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Every potential student nurse to face aptitude test in wake of Francis

Exclusive: Every potential student nurse will in future be interviewed and tested to make sure they have the right values and skills to provide good quality care, Nursing Times can reveal.

Robert Francis QC published his long-awaited Mid Staffordshire Foundation Trust public inquiry report last week, making 290 recommendations aimed at transforming culture in the NHS and safeguarding patients.

In light of the report, Nursing Times has been told plans are being drawn up to ensure anyone seeking a qualification to work in healthcare will have to demonstrate they have the right values and attitudes needed to care for patients.

The work is being led by Health Education England, the new national body responsible for ensuring high quality NHS education, training, and workforce development. It was set up in June as part of the government’s health reforms.

In an interview following the publication of the inquiry report, HEE chief executive Professor Ian Cumming accepted testing every course applicant was a challenge.

He said: “It’s not something that can happen overnight but I want to see anyone who is entering training – whether it be for nursing, medical or whatever it may be – to show they have the right skills to work in healthcare.

“If people can’t demonstrate the right values and behaviours they should not get jobs in our NHS. It is as simple as that.”

Professor Cumming said there were a number of ways to test applicants and that HEE would not seek “dictate” to universities which method to use. But he noted that HEE would be working with NHS Employers and others to develop a “series of tools” to test the aptitude and behaviours of students, suggesting universities would be encouraged to use a set of standard national tests.

The public inquiry report also recommended the widespread adoption of aptitude tests for qualified staff seeking employment. They are already used by some NHS organisations, especially in the mental health sector.

Highlighting his key message to “put patients first”, Mr Francis called on employers to check job applicants’ “values, attitudes and behaviours towards the well-being of patients and their basic care needs”.

They formed part of a raft of recommendations on education, training and standards in the NHS targeted at bringing about a cultural shift within the NHS.

For example, the report called on the government to “consider urgently” the introduction of a common “requirement of proficiency in communication in the English language” for healthcare staff.

The report also mooted proposals to increase the focus on the practical aspects of nursing care, with a similar increase in nurse development and leadership.

In addition, Mr Francis called for no students to be accepted on to a nursing course without having spent a minimum of three months working on the direct care of patients under the supervision of a registered nurse.

The report called for national standards in nurse training with the same examinations and a common qualification for all nurses.

Mr Francis also said more must be done to ensure trainee clinicians were able to speak up if they had concerns over the quality of care.

Professor Cumming agreed, saying: “We need to make sure trainees are able to report any concerns.”

“Feedback from trainee doctors and nurses is absolutely critical and one of the things we will be working on… is developing real time feedback from trainees on the quality of their training and the quality of care,” he told Nursing times.

Responding to the inquiry report, the Council of Deans of Health said in a statement it was “critical” that health education budgets were “ring-fenced” so the correct numbers of clinicians were coming through the system and continuing professional development for existing staff was maintained.

It said it recognised the report’s “challenge” to ensure education programmes “minimised the gap between theory and practice and emphasise care and compassion alongside technical skills”.

The government is expected to reveal its full response to the Francis report, including which of Mr Francis’s recommendations it will adopt, next month.

Readers' comments (47)

  • Well I never, the GNC test returns!

    July1972 aged 17, interviewed by a Chief Male Nurse and a Senior Nursing Officer, sent to the "School" to have a further interview with the Principal Tutor, then off into a room with another tutor and tested in maths and english against the clock before being sent back to the Chief Male Nurse and given my scores and offered a place. Nigh on a full day before I knew if I was worthy of a place .

    What goes around comes around!

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  • When I was a nurse manager I used to get invited to sit in on the selection process for student nurses. I recall once when reviewing a candidates interview (candidate having left the room) with the panel including course tutor, saying that regardless of whether the candidate was academically bright I would not employ them as a nurse on my unit. The course tutor responded saying that the candidate would achieve the academic requirements of the nursing degree and thus there was no reason to turn the candidate down.
    We need people who want to be nurses not people who want a degree. If you can get both then great.

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  • I went through the same as my friend above!!! I was so proud to have been selected.

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  • back to the good old days - thank goodness, am fed up with working with nurses who don't want to be there. let's make a return to selecting nurses for the right reason and open up the course for the right people.

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  • Phil Luff | 12-Feb-2013 11:34 am

    I had the same experience Phil, and stopped attending interviews as it was a waste of time.

    The pressure is on the Universities to fill places, so they may well "overlook" sub-standard candidates.

    If they do not fill the places their jobs are at risk.

    No contest.

    Bring back the school of nursing and a proper selection process that isn`t dependant on "bums on seats".

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  • michael stone

    This is still all about the 'attitudes' of clinicians - as numerous nurses are complaining that they are too overworked to 'display a caring attitude', clinicians really should not allow this post-Francis debate to concentrate on 'the attitude of clinicians' in isolation from things such as staffing numbers, ratios between HCAs/nurses, 'stupid obstructive diktats from above', unnecessary and time-consuming paperwork imposed from above, etc.

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  • The wheel is slowly becoming re-invented...

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  • this should also apply to everybody entering health care employment involving the administration and management of patient care who has not undergone professional training, regular evaluation, qualification and entry to a professional register.

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  • Agree with Phil Luff. The best of both worlds is attainable, but the selection process is clearly flawed. I have degree in nursing, but started out as a health care assistant. I knew I wanted to be a qualified nurse and had the correct attributes and practical experiences, but also had the academic ability to succeed. I love my job and couldn't think of anything else I'd rather do :)

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  • why can't we return to good, honest and caring human values and basic common sense in our society. concentrating on those who want a degree instead of those who want to be nurses with the option of getting a degree means a lot of excellent and caring people are slipping through the net and the others are passing through the sieve for the wrong reasons and ruining the reputation and ethics of the profession.

