Any move to reduce the length of nursing degrees would be “high risk” and endanger the quality of nurse education, experts have warned.
They were responding to leaked reports that the upcoming NHS workforce – which has been delayed again – could include a proposal to cut short student nurse programmes by six months.
“Instead of fast-tracking degrees ministers should commit to investing in nurse education”
The plan, which would see nurse degrees shortened to two-and-a-half years and doctor qualifications down to four years, was leaked by an NHS source, The Independent reported.
The proposal has been criticised by nursing leaders.
Professor Peter Griffiths, chair of health services research at the University of Southampton, said making degrees shorter would mean something had to give.
“Nursing students are already under enormous pressure to juggle the demands of placement alongside the necessary academic learning,” Professor Griffiths told Nursing Times.
“Students struggle as it is, and unless this just means a significant downgrading of the education or practice component, it is hard to imagine how you can fit it all in.”
At present, the Nursing and Midwifery Council requires student nurses to complete 2,300 hours of their learning time in clinical practice and 2,300 hours in the classroom.
Professor Griffiths noted how shortages of clinical placements were a current barrier to training more nurses, but expressed doubt that any changes to nurse education would fall in the favour of classroom learning.
“Given the tendency to downplay the importance of academic education for nurses, it would be ironic if one result of this was to shift the balance of nurse education more toward the classroom – although in truth we have been overly focused on practice hours as opposed to the quality of the learning experiences in the past,” he said.
Professor Nicola Ranger, chief nurse for the Royal College of Nursing (RCN), said reducing time in the classroom for student nurses would be a “high risk” move.
“Training on the job or spending less time in education are both high-risk moves that could compromise the supply of highly skilled nursing staff needed,” she said.
“The real issue is the shortage of students, not the time it takes. The policy to fix these shortages is to cover the tuition fees and costs of university for nursing students to rapidly boost numbers.”
A House of Commons research briefing from earlier this month suggested that, while a record number of applications for nursing courses was reached in 2021 (53,990), they then fell in the following years.
The report showed that UK-based student applications had dropped by 20% for nursing courses, and 22% for midwifery, between 2022 and 2023.
It referenced research by The Health Foundation, which found that finance was a potential factor affecting nurse supply and had warned that “the shift to a student loans-based system imposed a significant extra cost on acquiring a degree in nursing… this significantly reduced the financial returns of working as a nurse, especially for older students”.
Professor Ranger added: “Instead of fast-tracking degrees ministers should commit to investing in nurse education and provide a fully funded plan to recruit and retain the nurses needed to safeguard the future of the NHS.”
Dr Crystal Oldman, Queen’s Nursing Institute (QNI) chief executive, said, speaking to The Independent, that a pilot scheme would be critical, if this proposal did go ahead.
“How are you going to ensure that those nurses who go through a shortened programme meet the requirements of the registered nurse and come out confident and competent and don’t jump out of the workforce because they’re not properly prepared?” Dr Oldman asked.
Meanwhile, the NHS workforce plan is also expected to support the expansion of nursing apprenticeships, as another means of addressing staffing shortages.
Nursing apprenticeships have existed in England in 2017, but NHS England chief executive Amanda Pritchard recently announced “tens of thousands” of nurses, as well as doctors, will be trained this way in the coming years.
This is also opposed by the RCN, which has called for funding to focus on university-based education for nurses.
The proposal to shorten nursing degrees remains unconfirmed by any official source, and a spokesperson for the Department of Health and Social Care (DHSC) told Nursing Times it did not comment on leaks.
However, the DHSC spokesperson added: “We are continually improving medical and nursing training and have introduced innovations including blended online nursing degrees and medical and nursing apprenticeships, alongside increasing the number of hours of simulated training, providing greater flexibility.
“There are record numbers of doctors and nurses working in the NHS and we’re on track to deliver 50,000 more nurses by next year, with over 44,000 more nurses in March 2023 compared with September 2019.
“The NHS will shortly publish a long term workforce plan to go even further, including projections for the number of nurses and other professionals we will need in five, 10 and 15 years’ time.”
When the workforce plan will be published remains unknown.
Steve Barclay, health and social care secretary, declined, when asked earlier this week by the national press, to say when it was expected.
Mr Barclay said the pandemic and “various things that have been happening in recent years” were the reason the plan is late.
NHS Providers deputy chief executive Saffron Cordery told BBC Radio 4, over the weekend, that she was also in the dark about when it would be released.
“We know that when it comes, it will be a very significant commitment of funding from the government because what we’re talking about is setting out the number of training places and the number of staff that the NHS needs over the next decade or so,” she said.
“What everyone has been calling for, and what Jeremy Hunt committed to in his autumn statement last year and indeed talked about in the spring budget, was a fully funded and fully articulated workforce plan for the NHS. So I think that we are talking about something to do with the funding of this plan.”
Meanwhile, The Times reported that the reason for the delay could be due to costs, citing a senior NHS source as saying that the prime minister and chancellor Jeremy Hunt “can’t agree the financial commitment”.