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The future of nursing careers


Foluke Ajayi, head of NHS Careers and workforce supply at NHS Employers, examines the road ahead for trainee and qualified nurses based on evidence the organisation has just submitted to the reviews of pre and post-registration nursing

Based on responses from over ninety NHS organisations our evidence gives a clear steer on the views of employers about the future of nursing training and careers. So what might this future look like? A number of issues stood out as key for the profession and of particular interest to staff and the public alike.

A graduate-only profession?

The first is whether nursing should be a graduate-only profession. This question is one that has attracted a great deal of interest in both the trade and national media. Employers were of a clear consensus that the minimum academic requirement for a pre-registration nursing programme in the UK should be set at degree level.

There are two principal reasons for this. Firstly, it is believed that a degree requirement will help continue to raise standards and quality in nursing. Secondly, a large proportion of nurses who enter via the diploma route choose to top up to a degree at a later date. While this is usually encouraged by employers as part of continuing professional development, it does prove costly both in terms of financial assistance and the need for temporary cover while nurses are studying. For this reason it would be more efficient in terms of productivity, cost and quality and continuity of patient care if degrees were earned at pre-registration stage.

'It must be financially viable'

The responses we received made clear, however, that if we were to move to a degree-based system, we would have to give careful consideration to the issue of financial impact on prospective students. Currently the majority of nurses enter the profession through the diploma route, as diploma education is not means-tested while a degree is, and so the former route proves more financially viable for the majority of applicants. To avoid compromising recruitment levels or standards, therefore, any new degree-based system would have to be affordable for all applicants.

The second key issue was the content of nursing education more broadly. While employers feel that the degree route is the way forward for nursing education, this does not mean that nursing training would lose its practical content in favour of pure academia. Anything but: in fact, they believe that 60% of pre-registration programmes should be spent on practical learning, and that a third of the learning in practice component should be spent in the community.

Placement opportunities

However, we have been sure to stress that in order to increase this to half of the component within five years, as the NMC has suggested, we would need to ensure that an adequate number of placement opportunities were available for students; these could be, for example, in GP surgeries, the independent sector or in charities.

It was also clear from employers’ responses that they felt that nursing students would benefit from a comprehensive generalist training programme, designed to provide a broad set of skills upon which they could continue to build their specialisms over time.

This flexibility and focus on building a broad knowledge-base was also a distinct feature of employers’ responses to the Department of Health’s consultation on post-registration.

Post-registration training

Employers clearly believe that there is a need for change in the post-registration nurses’ career structure and would welcome a structured approach to post-registration nursing development. They feel the proposed changes would offer greater potential for nurses to develop flexible and transferable skills which can be applied in any setting, and that they offer a broader range of options for nursing careers in a community setting.

Employers welcome the proposals which will align nursing careers with the national NHS Careers Framework and develop new career paths for nurses.

What next?

The Department of Health and the NMC are now considering submissions to their consultations and we wait with interest their responses. What is without a doubt is that the future of pre- and post-registration nursing careers is set to change and nurses would be well advised to keep a close eye on the proposals as they develop.

Further information on the consultations is available on the NHS Employers website at


Readers' comments (6)

  • I feel that removing the diploma option will have a big impact on the amount of people choosing to train to be a nurse.

    I would have preferred to do the degree myself but due to living costs felt unable to do so. So having the degree option with a non-means tested bursary would have been beneficial for me.

    I feel that some people would struggle with degree level work, especially having to do a dissertation, plus an assignment and have a practice placment at the same time. Some people choose to become nurses because it is a more practical subject rather than academic. Some people may choose not to become a nurse due to the academic work that they would ahve to complete.

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  • This news concerns me a litle. I am currently on an access into nursing course, with the veiw to study at diploma level next spring. The idea of only training students at degree level in the future, would be detremental to me and my family.

    I am already relying on getting a bursary, my household would fall apart if no money came into our home for three years.

    Therefore if these changes come into effect before i am accepted into uni, i will have no option but to rethink a nursing career, and i would axpect many to follow in this decision

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  • Yet again I am in "despair " that the same old tripe is being seen as an "Advance" in Nursing, Pre. and Post qualifying. I have met too many "Nurses" with no experience of I/M INJECTION, BASIC ANATOMICAL KNOWLEDGE,HYDRATION IN ACUTE ILLNESS, NURSING THE UNCONSCIOUS and GENERAL MEDICAL CONDITIONS e.g.DIABETES. All these and much, much more were required for me to become competent and allowed to take "Hospital and State Finals". Yes , some of us are still alive and "kicking". Who replaces us!!!!!!

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  • Linda Semianiw leeds
    I like many people am working my way up with an NVQ level 3 but have been told that I may be too old at 51 to get any sponcerships this degree level will make it even harder for me the problem for anyone applying for nurse training is always going to be financial. The powers that be should help by upping the wages for any student so as they dont experience any hardship at all along the line then while nurses are training for a higher degree those who dont or feel they are not academic enough to do this would be there for the rest who do.

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  • how about the pay scales for nurses is it also going to change? because if you compare the pay scales for nurse in this country with other countries its quiet low and if the level education is going to go to degree level then atleast nurses should also be able to earn a well deserved graduate salary

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  • I disagree with having all graduate nursing workforce. This was not my background into nursing and am proud of the route i followed. I firmly believe my experiences as an enrolled nurse gave me the essential insights into basic nursing care that appear to be missing from many graduate, newly qualified, nurses skills clusters. i am currently a junior sister in a specialist unit.

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