Javid

My name is Javid, and I am thirty-four years old. I have spent the last five years trying to become a nurse practitioner in a health system that desperately needs nurse practitioners. This is not a story about my failure. This is a story about a system that claims it cannot afford to train the people it employs to ask for, even as those same people stand ready to learn and the training rooms sit empty.

I grew up in Sutton-in-Ashfield. My dad came here from Pakistan in the seventies and worked at the old colliery until it closed. My mum was a care assistant at a local nursing home. When I was sixteen, my mum was diagnosed with early-onset dementia. I spent my college years learning how to navigate care systems, sitting in waiting rooms, watching how thin the staffing was spread. The healthcare assistants were brilliant, but they were covering too much ground. The nurses were brilliant, but there were never enough of them. I saw the gaps every day, and I knew I wanted to help fill them.

After finishing biomedical sciences at Nottingham Trent, I worked as a healthcare assistant at King's Mill Hospital for three years. I loved the work, but I could see how much more I could contribute with advanced training. Patients would ask me questions I was not qualified to answer. I would have to fetch a nurse practitioner from another ward, adding delays to their day and mine. I decided to apply for nurse practitioner training through Health Education England East Midlands.

In 2019, I submitted my application. I scored highly on all the assessments. The feedback was positive. I was excited. Then the waiting started. The regional office told me applications were "under review pending budget allocation from NHS England." I understood. These things take time. Funding decisions are complex. I waited.

Six months later, they called. The Treasury had "constrained training budgets as part of fiscal responsibility measures." My cohort was cancelled. They were sorry. I was disappointed, but I understood. Money is tight. Everyone knows that.

I reapplied in 2020, this time through Nottingham University's direct entry route. I thought maybe a university pathway would be different. It was not. The admissions office told me they could only offer places that Health Education England would fund, and "unfortunately the funding envelope has been reduced." The woman on the phone sounded genuinely sorry. She said the demand was there, the university was ready to teach, but they could not run courses without the funding agreements in place.

I tried a different approach in 2021. I contacted Sherwood Forest Hospitals NHS Foundation Trust directly to ask about their training partnerships. Maybe if I went straight to the employer, they could find a way. The workforce development manager was helpful and honest. She said they had "seventeen vacant nurse practitioner posts but zero budget allocation for new training places." Seventeen posts. Real jobs. Real patients who needed those jobs filled. But somehow, there was no money to train people to fill them.

That was when I first started to notice the contradiction, though I did not fully understand it yet. I was standing in a hospital that needed nurse practitioners, speaking to a manager who wanted to train them, as a person who wanted to learn. All the components were there. But someone, somewhere, had decided that money was the missing piece that could not be found.

In early 2022, I booked a career advice session at the Health Education England offices in Nottingham. I thought maybe I was approaching this wrong. Maybe there was a pathway I had missed. When I arrived, I was directed to a meeting room on the third floor. Walking through the building, I saw an entire floor of empty training rooms. Modern equipment, rows of computers, simulation mannequins still in plastic wrapping. The receptionist noticed me looking and explained that they used to run three cohorts a year but "Treasury spending controls mean we can only afford one now, and sometimes not even that."

I sat in that meeting room looking out at a floor of unused training facilities, thinking about the seventeen vacant posts at Sherwood Forest, thinking about my neighbours back in Sutton who had healthcare qualifications but were working in Amazon warehouses because they could not get funded places to retrain or update their skills. That afternoon, walking home through the town centre, I counted them. Four people on my street alone. Sarah, who had been a physiotherapy assistant before her maternity leave and could not get back onto the register without a refresher course that no one would fund. David, who had nursing qualifications from the Philippines but could not get a conversion course place. Michelle, who wanted to train as a healthcare assistant but could not get onto the local college programme because the class was cancelled for lack of funding. And me.

The people existed. The training facilities existed. The vacant posts existed. But somehow, the money to connect them did not exist.

That was when I started to understand that "there is no money" was not an accounting fact. It was a political choice. The government that issues the pound, that prints every note and mints every coin, had told me it could not find enough of its own currency to train the people who were standing right there, ready to work in the jobs that were standing empty, ready to be filled.

I used to accept the excuse that "there was no money." I hear it differently now. When the workforce development manager said the budget allocation was zero, she was not describing a natural law. She was describing a decision. Someone at HM Treasury had looked at the NHS workforce crisis and chosen not to spend the money that would solve it. They had decided that creating nurses was less important than maintaining the fiction that government spending works like a household budget.

The real question was never about money. It was about whether the people existed, whether the skills could be taught, whether the equipment was available, whether the posts were real. They were. All of them. The training rooms were there. The hospitals needed the staff. The candidates were qualified and ready. The only thing standing between the problem and the solution was a political decision wrapped in the language of impossibility.

I am still here. I am still watching. I work as a healthcare assistant and I am good at my job, but I see every day what I could be contributing if someone in Westminster would stop pretending that the government that issues the currency cannot afford to spend it on the people who want to serve.

What happened to me is not unique to Ashfield or to healthcare. It is the story of every constituency where people and needs exist side by side while someone in a Treasury office says the cupboard is bare.