COVID-19 advice for students and trainee nursing associates

In March 2020 the NMC introduced emergency standards for nursing and midwifery education which will be in place for the duration of the COVID-19 pandemic. As part of these new measures, students are being offered the option of choosing to work in a paid clinical placement.

In addition, the NMC considered introducing a temporary register for students in the last six months of their nursing degree. However, in May 2020 the NMC announced that this would not be necessary and so students will not be invited to join the temporary register.

The NMC’s information for students and educators sets out the various options open to nursing and midwifery students dependent on their stage of education. 

The option to undertake an extended paid clinical placement is available to you if you’re in the second, third or final year of your education, but is your choice. You should not feel pressured to do so.

Your university will be able to explain your options in more detail, taking into consideration your individual needs alongside practical considerations that exist locally.

If you decide not to accept an extended paid clinical placement, for whatever reason, you should not be disadvantaged by taking this option. Your educational provider is responsible for organising alternative options to ensure that you can continue to progress through your course and complete your programme on time. If this isn’t happening you should raise your concerns with your university tutor in the first instance. If you are still concerned and haven’t been able to resolve the issue do speak to your local RCN representative or contact RCN Direct on 0345 772 6100 for advice.

The RCN is clear that students deployed on placement to support the COVID-19 emergency response should receive fair pay for the work that they do – respecting the principles of the NHS Job Evaluation Scheme – and be given contracts with full employment status and employment protection, including contractual entitlements contained in the NHS terms and conditions of service. Deployed students must also have access to all the measures and protections put in place to support NHS staff during this exceptional time.

The RCN worked in partnership with health departments, employers and relevant educational establishments to agree the following for pre-registration students:

Mid programme students (second year and third year students in their first 6 months)

• England: students should be deployed to a suitable role defined by an existing job description that matches to the band 3 Clinical Support Worker Higher Level national profile
• Scotland: students will be employed at band 3 on a national contract with an agreed job description (employed by NES and deployed to relevant health boards)
• Wales: work is ongoing to produce a standardised job description for students at band 3
• Northern Ireland: students should be deployed at band 3 as agreed by the Department of Health.

End programme students (final year students in their final 6 months)

• England: will be employed on a band 4 contract (a template job description is provided for local use in the agreed guidance)
• Scotland: will be employed at band 4 on a national contract with an agreed job description (employed by NES and deployed to relevant health boards)
• Wales: will be employed on a band 4 contract (a template job description is provided for local use in the agreed guidance)
• Northern Ireland: such students should be deployed at band 4 as agreed by Department of Health.

There are slightly different arrangements for Honours Students on four year programmes in Scotland depending on their institution, which takes into account that students on some courses will have more to achieve to complete the requirements for NMC registration.

Further information

Guidance published by Health Education England for students in England, including a statement from HEE about arrangements until 31 July 2020. Student midwives in England should also see Health Education England's guidance on deployment. 

Guidance published by the Scottish Government for students in Scotland. Please also refer to these FAQs developed by RCN Scotland.

Guidance published by the Welsh Government for students in Wales. You can also find more information from RCN Wales.

Guidance published by the Northern Ireland Department of Health for students in Northern Ireland.

What support will I get in practice?

Your educational provider is responsible for offering you a suitable placement which will take into account your knowledge and experience around the environment you are asked to work in. Once on placement you must discuss your assessment of competence and confidence with the nurse in charge.

Students should work to the NMC Code of conduct, preserving safety at all times. Support will be provided for students on extended paid clinical placements to provide safeguarding for the student, existing workforce and patients. Students will remain accountable for the care that they provide. It is essential that students only undertake care that they feel they are competent and confident to carry out.  

What support will I get from the RCN?

Existing RCN members who are in the Student category on extended paid clinical placements will receive full support and representation as student members whilst they are on these placements.

Any non members who are students (in their final year of study) who join as a Student member (£10 per year or 84p per month), will receive full support and representation as student members whilst they are on extended paid clinical placements.

