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Nursing courses expected to rise but placement capacity issues continue, says regulator

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The forthcoming removal of student bursaries in England has prompted an increase in the number of applications from universities to run nursing and midwifery courses, the professional regulator has said.

Since the switch to loans system for healthcare students was announced at the end of 2015, the Nursing and Midwifery Council has seen “a number” of universities either apply to run courses for the first time, or request approval to run additional pre-registration programmes.

“Increased numbers of approved education institutions may also impact on the availability of support for students”

NMC council papers

However, the regulator also noted there were ongoing problems this year with student placement capacity, which could worsen if increasing numbers of courses were set up.

The NMC was unable to provide Nursing Times with figures on how many new universities and courses had applied in the past year.

But in its latest council papers it confirmed two new universities had already been approved in 2016 – the University of Portsmouth and, in Scotland, the University of Highlands and Islands.

In a report within the papers, it noted the contrast to the two previous years in which only one university had sought approval to run a pre-registration course for the first time.

However, in the same report, as part of its annual assessment of course providers, the NMC found almost half (31) of 77 UK universities said placement capacity was an issue.

This has worsened since last year when the NMC found 15 out of 77 universities had reported problems with placement capacity in the previous 12 months.

It said this year’s problems were due to factors including increased student numbers and reduced placement provision due to reconfiguration of services, adding that 20% of universities reported having insufficient numbers of mentors.

“The things we can also be doing is not being quite so prescriptive about mentorship”

 Geraldine Walters

The regulator highlighted that this could become more of a problem if a larger number of courses were approved.

“Increased numbers of approved education institutions (AEIs) may also impact on the availability of support for students in practice learning settings. This has been identified as a key risk area in this year’s monitoring of pre-registration nursing,” said the council papers.

“Our intelligence already indicates that the availability of safe and effective practice learning environments is decreasing due to student demand, a shortage of mentors, lack of protected time and support for mentors, and budget restraints,” they added.

At an NMC council meeting last week when the papers were discussed, council member Professor Karen Cox, a nurse by background and deputy vice-chancellor at the University of Nottingham, noted problems with placements were a “sustained issue” and questioned what action the NMC was taking.

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Geraldine Walters

“Given the variety of groups [of students], the expanded number of providers and the expanded number of people who are going to be in the system, what does that mean in terms of thinking through the quality of the experiences and the support to colleagues in practice trying to provide that education?” she said.

The NMC’s recently appointed director of education, standards and policy, Dr Geraldine Walters, told the council the regulator knew practice areas were under pressure due to a lack of mentors.

She said that if the NMC identified safety problems within specific services – such as those related to staffing – it notified other system regulators.

“The things we [the NMC] can also be doing is not being quite so prescriptive about mentorship and encourage organisations to develop their own models, while making sure we still get the outcomes we need,” she said.

Dr Walters recently suggested at a separate event that the number of hours pre-registration student nurses spend on placements could also be reduced in the future to allow for more learning through simulation activities.

This is being looked at as part of the NMC’s ongoing review of pre-registration standards.

Jackie Smith

Jackie Smith

Jackie Smith

In an interview with Nursing Times following last week’s council meeting, NMC chief executive and registrar Jackie Smith said ensuring high quality placements was a “major challenge”.

“We’ve had plenty of feedback that there are concerns around placements and mentorship and the number of hours and the EU directive [laying out the requirement for 2,300 student hours to be spent in practice],” she said.

“We need a radically different approach, bearing in mind all that is going on in this arena and the prospects of new providers coming in and making sure we approve those according our standards and expectations,” she added.

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