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Nursing leaders respond to apprenticeship route into nursing plans


Plans for new apprenticeships to fast-track healthcare assistants into nursing must not be used as a way to dilute the graduate-level profession nurses have worked towards for many years, say nursing leaders.

The Department for Business, Innovation and Skills last week announced a new programme targeted at the “brightest and the best” healthcare assistants already working in hospitals.

The Nursing Higher Apprenticeship will have a degree built into it and have to satisfy Nursing and Midwifery Council standards. It will be developed by a group of NHS organisations and private providers working with Health Education England.

Royal College of Nursing head of policy Howard Catton said he welcomed initiatives to widen participation in the profession but called for more detail on how the programme would work and be funded.

Above all he said it should not be seen as an easier route into the profession than a more traditional nursing degree. “This is not and at the current time cannot be and in the future must not be a way to circumvent an all-graduate profession,” he said.

“Some people have asked if this is an alternative route to become a nurse without being a graduate and I don’t think it is.”

Howard Catton

Howard Catton

He said the programme could have a role to play in bringing good people into nursing and addressing shortages of registered nurses. But there were big questions around the size and scope of the scheme and funding.

“We do not know what numbers we are talking about here,” he said.

Universities have questioned the value of the scheme because it would not tackle barriers such as lack of funding and “lack of equivalence of qualifications” with HCAs finding their vocational qualifications and experience were not enough to get on courses.

Professor Ieuan Ellis

Professor Ieuan Ellis

Professor Ieuan Ellis, chair of the Council of Deans of Health, said: “With the existing flexibilities in work-based higher education, it’s not clear what value this [programme] will add.”

Anne Marie Rafferty, professor of nursing policy at the Florence Nightingale School of Nursing and Midwifery at King’s College London, said the policy “raises more questions than it answers”.

“What will the academic value of this qualification be and is it enrolled nurses by another name?” she said.


Readers' comments (10)

  • Nursing is an all graduate entry profession. That means that you cannot become a registered nurse unless have a degree in nursing.

    The apprenticeship will have to have degree level study built into it and therefore it is difficult to see how this is innovative. Or why it is necessary.

    Most universities offering nursing degrees have broad mechanisms for ensuring those without traditional qualifications i.e. A levels can enter the programme and also that mature students and experienced HCAs can bridge into the degree.

    It seems rather a white elephant. The danger is that it is undermining the notion of university preparation for nurses, when the profession only won that battle just two years ago. I wait with interest to see how these Apprenticeships will be organised, educationally validated, (they have to be under the aegis of an NMC approved provider, so that should be interesting), and most especially, funded.

    Nursing is no longer a profession suitable for apprenticeship style training, that has been the case for over twenty years. It is very worrying that DBIS and especially HEE don't seem to be aware of that.

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  • As I have said many times it is enrolled nurses by the back door a good old government ruse.

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  • "The Nursing Higher Apprenticeship will have a degree built into it"

    So why are people getting their knickers in a twist? It is still the same standard of education as a "more traditional nursing degree", but in a different style.

    Also.. a "traditional nursing degree"? Since when did having a degree become a "tradition"? Nurses never used to be trained in Universities.

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  • To be perfectly honest the more nurses the better ......enrolled or university based. ... as long as desirable patient outcomes are achieved

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  • These nurses will not be ENs, but RNs, and it is just a different route to getting a degree. A degree is a degree and will of degree standard. There seems to be a lots of concern for graduate nurses, but what about these apprentice nurses who are already being tarred as second rate. It's not fair.

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  • Fabulous initiative and a very positive development for the profession. Brings forward skilled and knowledgeable health care assistants and creates job opportunities for young people.

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  • As a recent graduate I think this is a joke really. Its all very well saying that nurses were never trained at universities but does that mean we have to take a step backwards where nurses were slaving away with very low pay?.

    Nursing has seriously moved on from those days big time! look at the responsibility that nurses have today, most are now taking on doctors responsibilities! and i think i wouldnt have been prepared for all that if i didnt have to go through my degree and all those placements along with it.

