Has HEE got the balance between generic and specialist training right?

Changes to the make-up of nursing education warrant more debate

Health Education England’s (HEE) long awaited response to the Shape of Caring review report Raising the Bar leaves unanswered questions over the future of children’s nurse training, but also room for debate.

Nurse training
Health Education England’s report raises questions on children’s nurse training. Picture: Alamy

The new report accepts all 34 recommendations to overhaul nurse education and training made in Lord Willis’ review, commissioned in the wake of the Mid Staffordshire scandal. 

Raising the Bar focuses on developing a robust, generic and flexible nursing workforce. However, when it was published in March 2015, there were concerns over how children’s nursing fitted into this ambition.

2+1+1 system

The main area of contention for the UK Committee on Children’s and Young People’s Nursing was the proposal for a 2+1+1 system for education – moving from 1 year of generic training with 2 years of specialism to a 2-year generic preparation followed by a specialist year and 1-year post-registration preceptorship. 

Committee member Bernie Carter, professor of children’s nursing at Edge Hill University, Lancashire, believes halving the time for specialising means nurses would be less equipped with the in-depth skills required.

She says: ‘In a crowded curriculum it is easy for other areas of nursing education to be squeezed out.’

No decision yet

There is concern about the future existence of the 4 fields of nursing, which the Willis review recommended should be reconsidered by the Nursing and Midwifery Council.

The UK committee’s survey last year found 50% of children’s nurses would not have entered nursing had they not been able to specialise.

No decision has yet been made. 

Child health outcomes

London South Bank University head of children’s nursing Alison Twycross says: ‘Evidence indicates poorer child health outcomes in the UK than in other European countries.

‘Moving back to a model of generic nurse education, and removing the opportunity to study children’s nursing at a pre-registration level, risks this gap becoming larger.’ 

HEE director of nursing Lisa Bayliss-Pratt told NCYP that there would be more discussion.

‘Children’s nursing was identified as a key theme during our engagement on the Shape of Caring review,’ she says.  

Working together

A meeting was due to be held early this month and Professor Bayliss-Pratt says it will be a chance to agree how HEE and the field can work together for better outcomes for children.

Cardiff University’s senior lecturer in nursing and deputy head of school Dave Clarke says the ‘door is still open for debate’ over the RCN’s proposal for a separate education system for children’s and adult nursing.

This would include skills in mental health, learning disabilities, physical care and public health. However, this proposal was not included in the HEE response. 

‘The NMC has until 2018 to publish new standards,’ he says.


Raising the Bar

The HEE report sets out 5 priority areas that it hopes will be achieved through an overarching career and education framework supporting progression from care assistant to nurse consultant. These are:

  • Excellence in nursing practice.

  • Valuing and developing the care assistant workforce.

  • Ensuring meaningful patient and public involvement.

  • Flexibility in pre-registration education.

  • Standards for post-registration education.



  • HEE’s response to Raising the Bar here

  • Raising the Bar: Shape of Caring review here


Louise Hunt is a freelance writer


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