Nursing apprenticeships could put ‘both patients and apprentices at risk’

Previous research found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future.

James McKay
6 June 2018
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The Royal College of Nursing has warned MPs that the apprenticeship system risks putting both patients and apprentices at risk.

Speaking at the Education Select Committee, Janet Davies, Chief Executive and General Secretary of the RCN, said there was clear evidence that trainee nurses should complete degree-based training – which is safer and more consistent than the old-style apprenticeships.


Evidence from the Judge Report and Project 2000, both carried out in the mid-1980s, found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future. Under the old system, apprentices had to learn from an inadequate number of fully qualified registered nurses, which reduced both patients’ quality of care, and the quality of the training.

With more than 40,000 nurse vacancies in England alone, there are fears history could repeat itself with the new apprenticeship scheme.

The RCN claims that apprenticeships risk putting undue pressure on overstretched NHS services, as they place the responsibility for training staff on cash-strapped employers, instead of universities.

Apprentice levy does not cover the full cost of training.

Danny Mortimer, Chief Executive of NHS Employers, previously told the House of Commons Health & Care Select Committee that the cost was “probably something in the region of £125,000 to £155,000 over the four years of a nursing apprenticeship, and the levy will not capture all that cost.”


Nursing degree students fund their own studies and spend 50 per cent of their time in practice placements – where they can learn directly from experienced staff.

For apprenticeships to work as they must…

The Royal College of Nursing believe that the following steps should be taken to ensure apprenticeships works.

  • Ensure access to a variety of clinical placements across community, general practice, social care and acute settings to ensure nursing students have the necessary exposure and experience of working in different environments.
  • Ensure access to safe, effective and appropriate learning environments where nursing apprentices have protected time for learning and access to mentors and assessors. Currently, providers will struggle to meet this requirement due to the unprecedented pressure they are facing.
  • Protect the supernumerary status of nursing students. Any compromise to supernumerary status of nursing students would compromise patient safety as well undermine nursing students’ learning ability.
  • Ensure a robust quality assurance process is in place to make sure that patient and learner safety is guaranteed and that there is consistency is the skill, knowledge and abilities of all nursing graduates, whatever route they take into becoming a registered nurse.

We need to keep both students and patient safe.

Janet Davies, Chief Executive and General Secretary of the RCN, said: “The big challenge we have is ensuring we’ve got a proper environment where students can be students and where patients can be kept safe.

“Many of the Directors of Nursing that we talk to feel the cost of training has just been transferred from the Government to employers, who are already overstretched.


“We are currently working in an environment where we have 40,000 registered nursing vacancies. These are the people who have to be the mentors and supervisors and their focus has to be providing safe care to their patients.

“It is not chance that we have the level of vacancies that we have. This was because of poor policy, and saving money in the past. Apprenticeships themselves will not fix this. We need a whole picture of where we need investment in nursing education.

“Before the introduction of the graduate fee, 41% of people on nursing degree programs were over the age of 25. We know the representation of people from local communities and ethnic minority backgrounds was better than the rest of the student population.

“We need to have incentives for people to be able to have a university education as well as people having the opportunity via an apprenticeship. Both models need investment not just one over another.”

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