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Exclusive: Returner courses failing to plug nurse staffing gaps quickly


Around a third of government-funded course places for nurses wanting to return to practice have failed to deliver additional nursing staff for the health and care service in the first 18 months since a national campaign launched, a Nursing Times investigation has indicated.

The Come Back campaign was set up in autumn 2014 by Health Education England to tempt former nurses back into the profession and help fill staffing shortages by paying their course fees.

NHS leaders have consistently cited it as part of the solution to the current nursing recruitment crisis, though when the campaign was launched HEE admitted it had no clear idea of the likely scale of demand.

Nursing Times can reveal that, in the first academic year of the scheme more than 1,000 course places funded by HEE could have been made available at universities across England, but a year and a half later only around 700 nurses had completed the course.

In addition, during the second academic year that the campaign ran, only around 270 people out of more than 890 possible course places had completed the programme after six months.

Course leaders said there were a range of reasons behind the findings, which are based on data supplied to Nursing Times by three quarters of universities offering return to practice courses.

“I firmly believe the return to practice programme has shown some great results”

Lisa Bayliss-Pratt

Some of the 28 universities said they decided not to take on the maximum number of HEE-funded places as they had never offered the course before and wanted to begin with lower numbers, while others said some participants took longer to complete than others because they studied part-time or continued in employment at the same time.

Others said the overall number of applicants was less than anticipated in their region. Another university said adjustments made to the length of their course and level of training meant applicants had reconsidered and decided not to take up their place.

In addition, one institution – the University of West London – was due to run a return to practice course in 2015-16 with HEE-funded places but cancelled due to the low numbers recruited.

Meanwhile, the University of Gloucestershire has not offered its course over the past two years and is in the process of phasing it out.

Previous efforts to fill nursing shortages saw 18,500 former nurses and midwives returning to work in the NHS between 1999 and 2004 following a centrally funded return to practice initiative.

HEE’s own data from its current campaign, collected from all participating universities in England, shows that around 800 people were employed as a nurse at the end of June – 21 months after the scheme launched.

The workforce planning body stressed it could take between three and 12 months for nurses to complete return to practice courses, that there were multiple start dates throughout the year and that it could take up to four months to secure a PIN from the regulator, which added delays to taking up nursing posts.

It also said universities offered “bespoke” learning packages of clinical hours for each student based on their time out of work and highlighted that the return to practice route was still a faster way of plugging workforce gaps than training pre-registration student nurses on three-year courses.

Health Education England

Senior HCA ‘bridging’ role will be piloted next year

Lisa Bayliss-Pratt

While HEE said there were some complexities involved in implementing the scheme, it maintained the initiative was a “quick and efficient way of boosting the current workforce”, adding that attrition rates were an average of 7%.

HEE’s director of nursing and deputy director of education and quality Lisa Bayliss-Pratt said she was “delighted” with the enthusiasm and interest shown in the scheme but noted there were complexities in delivering it.

“It is important to stress there are complexities involved in this work and it is simply not a case of one size fits all. We have to make sure that we take a number of factors into consideration in order to meet the needs of those nurses taking part,” she said.

“I firmly believe that the return to practice programme has shown some great results which is good news for patients but is also a quick and efficient way of boosting the current workforce,” she added.


Return to practice: A snapshot of how universities have fared

The data collected by Nursing Times via Freedom of Information requests in February found universities could have made at least 1,037 places available through HEE’s return to practice campaign during the academic year from September 2014 to August 2015.

But only around 79% of these possible places were filled. By the end of February 2016, 706 had completed the course from this cohort – around two thirds of the original maximum number of possible places.

Meanwhile, between the start of September 2015 and the end of February 2016 universities had a possible 891 places available funded via HEE, of which 83% were subsequently filled. By the end of February 2016 only 269 people had completed from this group.

The University of Worcester filled 26 funded places out of a possible 40 between September 2015 and February 2016, but no nurses completed in that period.

“The university is committed to supporting flexible study patterns”

Ann Cysewski

The university said that, while it could have been commissioned for up to 40 places, it was only paid for the number of students that actually entered the course, and that 11 out of 14 students from its autumn cohort had now completed.

