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.
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.
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.
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 http://www.nhsemployers.org/workforce/workforce-3133.cfm