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Covid inquiry: Government considered cutting nurse training years

The government has considered reducing the number of years that nurses spend in training, to try and meet its 50,000 additional nurses target, evidence from the UK Covid-19 Inquiry has revealed.

Nurse leaders have responded to the revelation with concern, and have urged the government to confirm that plans to “cut vital education time” are no longer on the table.

“The government should confirm this plan is permanently off the table”

Patricia Marquis

The proposal to squeeze nurse training time came to light during Lord Mark Sedwill’s recent evidence-giving hearing at the UK Covid-19 Inquiry on 8 November.

Lord Sedwill, the former cabinet secretary, was running the civil service when the coronavirus pandemic began but resigned in September 2020.

During his session last week, a letter was shown which detailed discussions from a meeting between then prime minister, Boris Johnson, and then health and social care secretary, Matt Hancock, on 4 February 2020.

The letter, written to the Department of Health and Social Care (DHSC) by the private secretary to the prime minister, said the ministers had discussed plans to meet the target, set in 2019, to boost the registered nurse workforce in England by 50,000 by autumn 2023.

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The letter suggested that, to try and meet the target, the prime minister and health secretary had considered cutting the number of years that nurses spend in training.

It said: “We must overhaul nurse training, so it is fit for purpose, looking for instance at reducing the numbers of years in training or more ‘on the job training’.”

Meanwhile, the letter outlined other ways the government had planned to overhaul nurse training, including looking at adopting an Australian model of training, which has just 800 hours of practice learning compared to 2,300 in the UK.

In addition, the government wanted to look at “alternative/digital provision of courses” like those provided by the Open University, said the letter.

Nurse leaders have raised concerns about the proposals outlined in the letter and have called for clarity from the government about whether plans to cut nurse training are still under consideration.

Royal College of Nursing director for England, Patricia Marquis, said: “The plan revealed here to cut vital education time demonstrates a fundamental lack of understanding and respect for the importance of the training that nursing students receive and that is why we fight so strongly for the full university nursing degree course.

“The government should confirm this plan is permanently off the table.”

When asked by Nursing Times whether cutting nurse training time was still being considered, the DHSC neither confirmed nor denied, but said the recently published NHS Long Term Workforce Plan had set out government plans for reform.

The plan, published in June 2023, encouraged opportunities for more newly qualified nurses to join the Nursing and Midwifery Council (NMC) as soon as they complete their learning rather than waiting until the end of the academic year, which allows new registrants to start work up to four months earlier.

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Additionally, it cited the “welcomed” committment from the NMC to explore potentially reducing the number of hours that student nurses are required to complete on clinical placement before they can register.

These finalised pledges followed leaked reports earlier this year that the workforce plan would include a proposal to cut short student nurse programmes by six months, which was met by backlash from nurse leaders.

Separately, the letter presented to the UK Covid-19 Inquiry highlighted the “notable” increase in international recruitment that would be needed to meet the target.

“We agreed a stretch target of 50,000 additional nurses by autumn 2023, off a September 2019 baseline at the [prime minister’s] request,” said the letter.

“This will require us to ‘pull on all levers at once’ with notable additional international recruitment, while reforming domestic supply.”

Responding to this point, Ms Marquis said: “This is proof that the government’s infamous 50,000 nurse target was built on shaky foundations and that the unethical raid on the workforce of other countries was planned at the outset.”

She added that, in the four years since the target was established, demand on the NHS had “soared” and that the health service was “missing record numbers of nurses”.

“Long-term investment is needed to recruit and retain more nursing staff, not politically driven targets,” argued Ms Marquis.

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