1,000 student nurses to train on the job under apprenticeship scheme

Updated: 

Student nurses will be able to train on the job rather than having to do a traditional degree, the Health Secretary is to announce.

Jeremy Hunt will unveil plans for a new apprenticeship which could see up to 1,000 apprentice nurses joining the NHS each year.

The new role will sit with fully qualified nurses and another role, nursing associates, which has come under fire over concerns about "nursing on the cheap". 

Researchers argue that allowing health workers other than fully registered nurses to care for patients and carry out nursing tasks increases the risk of death for patients.

Unison has said the Government must tackle the shortage of nurses head on rather than look for "cheap alternatives".

Under the new plans, apprentice nurses could be on NHS wards from next September. They may include people who work as healthcare assistants or those already working towards nursing qualifications.

While nursing associates may wish to stay in their role and not progress to becoming a full nurse, apprentices are expected to fulfil all requirements to becoming a registered nurse.

Trainees will join the apprenticeship at different stages, depending on their qualifications and experience.

Mr Hunt will say: "Nurses are the lifeblood of our NHS, but the routes to a nursing degree currently shut out some of the most caring, compassionate staff in our country.

"I want those who already work with patients to be able to move into the jobs they really want and I know for many, this means becoming a nurse.

"Not everyone wants to take time off to study full time at university so by creating hundreds of new apprentice nurses, we can help healthcare assistants and others reach their potential as a fully trained nurse."

In a speech at the NHS Providers conference in Birmingham, Mr Hunt is also expected to tackle a central criticism of the new nursing associate role - that they are able to administer controlled drugs to patients.

Janet Davies, chief executive of the Royal College of Nursing (RCN), has described this plan as "ridiculous".

Mr Hunt will say that statutory professional regulation will be a necessary requirement for the new nursing associate role, under the stewardship of the Nursing and Midwifery Council (NMC).

He will say allowing nursing associates to administer medicines "means that a stronger regime of assurance is necessary to ensure safe and effective clinical practice".

He will add: "Nursing associates are not there to replace registered nurses but to support and complement them.

"But I have listened carefully to what has been said and agree that, on balance, statutory professional regulation is a necessary and proportionate requirement for this important new role."

Earlier this month, research found that patients were a fifth more likely to die in hospitals where nurses are replaced with less-qualified staff.

Patients also suffered poorer quality of care when the proportion of qualified nurses was diluted with lower-skilled nursing assistants, it showed.

Experts warned that diluting the skills mix - especially in England, which already has one of the lowest ratios of qualified nurses to other staff - puts lives at risk.

One of the researchers, Professor Peter Griffiths, from the University of Southampton, said the new nurse apprentice role could "provide real opportunity to those who are put off nursing by the onerous financial burdens since bursaries for nursing students were abolished".

But he added: "It will be important to ensure that these courses are just as rigorous as standard routes and that the programmes are properly evaluated.

"We have seen in our research that lower levels of qualification in the nursing workforce is associated with higher mortality. That relates to both qualified versus unqualified nurses, but also the academic level of qualified nurses."

The Department of Health confirmed that apprentices would receive a salary and this would be set locally.

Professor Jane Cummings, Chief Nursing Officer for England, said: "Many staff across our health and care system want to progress in their careers, but the traditional full-time university route doesn't work for everyone."

Unison head of nursing, Gail Adams, said: "Nursing degree apprentices need to be properly paid and supported or they'll be unable to balance studying for a degree with the pressures of work.

"And nursing associates shouldn't be a substitute for registered nurses. Jeremy Hunt risks diluting the vital work of nurses in providing compassionate and dignified care to patients."