A spokeswoman added: “The University of Worcester aims to be as flexible as possible regarding practice hours for candidates who have not studied in theory or practice for some time and therefore students are able to complete the hours either full-time or part-time.”

At Anglia Ruskin University, between September 2014 to August 2015 funding was available for a possible 50 places, but only 26 former nurses took up places. By February 2016, 21 people had completed the course from the cohort.

A university spokesman said: “The number of applicants was less than anticipated in our part of the East of England. However, most of those who have engaged with return to practice have successfully completed and also evaluated the course very positively.”

The University of Wolverhampton could have offered 60 funded places in the academic year starting in September 2014. It filled 31 places and by February 2016, 29 people had completed the course.

Meanwhile, between September 2015 and the end of February 2016 it filled all of its 32 HEE-funded places, but no participants had completed in that time.

“For us this has been a successful enterprise”

Bill Whitehead

Ann Cysewski, associate dean in the university’s faculty of education, health and wellbeing said the size of intake for the course had increased by around 60% in 2014-15 compared with the year before, and that eight students from the current academic year had now completed.

“The university is committed to supporting flexible study patterns taking into account their personal circumstances, as several students combine return to practice programmes with other employment,” she added.

At the University of Derby, 60 funded course places could have been offered in the 2014-15 academic year, but 38 ex-nurses took up places and by February this year 33 had reached the end of the programme.

In addition, between September 2015 and the end of February 2016 the university had 64 places available, resulting in 54 filled spaces and at the end of this period 17 former nurses had completed.

Bill Whitehead, head of the department for health care practice at Derby, said the university had decided not to offer the maximum number of funded places in 2014-15 because it was the first time it had run a return to practice course and wanted to ensure quality.

Bill Whitehead

Bill Whitehead

Bill Whitehead

“Essentially we have filled all the places we intended to fill on both occasions…For us this has been a successful enterprise. The numbers we are counting is the number we recruited and the attrition from those is very small. So we’re not looking at the absolute maximum amount we were allowed to recruit to,” he told Nursing Times.

However, he did say his university was involved in discussions with the Nursing and Midwifery Council – which sets standards for nurse education – and HEE about whether return to practice courses should be delivered in set timeframes, rather than the current flexible model.

The University of Northampton had 30 funded placed available between September 2015 and February 2016, but filled 21 and saw 8 nurses complete the course in that time.

Senior lecturer in return to practice Ros Wray said the University of Northampton had made adjustments to the length of the course and level of training in November which meant some applicants had reconsidered and decided not to take up their place.

“To support students to study at graduate level, our response has been to increase the course length and reduce our annual intakes from four to three cohorts in order to maintain the quality of our provision,” she said.

“Our response has been to increase the course length and reduce our annual intakes”

Ros Wray

Meanwhile, the University of Brighton saw 48 nurses take up funded places on its course out of a possible 60 between September 2014 and August 2015 and by February 2016, 35 had completed the programme.

In the first six months of the 2015-16 academic year, a maximum of 40 places could have been offered, but 31 were filled and by the end of February seven had finished.

A spokesman for the university said its 60 places last year were an upper limit and not a recruitment target and that while there was some attrition on courses most participants had gone on to secure nursing jobs.

It added that its estimated completion rate for this academic year was 94% and that course feedback had been “overwhelmingly positive”.


Readers' comments (7)

  • As a Return to Practice student I struggled as I was hospitalised and underwent major surgery and suffered a breavement in the space of a couple of months 2 months in. As I was trying to deal with grief as well as trying ro catch up with doing assignments and travelling up to an hour each shift working a 37.5hr week I struggled with the course getting no support.

    I would dearly love to try again as it is my dream to be a Registered Nurse to help fill this gap. It was only due to financial implications I had to carry on with the course. I feel if I had better support I wouldn't feel like I had let myself down.

