The government must invest more in teaching staff and accommodation at universities if it is to meet its targets for nursing, midwifery and health professional students, says a National Audit Office report published this week.
Owing to a serious shortage of staff in the National Health Service, the NHS plan proposed an increase of 5,500 nurses and 4,450 therapists and other health professionals training each year by 2004.
The NAO report, Education and Training the Future Health Professional Workforce for England , reviews the effectiveness of arrangements between the NHS and higher education.
Sir John Bourn, head of the NAO, said: "The NHS and HE institutions must continue working together to improve value for money, to ensure more students complete courses, to reduce the constraints on providing practical experience and to invest in new capacity where needed."
The report found that universities and colleges had accommodated year-on-year increases in student numbers since 1994-95 while maintaining quality, but that "there were indications that the institutions were now beginning to reach full capacity".
It says that about one in six students did not complete their course. Karen Taylor, an author of the report, said: "We found attrition [dropout] rates for students who started in 1996-97 ranged from about 10 to 37 per cent."
She criticised government attempts to set a dropout target of 13 per cent for nursing and midwifery courses: "Some [institutions] are so far from this it is impossible, and for others it is too low a target."
The report is critical of the contracting system: "While the price per student has gone down in real terms, the costs and prices for similar qualifications at different universities varied greatly; many course contracts failed to specify outcomes; contract monitoring could be improved and the recovery of overhead costs was less than for non-NHS contracts."
Paul Turner, executive officer of the Council of Deans of Nursing, said:
"We are very encouraged that this report has recognised the increased need for investment in staff and buildings and has called for longer-term contracts."
The Audit Commission also published a report, Hidden Talents , on the training needs of the existing healthcare workforce this week.
It found: one-third of staff had not agreed training needs with managers in the past year; some NHS trusts spend five times as much as others on staff training; in a minority of trusts, more than a quarter of post-qualification nurse training places are not being used; and some groups, such as part-time staff and nursing auxiliaries, miss out on training.
The commission recommends that trusts work better with higher education to match training to service needs.