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Poor maths and English barring ‘thousands’ from nursing career


Thousands of people have been rejected from nursing associate courses because they did not have the basic maths or English skills required, according to the chief executive of Health Education England.

Professor Ian Cumming told delegates at the chief nursing officer for England’s summit yesterday that this problem was proving to be one of the biggest “stumbling blocks” to making the workforce more representative of the population it served.

“The variations are absolutely immense”

Ian Cumming

He said: “We have had to turn away a large number of people, I’m talking thousands of people, who wanted to access training to become a nursing associate but they didn’t have the basic numeracy or literacy that was required.”

His comments about the new nursing associate role echo points made earlier this year regarding access to registered nurse education.

Professor Brian Webster-Henderson, chair of the Council of Deans of Health, which represents faculties of nursing in the UK, told Nursing Times the “biggest challenge” for universities in recruiting undergraduate nurses was around applicants not having adequate levels of maths and English.

To help widen access to nursing education, HEE was looking to work with “staff-side colleagues” to “put an offer there around numeracy and literacy”, Professor Cumming told the audience of senior nurses.

During the summit, he also highlighted an “immense” regional variation in undergraduate student nurse figures around England – with the north outstripping the south.

“We have seen quite a significant growth in undergraduate nurses in the north of the country and we have seen a lack of growth in nursing students in the south of the country,” Professor Cumming told delegates at the conference in Birmingham. 

He said in order to address this, best practice needed to be shared equally around all corners of England instead of happening in “silos”.

“The variations are absolutely immense and I firmly believe that if we can take this best practice, if we can encourage people to adopt this best practice, then that will get us a long way down the line to solving these real challenges we have at the moment,” he said.

In addition, Professor Cumming demonstrated the extent to which nursing numbers were struggling to keep up with increases in patient demand.

He said the level of patient interaction with clinicians in England’s NHS had more than doubled since 2005, from one million patients every 36 hours to one million every 17 hours.

“The average age of an undergraduate nursing student at university now is significantly lower”

Ian Cumming 

To keep up with this growth, the workforce needed to increase by 3% every year but nurse numbers were only rising by 0.9%, Professor Cummings said. He said there was a need to “grow all the routes” into registered nursing in this country.

However, head of HEE said that, in order to plug the immediate gaps, focus needed to be placed on retention, international nurse recruitment and return to practice.

During the session, Professor Cumming was also quizzed on the removal of the student nurse bursary. He admitted that the funding reforms had “definitely” had an impact on mature student recruitment. 

“Clearly if you look at the data the average age of an undergraduate nursing student at university now is significantly lower than it was when we had the bursary and when we had tuition fees funded,” he said. “So, it has definitely had an impact of mature entrants into nursing degrees.”

However, Professor Cumming highlighted how mature students were instead deciding to go down the nursing associate apprenticeship route into registered nursing.

“What we are seeing, however, is the route from trainee nursing associate to registered nursing associate and from nursing associate to registered nurse that is now on offer is attracting a much more mature group of people,” he said.

“So what seems to be happened is the 18-year-olds leaving school passionate about a career in nursing are accessing the undergraduate route and the people who would find it much harder to be able to give up work because they have financial commitments, children, mortgage, rent to pay etc are looking at alternative routes,” he added. 

He stressed that this was why it was ”really important” to keep pushing for the nursing associates to be a viable route to become a registered nurse as well as being a career in its own right. 

It was revealed at the CNO Summit that HEE had committed £42m for 2019-20 to create a 50% growth in nursing associate recruitment and support those in training.


Readers' comments (8)

  • Doesn’t surprise me in the least, I left school with about 6 Low grade CSE’s, 30 years later I decided on a change in career, and went to evening classes got my 5 GCSE’s and did a Btec course and now I’m in my final year at University (Adult Nursing). I’ve met a lot of HCAs that want to be nursing associates, but are not getting the support to gain the necessary qualifications to get on the courses. More support is needed.

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  • What about life skills over GCSE English and Maths - at C and above - just how valid are these anyway to make a good bedside nurse which is what the nursing associate is supporting the RN.

    It is sad state that we have set standards so high for our nursing associates who are meant to be more representive of local population and yet we are failing.

    They to be able to read and write true but who decides at what level? I am an older nurse and I seriously wonder how some of the newly qualified degree RN's ever got through with their command of English and ability to communicate in writing. I suggest we have a problem all round not just with nursing associates and we wil not be the only employer with these concerns.

    In meantime we need to make some serious changes to encourage and support those who want to progress in nursing otherwise staffing is only going to get worse.

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  • It is right, the focus should be on helping people to get the skills not ' dumbing ' down the entry requirements . I am sick and tired of nursing being the poor relative . Why should the standards be lower than the othe rprofessions? The biggest problem is the lack of the bursary. Perhaps Professor Cummings should revisit thsi instead ?
    It woudl be useful to see comparative figures for other professions

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  • Well said anonymous 8:33. Ruth May should also support the return of the bursary but she seems too busy promoting gender neutral nurse uniforms for children.
    The nursing associate role certainly dumbs down our profession, little wonder we are taken advantage of by the government when our own seniors don't actively support us.

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  • The profession should be degree level throughout no matter how one enters in initially.
    The job is hard the pay should reflect that once RN qualification is gained.

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  • I'm not surprised; education has been dumbed down all across the board. The only surprise is that it is still thought necessary to be numerate and literate when all you have to do these days is tick boxes on a computer, IT skills are probably more useful. People these days are becoming more and more robotic, try to show any initiative, or hold a controversial opinion, the computer will say 'no' and you get nowhere.

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  • My comment has been redacted. so much for free speech.

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  • Numeracy and literacy are essential to modern nursing and the entry requirements should certainly not be relaxed. If people don't meet the requirements they should be able to access support to enable them to do so. Allowing people to start a degree course without the necessary academic skills is setting them up to fail.

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