    This idea is silly why cant they just support health care assistants in getting onto a degree course as it is now. There is no need to change things at all, but i do believe healthcare assistants that are experienced should be given a different route thats easier for them to get onto the degree experienced ONLY.

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  • The belief that there should be only one(graduate) entry to nursing is offensive to my intellect, experience and logic- all professions should allow entry by apprenticeship.
    The lawyers of the UK do it, so why should any other profession regard itself above the law.

    Nursing in particular is failing very badly at present and we need to carefully consider what patients need from nurses, and abstract or theoretical knowledge does not come high on the list. Good apprenticeship training on the job would be far better at developing nursing skills than hours at lectures in universities given by people who no longer-or who never-practice(d) what they preach.

    Tony Levi

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  • 30 years ago a drug round took a fraction of the time that it currently does and unlike today actually carried the security of two staff witnessing the patient actually taking the medication and not going down the sink with no time wasted in pleasuring paper verisimilitudes. The current application of habits like audit trails and universal accounting and apparent compliance evidence does not ensure this. Instead of 20 individually named boxes of paracetamol and the huge time investment in their trace management there was simply a bottle of them. SEN's enabled registered nurse to get on with the managing of shifts and the option of the disciplined order inherent in delegating to another nurse and avoiding the hazards of coordinating in comparison to a senior carer who resentfully knows their practice to be very often equivalent to the nurse but carrying half the pay and even rivaling via superior specific practice skills causing junior carers to identify with the 'predicaments' of the seniors consequent dilemma and even regarding the senior as prevalent especially in respect of a young inexperienced nurse needing the helpful role of auntie SEN rather than the quiet resentment of sister senior carer who knows that they do virtually everything that the nurse does and occasionally better. Care plans were read in the simple terms of who does what where when and how regarding direct care rather than the quasi academic notion documents governance-locked away from where they are most usefully sited, by the bed. The nurse now hopes that between the hopeless circle of infinite paper tasks that carers are practicing as they would have it whilst hoping that seniors are carrying the practice standards of what they would like to demonstrate but simply do not have the time unlike 1980 when they could ask their professionally connected colleague SEN to take over in a general and not the schizophrenic nightmare of differential current service provision often different bu too often scarily similar so throwing themselves into bursts of direct care presence..clinically 'hanging out' thus presenting competent control and relaxed expertise ensuring things are done in accordance with their passions whilst reminding everyone who is responsible and importantly, in charge and driving inspired morale at the right speed and in the right direction in chosen way and when when navy blue meant something.

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  • I dont see how three years of degree level study, after years of service as a HCA is a 'fast track' into nursing?

    I think the article headline is divisive right of the bat. It suggests that these HCA's will snatch nursing degrees with less effort and time than the university trained RN's. This breeds instant resentment without even giving the course, or the qualifying nurses, a chance.

    It is a misconception to believe that this will devalue university trained nurses, as the theory units, will be likely also set within the university. The approach will be focused in a different way, and intelligence is measured not by being within university but how skills and theory is encorporated into practice. Some people just learn differently in different ways, and it is not a reflection on their ability, or intelligence.

    Why is it, in nursing practice, we are trained to understand that patients are all different and their care needs will differ, hence the need for holistic practice, yet when it comes to our own, the holistic approach and understanding goes out the window?

    I am a hands on person, a do-er, with a canny knack of intuition in whatever I am doing. I also like academic challenge where I can explore and question theories put to me, but I do seem to soak knowledge better where I am there with a nurse telling me this is how, and why we do this, and then doing it on the job. I know my learning style.

    I would like to consider this course if they offer it to over 25's that is, but I feel it would be tainted by the few nurses who would look down upon me and my training because I learnt my practice in a different way, even if I still came away with a credited degree.

    The nurses who I work with are pleased this is coming, and think it is about time nursing recognised different approaches to qualification. They also think I should go for it.

    Lets see if age is not the decider.

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