Thousands of NHS nurses could be retained in their roles for up to 10 extra years if their student loans were forgiven, according to a new report published by the Royal College of Nursing (RCN).
Independent research, conducted by London Economics, found that a loan forgiveness scheme could retain over 14,000 nurses in the NHS over a ten-year period—equivalent to more than half of current nursing vacancies in England. The economic value of the additional work these retained nurses would provide is estimated at £1.162 billion per year, significantly bolstering both productivity and patient care.
The findings come as the government takes direct control of the NHS in England, and the RCN urges ministers to take responsibility for the workforce supply crisis. The report, released on Friday 21 March, is being described as a blueprint for halting the dramatic exodus from the profession and reinvigorating domestic nurse recruitment.
“A loan forgiveness model for those who commit to working in the NHS and public services would make nursing a much more attractive career,” said Professor Nicola Ranger, RCN General Secretary and Chief Executive.
“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.”
A Model for Retention and Reform
Under the proposed loan forgiveness scheme, nurses would have their tuition fees waived or repaid by the government in return for committing to work in the NHS or wider public services for a set number of years following graduation.
The RCN report shows that this offer could result in an additional 65,000 nurse-years worked in the NHS for each graduating cohort. Survey data from hundreds of nurses in England found that they would be willing to stay in NHS roles seven to ten years longer if their student debt were written off.
The findings have emerged amid an ongoing crisis in recruitment and retention. Between 2021 and 2024, the number of nurses leaving the Nursing and Midwifery Council (NMC) register within five years of joining rose by a staggering 67%, while the number leaving within ten years increased by 43%.
If current trends continue, the research warns that 11,000 nurses will have left the profession before reaching a decade of service by the end of the next parliament.
Education System ‘Broken’, RCN Warns
The report also highlighted deep-rooted challenges in the pipeline of new nurses, with England seeing a 35% drop in nursing course applications since 2021 and a 19% decrease in acceptances. Additionally, 21% of nursing students are now dropping out before completing their degrees—many citing financial stress as the main reason.
The RCN argues that the government’s 2016 decision to scrap bursaries and charge tuition fees has been a major barrier to attracting new students. From the academic year 2025-26, nursing degrees in England will cost students £9,535 per year, further increasing the burden of debt.
“Nursing and patients are being failed by a broken education system,” said Professor Ranger.
“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.
“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 highly skilled professionals.”
A Way Forward for the NHS
The RCN is urging the government to consider loan forgiveness not just as a retention tool, but as a catalyst for system-wide reform, helping to stabilise workforce numbers, lift the standard of care, and reduce reliance on costly agency staffing.
The report’s publication comes at a critical time for the NHS, with the workforce under intense pressure and vacancies in nursing remaining persistently high.
The RCN says the time for bold action is now:
“Nursing is an incredible career,” Professor Ranger concluded, “but we cannot afford to watch thousands walk away from the profession and for student numbers to collapse further. The cost of inaction is simply too high.”