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Should qualifications be based on competency not clinical hours?

A report by the University Alliance suggests that nursing students should be allowed to qualify on competency rather than on clinical placement hours

A report by the University Alliance suggests that nursing students should be allowed to qualify on competency rather than on clinical placement hours

Nursing students should be allowed to qualify on competency rather than clinical placement hours, says University Alliance.
Nursing students should be allowed to qualify on competency rather than clinical placement hours, says University Alliance. Picture: Barney Newman

Nursing students should be allowed to qualify based on competency rather than number of clinical placement hours completed, a new report suggests.

Additionally, NHS trusts should get more money to provide clinical placements for nursing students in a bid to tackle the workforce crisis.

Barriers to students entering nursing workforce

University Alliance (UA), an association of universities which collectively trains 30% of England’s nurses, suggests one of the barriers to nursing students entering the workforce is the Nursing and Midwifery Council (NMC) requirement to complete 2,300 hours of clinical placement to qualify, much higher than in other countries such as Australia and New Zealand.

UA instead suggests nursing students should be assessed on competency rather than having a fixed number of placement hours.

‘Time served on live placement does not necessarily correlate with competency, and the significant number of hours required places a strain on the NHS, who host the majority of clinical placements,’ the report added.

‘Universities could train significantly more nurses if the NMC moved to a regulatory framework based on competency rather than time served.’

NHS lacks capacity to provide clinical placements, says University Alliance

Workforce shortages also make it increasingly difficult to find staff with the capacity to supervise students on clinical placements. UA claimed it turns away thousands of applicants every year because the NHS ‘lacks capacity’ to provide placements required for nursing students to qualify.

One of the reasons for this is the difference in funding NHS trusts receive to provide clinical placements for nursing students versus trainee doctors, according to UA.

In 2022-23, NHS trusts received £30,000 to host trainee doctors compared to just £5,000 for nursing students.

NMC overhauls some of its education standards

While doctor education is longer and the fee most likely reflects this, a difference of £25,000 can be a deterrent for trusts to offer nursing students placements to complete their education, UA said.

The NMC has recently overhauled some of its education standards to allow educators to offer simulated education for up to 600 of the 2,300 practice learning hours to allow more flexibility in how the hours are completed.

The regulator said it was exploring possible further changes to its education standards around the number of practice learning hours required.

NMC senior nursing adviser Paula Jane Holt added: ‘We’ll need to work closely with our partners, drawing on research and evidence to understand the potential impact, and how best to maintain effective quality assurance.’

A government spokesperson said it was committed to boosting the NHS workforce, with 10,900 more nurses working in the NHS compared to 2021. But they did not address why placement providers were paid significantly more for trainee doctors.


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