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  • I just completed a RtP course, it took me 3.5 months to complete it. I had to fund my living expenses myself which involved me getting a loan from the bank although the course itself was funded. It went very smoothly for me and my uni was fantastic and very supportive. I had been out of nursing for 16 years and after 2 weeks back on the ward it all fell into place again despite the use of new technology and methods of working which were challenging! I urge you to try and do it if you are thinking about it. I am now waiting for my NMC registration back and have had a job offer, it can be done!!

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  • Rubbish! I have just completed the course. I started in Sept15 and worked full time throughout. I did my practice hours in my annual leave. It was the Uni that slowed the process down. It has taken my cohort 10 months to regain our pin no.s it could have taken 3 tbh. It was a frustrating experience and not one i would recommend. I have now got a job in the nhs which again was put under jeopardy by the uni's inefficiency in and set ways in telling the NMC. The return to practice course should be more flexible and not have to run alongside usual Uni protocol. If you want nurses back help them not as was in our case frustrate and hinder them.

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  • I have just completed a RTP course, although the course itself ran for 6 months it has taken the uni 4months to upload our names to the NMC for re registration. The Uni showed no interest in the needs of the participants in securing jobs and needing the process to be smoother and quicker. the NMC now are saying it will take from 6-10 weeks for our information to be uploaded. So all in all the course will have taken 1 year to complete and 6 months of that has been the slowness of the uni and the NMC..

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  • Surely one of the first lessons on a RtP course should be how inefficient the NMC is and how they will overcharge you for their inefficiency!

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  • I completed a RTP course. I was unemployed at the time and met with considerable obstruction from the job centre. They said I would almost certainly lose the bursary (no tuition fees and a £1000 bursary) and probably my benefits whilst doing the course. I filled in all the relevant paperwork and it turns out I didn't lose my money though this seems to be pot luck as I know of at least one student who had benefits withdrawn. The job centre made the process far harder than it should have been.

    The university was much as others have described. The timetable seemed hopelessly spread out so as a group we asked for the assignment date to be brought forward and I had completed within six months. It would have been a minimum of nine months if we'd stuck to the uni timetable and would also have meant submitting the paperwork to the NMC at a far busier time meaning that whole rigmarole would have taken longer.

    The course content was poor too. Things could definitely be improved with far more attention to changes in the time period students have been out of nursing and revisiting skills that may not be used regularly in all areas.

    Returning to nursing was the best decision I ever made. I just wish the course had been better. All of the real learning is done on the ward - nothing new there but the acute wards are frantic and staffing levels so poor it is hard for nurses to find adequate time for students.

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  • My partner has just completed an RTP course. Unfortunately they are wary of passing comment, however I will and I can say that (the funder) ie the Scot Gov/NHS needs to speak to the students privately to find out what the students really think re the RTP courses they have experienced.

    The course that we experienced has been poorly organised, many students have not been to University before and are unfamiliar with the help that is available (particularly IT) in writing essays or completing assignments. Many are good nurses who simply wish to get back to the job they used to do, after having families, unfortunately the RTP and the way it was "run" due to poor administration and leadership, has meant that students have waited far to long to get re-registered. Administration and communication seems to go from one person at a university to another, some including course tutors are just not available or have not replied to e-mails or followed up with a requested reference for registration paperwork completion, this delays things for weeks with the NMC (and is actually un-professional). In the meantime e-mails have come through from the gov't, asking students if they have found employment, and reminding them of the course fees that need to be paid if they don't get employment. Unfortunately Scotland covers a wide geographic area, and employment in one area may not compare with that in others, particularly students with family commitments or single Mums or Dads.

    The experience that we have had of an RTP, would suggest that many who attempt to get back to nursing through an RTP course (1 experienced) would seriously wonder if they have made the correct decision.

    There are serious problems with the particular course experienced, how it was run, led and administered, the support given to students, the lack of care for students and the way students are looked after to guide them back to employment. We are told that the NHS is short of caring people (Nurses) and its a concern that the lack of care shown by this course for RTP Nursing students has been allowed to happen. Who when funding is allocated, actually comes to speak to students individually to find out if courses are being run properly and that after completion, that courses are being improved to attract more ex-Nurses back to the profession.

    The RTP course experienced has been far from perfect. It needs to be checked out thoroughly before another batch of RTP students comes through the door.

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