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Alison Twycross: Give more school-leavers a solid foundation for entry to nursing courses

Many young people just miss out on the qualifications needed to undertake a nursing degree course. The option of a foundation year would help them to make the grade and could ease the workforce crisis, says nursing professor Alison Twycross

Many young people just miss out on the qualifications needed to undertake a nursing degree course. The option of a foundation year would help them to make the grade and could ease the workforce crisis, says nursing professor Alison Twycross


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Most people living in the UK will be aware that there is a crisis in the registered nursing workforce, with around 40,000 unfilled posts in England alone. There are many reasons for this shortage, including incredibly poor workforce planning in the NHS for many years.

Media coverage of poor patient care and working conditions, along with relatively low pay, is likely to be contributing to a public perception that nursing is not a good career option.

Given this, it is perhaps not surprising that data from the Universities and Colleges Admissions Service (UCAS) suggest that by this year's 15 January deadline applications for pre-registration nursing courses were down 10% on last year.

A recent report by the House of Commons Health Committee highlighted key factors contributing to the nursing workforce crisis. Currently, one in eight adults in the UK works in health and social care. Just to maintain the status quo, we need to attract one in five school leavers into the health and social care workforce.

Longer-term solution

So, part of the longer-term solution to the crisis in the nursing workforce is to look at ways we can enable more school-leavers to access preregistration nursing courses.

The bottom line is that there should be a route into nursing for anyone who wants to be a registered nurse. By this I don’t mean that we should reduce the entry requirements for preregistration courses – this would, in all likelihood, just increase attrition from courses.

Nor do I think that everyone can or should be a nurse. Instead, we should identify ways of supporting more school-leavers to gain the qualifications required to commence a preregistration nursing course.

One solution could be to establish a foundation year for BSc nursing courses. Each year there are a significant number of applicants who just miss out on achieving the grades for a place on a preregistration nursing course.

Having a foundation year available would enable these potential students (and future registered nurses) to meet the entry requirements for the NMC-approved programmes. The foundation year would become one of several entry routes to a nursing course.

For students to access funding via the student loan company (course fees and maintenance grants) the course would need to be described as a BSc in (children’s/adult/learning disabilities/mental health) nursing with a foundation year.

Watch this space

Universities would need to validate a one-year foundation course plus a three-year NMC-approved nursing programme. Students would have to pass the foundation year to be accepted onto the BSc. The content of the foundation year would focus on ensuring students have the skills and qualifications to succeed on a BSc nursing course.

Could foundation year courses become a reality? We are waiting for the new NMC standards for nurse education to be released and do not yet know what the minimum entry requirements for courses will be.

At the moment, it is a case of watch this space while continuing to consider innovative solutions to the nursing workforce crisis.


Alison Twycross is editor of Evidence Based Practice and deputy dean, lead nurse and professor of children’s nursing at the school of health and social care, London South Bank University

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