nicola Ranger, said: 

“Nursing and patients are being failed by a broken education system. The prospect of huge debt continues to put off the nurses of the future, whilst those that do enter the profession are given little reason to stay in their jobs. This results in too few nurses in our services and falling standards of care for patients, with the most vulnerable suffering the most.

“A loan forgiveness model for those who commit to working in the NHS and public services would make nursing a much more attractive career, boosting recruitment and retention. There is a clear economic case for this policy, providing great value for money to both the taxpayer and our public services. The government must give it serious consideration if it wants to transform patient care.

“Last week, ministers announced they will take direct control of the health service. They must now apply the same logic by undoing failed nurse education reforms and investing in the future supply of the highly skilled nursing professionals our services desperately need. Nursing is an incredible career but we cannot afford to watch thousands walk away from the profession and for student numbers to collapse further.”

Ends  

Notes to editors 

To read the full report, “Fixing the Leaking Pipeline: Measures for growing and retaining nursing students, apprentices and early career nursing staff in England”, please email mediateamhq@rcn.org.uk  

In 2024, London Economics conducted a survey of 5,441 RCN members in England, in which there were choice experiments to determine the effect of various factors on public sector retention. 328 Newly Registered Nurses, who graduated with tuition and maintenance loans, responded to a choice experiment where they were presented with alternative job roles with varying factors such as pay increases, loan forgiveness, flexible working and better nurse to patient ratios. The analysis found that, on average, nurses with student loans are willing to commit to 7-10 more years in a role that offers student loan forgiveness compared to a role that does not.

The proposed loan forgiveness model would see 30% of the loans be forgiven after 3 years' service, 70% after 7 years and 100% after 10 years of service. It would apply to those who work in the NHS and wider public services for a period of time, following the completion of their degree.

Introducing loan forgiveness for nurses in England would provide a societal benefit of £1.162bn per cohort (in Net Present Value terms), based on an additional 65,005 nurse-years worked in the NHS.

If this policy were implemented for 10 cohorts, starting with the 2024-25 cohort, then it can be estimated that there would be an additional 14,249 nurses working in the NHS, by the time the 10th cohort entered the workforce in 2036-37.

The number of people applying for and being accepted onto nursing programmes in England is declining. End of cycle 2024 data shows a 19% decrease in acceptances to nursing courses since the peak in 2021. As of January 2025, the latest data indicates that this downward trend is continuing, with the number of applicants falling from 24,680 in January 2024 to 23,730 in January 2025—a 4% decrease. The number of nursing applicants has decreased significantly across all four UK nations since the peak in 2021. England has seen a 35% drop. 

An average of 21% of nursing students leave before completion and 46% of students consider withdrawing from their degree programme at some stage. Financial reasons are the biggest reason for students to consider withdrawing (70% of students currently considering withdrawing told us that financial difficulties were a cause of this).

Since 2021, the number of UK-educated nursing staff leaving the Nursing and Midwifery Council (NMC) register within the first 10 years of joining has increased by 43%, including a 67% rise in those leaving in the first 5 years. 

There are 27,452 nursing vacancies in the NHS in England.