Your future nurses - the different routes to recruiting your workforce

Routes-into-nursing-Infographic

Until recently, the routes into nursing have been limited, with university degree education being the primary way to train registered nurses. However, the introduction of the nursing degree apprenticeship gives a new opportunity for employers to train nurses. On top of this, the creation of the new nursing associate role can also be a bridge between healthcare assistants and graduate registered nurses. 

All the new options for recruiting registered nurses can create a confusing picture for employers and so we have developed an infographic to support you to make the most of the new and existing routes into nursing.

You can also find out more about the different routes below.

Nursing degree apprenticeship

The nursing degree level apprenticeship was approved for delivery in time for roll out in September 2017 and provides a new route to becoming a registered nurse. It takes up to four years to complete, but this may be shortened with the use of Accreditation of Prior Experiential Learning (APEL) depending on the local higher education institution (HEI) requirements. 

Apprentices achieve the same standards as student nurses using the traditional university route and on completion will meet the qualification requirements to apply for registration with the NMC. With the removal of the student nurse bursary, the nursing apprenticeship could be an attractive route into the nursing profession, and may also increase social mobility and widen participation.

Costs to the employer will include paying the salary of each apprentice, alongside any additional training requirements not covered by the apprenticeship levy. The levy can be used to cover the cost of the training and end-point assessment up to £27,000, paid over the four-year period for each trainee. A percentage of the trainee’s time will need to be spent in ‘off the job training’ in order for them to progress through the degree and meet the statutory requirements to become a registered nurse and that learning time is protected through supernumerary status.
Alongside this the nursing associate role is being developed to act as a bridge between healthcare assistant and registered nurse. The intention is that on completion of their training, those wishing to become a nurse may be able to undertake the degree level apprenticeship using APEL to do a shortened course. 
Employers can find more information about the apprenticeship standard at Healthcare Apprenticeship Standards Online.

Employers will need to consider the capacity of their organisation to host additional staff and clinical placements when considering this route. 


Apprentices can be recruited from:
 
If recruiting from support staff such as healthcare assistants, assistant practitioners or nursing associates, or bridging programmes, you may be able to use APEL to shorten their training time.

Bridging programmes can be used to help upskill your existing staff and can include maths and English skills. They are designed to help learners to develop the study skills they need to progress and succeed in nursing and other health professional education programmes, including degree level apprenticeships. You can find out more about the Skills for Health bridging programme on our webpages.

University degree

Typically, entrants for the university nursing degree will need a minimum of five GCSEs at grade C or above, plus two A levels or equivalent level 3 qualifications. Some universities may ask for three A levels or equivalent but each university sets its own entry requirements. This has meant that for some staff, a university degree has not been available to them due to the academic requirements. 

The university degree takes three years to complete, although this can be shortened with the use of APEL depending on the local HEI requirements.

In 2015 the attrition rate for the university nursing degree was 20 per cent according to the Shape of Caring Review. Both NHS England and Health Education England have been working to reduce this and improve the experience of students on the nursing degree programme. The clinical placement is an important part of this, and therefore employers need to think about the placement experience they offer. You can find out more about what makes a good clinical placement on our webpages

With the removal of the student nurse bursary, students will need to pay for the course themselves which may require them to take out a student loan. 

Employers will need to consider the capacity of their organisation to host the students and provide clinical placements when considering this route. 

Students may enter the university degree programme from:

Employers may support their existing staff such as senior healthcare assistants, assistant practitioners or nursing associates, to do the university course on a part-time basis, or they may be able to use APEL to shorten their training time.

Employers can also use bridging programmes to help upskill their existing staff, including maths and English skills. These are designed to help learners to develop the study skills they need to progress and succeed in nursing and other health professional degree level education programmes. You can find out more about the Skills for Health bridging programmes on our webpages.

Post-graduate degree

Similar to the university degree, with the removal of the bursary, students will have to fund this route themselves. If you have any existing staff or are engaging with anyone in the local community who has a degree in a related subject, this may be a good route for them to take. It takes two years to complete, with the use of APEL. 

Employers will need to consider the capacity of their organisation to host additional staff and placements when considering this route. 

Return to practice

Since 2014, the return to practice programme has been available to qualified nurses who have left the NMC register and have not practiced for a while. It is a short course, provided by 40 HEIs across the UK, with a one-off cost of between £1,500 - £2,000. Nurses in training will need to complete between 80-150 hours (dependant on previous work experience and gap in employment) in a placement at a trust, which will require sign off by a mentor. 

Employers will need to consider the capacity of their organisation to host additional staff and placements when considering this route. 

International recruitment

Recruitment from outside of the UK has made a valuable contribution in the NHS over recent years and forms an important part of the workforce supply strategy of NHS organisations. Over recent years the Home Office has introduced several changes to the immigration system governing the way individuals from outside the European Economic Area (EEA) and Switzerland can work, train or study in the UK. 

Employers will be required to ensure that recruitment from outside the EEA is done using the current points-based system. This is an assessment that international recruits are required to carry out before entering the UK. The route used for nursing is Tier 2, which applies to skilled workers who are offered a sponsorship to fill gaps in the UK labour force. 

Nurses are also currently on the shortage occupation list, which allows employers to recruit internationally without the requirement to meet the minimum thresholds set out by the Home Office.

International recruitment from outside of the EEA can take up to 18 months, with six to 10 months before a nurse can arrive in the UK, followed by up to eight months in a pre-registration role. International nurses will then need to pass the IELTS and OSCE exams in order to be registered on the NMC and to be able to practice as a nurse in the UK. 

For an international nurse to stay in the UK for six years (the maximum they can stay without applying for leave to remain) it costs approximately £7,000. This excludes any health surcharges and other regulatory, relocation or agency costs. 

It may be that international staff are unable to meet the requirements to register as a nurse on the NMC register. Some trusts have created support or bridging programmes to upskill these staff and help them register in the UK. 

NHS Employers have published a guide which helps employers in the planning and delivering of a successful international recruitment campaign. 

You can find good practice on the different routes into nursing on our webpages.

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