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  • As I recall back in the day hospitals had a cadet scheme. Leave school at 16 ( with or without 'O' levels) become a cadet, attend technical college 1 day per week, working towards additional educational qualifications, spend 4 days working in a department within the hospital, learning and understanding what made a hospital work, and then and only then, if you had the pre requisite educational qualifications or could pass the General Nursing Council entrance exam were you offered a place as a student leading to registration.
    Fail and you were given the option of pupil training leading to state enrolment.

    By the time you reached 18 and were let loose on the wards you knew if the career was for you or not. Many of my contemporaries who like me progressed through a cadet scheme remianed within the service until retirement and never lost an ounce of the passion they had years earlier even in the face of a changing service.

    I wonder how the hospital secretary, the two people in personnel, the 3 people in supplies the two records officers and so on and so forth would manage today?

    Keep saying that we shouldn't look back but I often wonder if we really have got it right...... somethings gone wrong somewhere!

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  • As a nursing student I totally agree that the ability to carry out compassionate care and to treat patients with the respect and dignity they deserve is an essential skill. There are many healthcare assistants who would love to commence their nurse training but are not given interviews because they are deemed to be not academically able. Surely the fact that they have experience in the delivery of patient care should have some bearing as to whether they meet the requirements.

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  • Yes I think maybe we threw the baby out with the bath water some years ago. Not all that we did in the '70's were great - remember the sisters who terrified all & sundry, the surgeons who behaved like the one on "Call the Midwife" recently, spending hours in the sluice if the sister had taken a dislike to you.
    However, we all knew what to do, where to do it & when. If you didn't, it wasn't long, like others have said, before you left.
    None of this report is rocket science & not new like many things that have come out in reports in recent years - theatre check list! Thought we already did that.
    As nurses, we have to take back nursing, be more proactive, demand resources back up by evidence to support the demands (clerks on wards for more than 7 hours a day to do all the paper work would be a start).
    We need role models who are not frightened to stand up but most of all, good nurses need to stand together and not look the other way, we cannot moan if we don't do anything about it. Senior managers and directors also need to start to listen to what those of us at the coal face have to say as we are the ones who have been there for years and probably going to be there for even more, unlike many of them who are just passing by.

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  • Maybe it is now time to pick the best aspects from traditional and post P2000. Lets combine them. When I trained I was one of the first through P2000. I attended the Romford school of nursing. This was at Harold wood Essex. I think it was a good compromise between the new and the old. My training was pretty rigorous, I couldn't escape critical eyes. I was monitored very closely. When i did something wrong on the ward my tutor knew immediately. The school was very close knit, and actually a great place to train.

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  • i find it strange how anyone could want to join nursing and not care about patients. Surely that is the point, or why bother.

    However, as someone who worked as a H.C.A for a couple of years. Then realised that health care was the correct path to follow, i did meet a few nurses who really had lost their passion.

    Was this due to being overworked, or just bitter people. I'm afraid i can't answer this. For me it has been a long road back in to education to get to the standard but i do think some people do it to get a Degree

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  • I have never met a student or newly qualified nurse who wasn't keen and compassionate. Maybe I've just been lucky. But the problem seems to be as time passes and the system crushes them, and that same enthusiastic caring nurse becomes exhausted, drained, emotionally and physically worn out. Shouldn't we be caring for the rest of our workforce too? I would like to see something that helps that student or newly qualified nurse hold onto the passion that drove them to enter the profession. We're thinking of rotating nurses out of frontline high intensity roles for short periods of a few weeks, as a pilot, to see if that helps reduce stress.

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  • the nobody - sadly I have met many students and NQs who don't like patients or nursing - also obviously met HCAs and staff nurses like that too.

    perhaps we should re-introduce the post qualifiying 6 months medical/surgical/care of the elderly placements that hospitals used to guarantee their NQ nurses - good all round experience for everyone.

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  • "I would like to see something that helps that student or newly qualified nurse hold onto the passion that drove them to enter the profession."
    the Nobody

    that something would be compassion from the very top of the organisation down. you have to instil a culture of compassion throughout the organisation instead of all the micro malicious sub-cultures which are rife such as secrecy,stereotyping, judgement, gossip, bully, ostracism, etc. we must all work together and communicate effectively with each other at a personal as well as electronic level in the interests of the patients and their care.

    as it stands in many institutions, stressed senior management pass the pressure down the lines and the worst ends up on the most junior and newest staff at the bottom of the pile.

    Staff need support and especially students and juniors, open, transparent non-judgemental, respectful two-way communications and all their questions about care, hospital policy, legal aspects of the job, organisational and managerial matters which concern them, etc. instead of just shutting them up and crushing them as so often happens.

    'get on with your job', 'i'm busy', 'you should know that', 'go and look it up in the library (knowing full well it is not possible to do this when the question arises or until after working hours)', etc. I am sure others could add many other responses to the list but how does that encourage people and especially students and new staff to question practice and learn?

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  • About time! I wonder if they will bring in psychometric testing. It will be interesting to see how they are going to measure compassion, empathy etc. Will they use situational judgement tests?
    Let's have nurses who want to be nurses rather than nurses applying for a freebie degree to avoid paying tuition fees and student loans!

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  • Maybe the only way to "measure" whether a potential candidate is right for the job is to give them a 6 month contract, working as a HCW, all the shifts, week-ends and "dirty" jobs, then decide if they come up to scratch or not. If they have

    If not, good-bye.

    Don`t think you can judge whether a person has the right qualities for nursing based on academic ability and an interview.

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