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Mixed picture on potential for return to practice schemes


Support for former nurses wishing to return to the profession is patchy, with many struggling to access courses and some forced to organise their own work experience, a review by Health Education England has found.

Return to Practice (RTP) schemes are a key plank of the workforce body’s plans to plug significant shortfalls in the nursing workforce.

However, initial research has revealed a mixed picture − with potential for the idea, but also vast inconsistency in existing courses and support for people who embark on them.

The first stage of work to develop a Return to Practice campaign – being led by Health Education England West Midlands – found luring back nurses whose registration has lapsed could be a fast and cost-effective way to tackle current shortages.

“We need to balance the risk of providing flexible working with the risk of having gaps in the workforce”

Michelle Norton

The research found those returning to the workforce were often mature nurses with a wealth of experience. In addition, RTP courses had low drop-out rates and nurses return via this route often went on to remain in the profession until they retired.

However, the study uncovered “significant variation in practice and process”, said Michelle Norton, nurse leadership associate at HEE West Midlands.

She unveiled the findings at Health Education England’s first annual conference in London last Thursday.

Often nurses found it difficult to find courses in their local areas and, while practice placements were a vital part of RTP training, some nurses had to organise these themselves.

“Some courses identified placements for people but some won’t accept you on a course unless you had secured a placement,” Ms Norton told delegates.

She said many nurses wishing to get back into nursing said they had asked NHS organisations about doing placements but their requests had been rejected.

HEE West Midlands

Michelle Norton

Meanwhile, RTP nurses’ reported mixed experiences on placements. “The level of support can vary depending on their mentor and the capacity to support learning in that environment,” said Ms Norton.

The study also found the costs of RTP courses varied from £600 to £1,500 but those on the most expensive courses did not necessarily have the best experiences. Some returning nurses were offered bursaries to complete training while other had to fund courses entirely by themselves.

There was also big variation in the support available once RTP nurses were back on the frontline with the best schemes offering a form of preceptorship and ongoing supervision.

A key issue for RTP nurses was lack of confidence, said Ms Norton, who said employers needed to recognise they had different needs to newly-qualified staff.

Employers needed to explore options to make it easier for these experienced nurses – many with family and other commitments – to come back, such as allowing them to work as healthcare assistants while doing RTP training or more flexible rostering.

“We need to balance the risk of providing flexible working with the risk of having gaps in the workforce and the costs associated with that,” said Ms Norton.

The next stage in the work to develop a national RTP campaign will focus on improving the process such as ensuring nurses who wish to return can easily access information about courses. A number of new trial RTP schemes are set to be launched in September this year.

However, Health Education England currently does not yet have a clear picture of the level demand for courses and the numbers of people potentially interested in re-joining the profession.

Ms Norton said other work by Health Education England would look at ways to bring back nurses currently working in non-clinical roles and overseas nurses who had struggled to get their qualifications recognised in this country and so were currently working in healthcare assistant roles.


Readers' comments (11)

  • I have just finished a return to practice course.I would really like to go back to the NHS but am finding all the jobs on local wards require internal rotation.I am unable to do this as my daughter is only 14 and it is illegal to leave a child under 16 on their own overnight.Therefore I am going to be joining the private sector in a nursing home.
    I was blessed to have been funded at the last minute by Kings Fund for Nurse Education, otherwise I would have been looking at £998 price tag for my course.
    Placements were an issue, but the University of Brighton where I did my RTP now charges every student £225 placement fee.This goes to the organisation that accepts the student on placement.That is proving enticing to employers, and helping secure placements.

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  • I too have just finished an RTP programme and was very lucky to have a supportive mentor and ward manager. However most NHS Trusts have adopted the 12/13 hour shift pattern with night and day duty within the same week. These are very long and tiring shifts that do not fit in with family life, or indeed 'normal' life, since it takes a day to get over your shifts! I will most likely return to the private sector.

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  • Hi, I have just read the nursing return to practice info and found it useful. I have really struggled with a RTP clinical placement. Unfortunately I was involved with a competency issue at work and reported to the NMC. My first post was in Theatre after qualifying, I was not getting proper training and an incident occurred. The surgeon put a swab in the op site, didn't tell me! I got blamed! The outcome of the hearing was that I could keep my registration but I will need to complete 350 hours clinical placement in order to return to nursing. (Criminals get less). I was told that hospitals are not contractually obliged to give nurses clinical placements like they do with students. So I'm stuffed, no placement, no more nursing. Please help, what can I do? One chance and you are out basically.

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  • Hi
    I am shortlisted to go on a return to nursing course but at 58 this year think I might be a bit too old - I understand that age cannot be discriminated against but would like to hear what other people think too.

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  • Anonymous | 27-May-2014 12:22 pm

    58 shouldn't be too old given the average retirement age. it depends very much on your personal level of fitness and ability to cope. if you are lucky enough to land a job which fits with these and the hours and number of days you wish to work you should be fine.

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  • I would not underestimate the stamina required to work the 12 hour shifts, nor the unpredictable, but usually relentless pace on the wards. You, nor the NHS can
    account for age, but there are age related changes, that are silent and perhaps not particularly obvious in current lifestyle. However rollout 12 hour shifts, being on your feet for the shift length, walking, standing etc and any inkling of osteoporosis could result in stress fractures etc.

    All RTP students should go for Occupational Health consult, or at least submit completed health declaration and course place is subject
    to successful OH.

    You will also be signing good health good character declaration ahead of starting , so if have any fears for own health, they too need discussed at OH consult.

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  • I am very fit and healthy, practice high performance sports, and in my mid-50s was always, and still am, told I look much younger than my age. I worked full time until 50 when I had to give up for a couple of years as a carer in my family (also a full time job, mentally if not always physically and on call 24/7).

    I stopped putting my age on my CV as I never got as far as any interviews but after that was offered quite a few. As I was unable to change direction in my career and find a job with more suitable and congenial hours, although i applied for all manner of jobs to fit my qualifications and experience, i also went for interviews in my own field of general medicine where I enjoy working. On one occasion, I was greeted by a friendly director of nursing but she took one look at me and asked how, at my age, I would manage the shifts? As i had gone to all the effort of getting there she kindly offered to introduce me to the ward leader, show me around the ward and then I could judge for myself - I liked the set up but with the shifts i would have been expected to work including internal night duty rotation, I opted for early retirement!!!!!!!

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  • I should add to my above comment I would not discourage others as a result of my own experiences as everybody's circumstances are very individual and differeent.

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  • I wonder how many of the "desperate" hospitals have considered the possibility of having SOME overlapping 6-61/2 hr shifts? While it would be less convenient from a scheduling standpoint, it might allow nurses to be able to continue their careers through their life rather than having it be an "all or nothing" lifestyle (imagine how many former nurses might be interested if they could continue working while their children were at school!).

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  • I have just done my RTP course and was pleased to read the above comments and article, as I agree with many of the above. I am also in my early 50's and think I was very naive when I decided to return to nursing. Finding a job with suitable working patterns and support is proving practically impossible. When I left nursing, 12 hour shifts were not the normal practice unless you worked nights. It is very tiring, difficult, (if not impossible) to adapt too these now common working practices, as well as putting patients safety at risk. I have read articles about the safety and individual health impacts of 12 hour shifts and feel strongly opposed to these practices. I also agree and believe that RTP nurses have different needs to newly qualified nurses and need appropriate support to address personal feelings of inadequacy and re build confidence. I presently have grave doubts of my decision to return to nursing!

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