Last week’s announcement that an apprenticeship route into nursing is to be developed has caused quite a stir.
Despite vociferous opposition from the “too posh to wash” brigade – who maintain nurses do little that requires the ability to think, this year nursing finally becomes an all-graduate-entry profession. And the benefits of having a highly educated nursing workforce have been confirmed by the authors of a huge Europe-wide study, who conclude that all-graduate nurses could reduce preventable deaths. It seems unfortunate timing, therefore, to announce a scheme whereby “the brightest and best” healthcare assistants can skip the requirement to go to university yet still gain a nursing degree.
Although we don’t have all the details yet, it’s difficult to see how it will be anything other than a “degree-lite” if there is no requirement to attend university. It’s also difficult to see how a 50:50 split between theory and practice can be achieved, or how NMC-approved education providers can deliver the apprenticeship – unless non-university institutions are to be approved.
I can see the logic behind a scheme supporting the brightest HCAs to become qualified nurses, but if the current system of access courses doesn’t work, surely that should be improved? We need to enable those capable of gaining a degree to do so, but this must not involve anything that devalues – or even just appears to devalue – existing nursing degree courses. Universities won’t attract the brightest and best prospective students onto nursing degree courses that are perceived to be equal to apprenticeships.
However, while the academic integrity of the nursing degree must be protected, all-graduate entry has widened the gap between HCAs and nurses. It leaves a huge group of HCAs who are capable of providing high-quality, compassionate care but who don’t have the academic capabilities to gain a degree with little opportunity to develop their careers and improve their incomes.
Some employers are addressing this issue by improving career pathways for HCAs. These HCAs are being trained to take on more responsibilities specific to their individual roles and capabilities, and employed at band 4; their role could be compared to that of the old enrolled nurse.
Surely it makes more sense to improve career opportunities for HCAs than to risk devaluing the nursing degrees the profession has spent decades fighting for?