Professor Dame Jessica Corner: 'We need to combat negativity – nursing is a wonderful career'
As the Council of Deans of Health chair prepares to stand down from her role after three years, she tells Nursing Standard why she supports the introduction of tuition fees for undergraduate nursing degrees, and remains cautious about the new nursing associate role.
As the Council of Deans of Health chair prepares to stand down from her role after three years, she tells Nursing Standard why she supports the introduction of tuition fees for undergraduate nursing degrees, and remains cautious about the new nursing associate role
Nurse education is undergoing major change in 2017, with new nursing associate and nursing degree apprenticeship routes to registration, as well as proposed changes to education standards. On top of this, undergraduate nursing degrees in England will, as of September, rely on a model of tuition fees and student loans, bringing nursing in line with related subjects such as medicine.
While this move is highly controversial, the outgoing chair of the Council of Deans of Health (CoDH), Professor Dame Jessica Corner, believes it is the right decision. Despite some unions linking the end of the bursary for nursing students to a 23% drop in nursing degree applications this year, Dame Jessica says the previous system was not sustainable. Funding and training places for nursing had been eroded, she adds.
Professor Jessica Corner elected chair of the CoDH.
'How else, given the funding and workforce crisis we face, could we have increased training places? In the end, I think we will look back and say the system change was the right way to go,' she says. 'It liberates universities to expand their training places and consolidates nursing as a science-based academic discipline within the mainstream of the university education system.'
As for the fall in university applications, Dame Jessica believes young people are being deterred from careers in nursing by 'constant negative media stories' about the NHS.
Degree funding model
'It's important we combat this: nursing is a wonderful career; it can take you anywhere,' she says. 'I’ve worked as a nurse in academia and research, as a charity director and now I'm a university pro-vice chancellor,' she adds.
Dame Jessica is proud of the work CoDH has done in helping the Higher Education Funding Council for England understand the costs involved in health degrees. 'STEM subjects and medicine got funding over and above the £9,000 fee funding model,' she says. 'We needed nursing to be recognised as a science-based subject, with a similarly high running cost.'
Accordingly, next year nursing, midwifery and allied health professional (AHP) subjects will receive £32 million in additional funding support. 'We did a lot of the analysis to let government departments understand what our costs involved and worked hard to get the understanding there,' Dame Jessica says. 'We'd like it to be more, but it's a good step and we've got to make sure it continues.'
Professor Corner is made a dame in the Queen's birthday honours for services to healthcare research and education.
Within the funding, there is also a 'student opportunity premium', which helps universities to support students from different backgrounds. 'Given nursing is already made up of many of those students, this money is good news,' she says.
On nursing associates and nursing degree apprenticeships, Dame Jessica sounds a word of caution. 'We fought long and hard for graduate status to be a right at the point of registration and nursing to be recognised as a serious and demanding job, doing many of the tasks doctors do,' she says. 'All of the evidence is that it’s safer to have graduate nurses in any clinical setting. So, there's a risk the nursing associate and apprenticeship roles will take us backwards. The problem is the thinking behind the roles has not been coordinated.'
Dame Jessica praises the decision that the Nursing and Midwifery Council will regulate nursing associates, but warns that support workers and assistant practitioners still don't receive 'proper training'. 'Yet we've invented a new role,' she adds. 'It's a diversion from the more important agenda to ensure we have a sufficient supply of graduate nurses, where there is currently a great shortage.'
She is also concerned that potential university undergraduates may see the new nursing degree apprenticeship as a better route into nursing. 'It may be more costly and difficult than the standard university training, which is the main way to train,' Dame Jessica warns. 'We need to align our thinking and not divert attention away from having sufficient numbers of nurses to graduate from training. Apprentices are still going to end up with a degree at the end, and they still need time to study, as well as have experience working in different environments and be supernumerary while doing that. It's not a simple route.'
Dame Jessica has also tentatively welcomed the new Nurse First scheme, which offers funded fast-track nurse training to high-achieving graduates from other related disciplines. While supportive of the programme's emphasis on career development and leadership, she says the CoDH is seeking clarification on details of scale, funding and location.
'Many universities already provide postgraduate pre-registration courses for graduate students who are among the most able applicants and are highly valued by employers for their problem-solving ability, critical thinking, engagement in evidence-based practice, professionalism and independence.'
At the other end of the scale, Dame Jessica believes there needs to be better capacity and funding in the system to enable more nurses to tackle doctorate-level roles. There are only 300 professors in nursing, accounting for about 0.05% of the workforce. According to Dame Jessica, that number should be closer to 6,000, or 1%, she says.
Dame Jessica elected a fellow of the Academy of Medical Sciences.
She also argues that nursing is still a gendered profession, and its research base and membership struggles to be valued in terms of science or taken seriously politically.
'How has the knowledge base for nursing clinical academia been valued over the past decade?' she asks. 'It hasn't. It needs a step change. There is funding, but is the architecture of funding working for nursing programmes?'
After three years as chair of CoDH, Dame Jessica will now continue with her role at Nottingham University as pro-vice chancellor for research and knowledge exchange.
She wants to remain 'connected to CoDH' and see answers to her questions unfold. 'I look forward to seeing the council continuing to influence the future of nursing.'
Brexit threat to research funding
Another topical concern is the looming impact of Brexit on the nursing workforce, given 6% of nurses in training are EU nationals.
Post-Brexit threats to research funding also loom large, says Dame Jessica.
'Our senior nurse researchers have done good work with European funding,' she says. 'The RN4CAST study comparing staffing levels and outcomes in hospitals and across the US was a European-funded study.
'It is unlikely work of this importance will be possible in future unless alternative funding models are found, as it looks unlikely that we will remain part of HORIZON 2020. Arguably, it's our most important research work and has been influential with NICE and guidelines around safe staffing.'