Sunday, 29 November 2015

I read the news today oh boy: it was all about changes to nurse education, Oh Boy!

Well the news we had all been expecting to hear finally arrived last Wednesday. The UK Chancellor of the Exchequer presented the outcomes of his Comprehensive Spending Review. The changes to the current arrangements which support the education and training of nurses in the UK had been long expected. The proposition to replace the current system where student nurse fees were paid for by the NHS with a student loan based approach, something all other students endure, was always on the cards. Many of us acknowledged that this was a possibility over a year ago when no agreement could be reached on the current so called ‘bench mark price’ system that pays universities the tuition fees for NHS commissioned students.

A year ago a no change moratorium was agreed between all the parties, which is due to end in September 2016. This was a sticking plaster solution that benefited none of those involved. Much work has gone on behind the scenes to try and ensure progress in resolving the increasingly difficult problem of paying for the preparation of the nurses we need in our health services. Last Thursday I joined my colleagues at the Council of Dean Health (CoDH) Executive to discuss the possible implications of the changes announced by the Chancellor. The CoDH is an organisation which represents the 84 universities providing NHS commissioned programmes. Without doubt, the CoDH has been the leading party in trying to negotiate an affordable solution with the Treasury.

The change to student nurses taking out student loans like all other students studying at university was always going to be controversial and spark high expressed emotion. There will be many who see this solution, which will be introduced in the 2017/18 academic year, as adding to the problem of a the growing nursing shortage in the UK. There is some merit in this claim. However, time will tell the extent of the impact on student numbers,. We currently attract nearly 5000 applicants a year, all trying to get one of the 700 student nurse places we are commissioned to provide each year. We are engaged in recruitment processes and selection activities every week of the year.

This is very different to when I started my nurse education. Back then there were only 14 students in my cohort, and we were taught by a Clinical Tutor, a Lecturer and a Head of School. I was 20 years old when I started. Today 60% of nursing students are over the age of 25, with the overall average age of student nurses being some 28 years old. Clearly this is a different demographic when compared with many of the students studying other programmes. Taking out a student loan aged 28 might be too difficult for some prospective nursing students to consider in the future. 

Thinking about these changes did make me recall what the world was like when I trained way back in 1975. Nursing programmes weren't taught in the University, but in Schools of Nursing located in hospitals.  I was paid £23 a week, and was given 2 free suits and 6 white coats to wear while at work (those were the days when it was thought that mental health nursing care was better provided with staff wearing white coats). £23 a week in 1975 is the equivalent to £158 today in 2015. I worked full time, and was on the rota and worked 12 hour shifts. Whenever I could, I worked overtime on nights most weekends.. 

During the 3 years of my training I bought my first house for some £6000, 2 of my 5 children were born, and I started a folk club. Two years in, I sold my first house and bought a smallholding in West Wales. Consequently, for the last 12 months of my training, I had a daily round trip of 80 miles, a journey I undertook in my trusty Citroen 2CV6. This magnificent little car could also carry goats, hay bales, as well as a growing number of children. However, back then there were no mobile phones, blogs didn't start to appear until the 1990s and the only texts to be found were those in churches. There were no smart motorways, indeed the start of the Welsh end of the M4 motorway was only opened in 1977. I remember the sheer joy of driving on it for the first time during that last year of my nurse training. So it really was a very different world. I know and accept that of course I am possibly guilty of looking at the past through slightly rose tinted glasses. 

We need to look forward to what the world expects of health and social care services. I am confident in the work of my colleagues who are developing new educational programmes. Such preparation will help ensure that nurses in the future will be fit for purpose as confident co-creators of their future alongside other professionals and service users. In a strange coincidence, one of my two children born during that time was also in the news last week. Sally is the General Manager of the Art Deco Trust, based in Napier, New Zealand. She had been working with the University of Auckland to assess the earthquake strength of Napier’s world renowned post 1931 heritage buildings. Apparently, according to a report in Te Waha Nui published last week, everything is looking good; the future of the many fine buildings is assured. Let’s hope UK nurse education enjoys the same future.