You can join the RCN online or to discuss your RCN membership, please call 0345 772 6100 and choose option 1 (Membership) or email membership@rcn.org.uk. 

Concerns about zero hours contracts and placement hours

The RCN expects employers to offer substantive roles to students taking on paid roles to support the pandemic response and does not generally consider that zero hours contracts are appropriate. If your contract is with an NHS employer (not a bank or agency contract) then you will be covered by the full NHS terms and conditions of service including those amended during this pandemic response. 

The RCN was a co-signatory with the NMC, other Royal Colleges and Trade unions of a joint statement on the deployment of nursing students which committed the Chief Nursing Officers across the UK to develop guidance covering terms, conditions and pay for students working in clinical practice. Each country’s guidance states that your working hours and pattern are a matter for agreement between you and the organisation you are to work in, and that those hours will be included in any future assessment of your progress to registration. The expectation from CNOs, the bodies responsible for nursing education (e.g. HEE in England and HEIW in Wales) and Universities is that you will be given enough hours so that you can enter the full register as expected.

If this isn’t the case you should raise your concerns with your university tutor in the first instance and the employer where you are placed but if you are still concerned and haven’t been able to resolve the issue do speak to your local RCN representative if there is one or contact RCN Direct on 0345 772 6100 for advice.

The RCN is pressing the NMC to ensure that all hours completed in extended clinical placements count towards students’ required 2300 hours of clinical practice. We have asked that they explicitly consider and describe the learning environment under COVID-19 and issue appropriate guidance accordingly.

Not been given a written contract/job description?

This is poor employment practice. Your employer must give you a document stating the main conditions of employment when you start work. This is known as a ‘written statement of particulars’. Your employer must provide the principal statement on the first day of employment and the wider written statement within 2 months.

The principle statement should include the following:

• the names of you and your employer
• the date you started work
• the title of the job
• the amount of pay and how often you will be paid, for example, weekly or monthly
• the hours of work
• where the job is based, for example, whether you will have to work in more than one location
• your holiday entitlement, including how many days off you are entitled to and what your holiday pay will be, if any
• how much warning (notice) you are entitled to if you are dismissed and how much warning you must give the employer if you want to leave the job
• what the disciplinary, dismissal and grievance procedures are in the workplace
• what sick pay you are entitled to
• the pension arrangements.

Some of these issues may be contained in your contract of employment, a staff handbook – or be available on the internal website.

If you have not received a written statement of employment particulars, you should in the first instance raise the issue with your line manager. If that doesn’t resolve the matter, then you should put a request for such a statement in writing (reference any formal guidance on student deployment and confirm your understanding of the nature and salary for your role). You then have a written record for the employer to respond to or challenge.

If you still don’t receive a statement and/or you don’t receive payment as expected, you should speak to your manager again but if you can’t resolve the situation with them speak to your local RCN representative if there is one or call 0345 772 6100 for advice. 

Pay delays

There are two probable reasons why you may not have been paid when you expected to be:

1. You didn’t start work before the payroll deadline or
2. You have been given the wrong contract or a contract with incorrect details.

In both cases the first thing you should do is raise the matter with your manager who may refer you directly to payroll.  If you are unable to resolve the matter this way contact your local RCN representative if there is one or call 0345 772 6100 for further advice.

Any backdated pay should be paid to you as soon as possible but you should keep your own records (e.g. how many hours you worked on what days) just in case this does not happen and you need to take the matter further. 

Reasonable adjustments

Reasonable adjustments are an entitlement under law and should not be affected by changes to your placements in response to COVID-19. Ensure that your needs are known by your university, and take a proactive approach in sharing your inclusion plan with your Placement Education Facilitator or other placement contact as early as you’re able to. If you are having issues in establishing or sustaining the adjustments you need, in the first instance consult your university's disability support team and RCN members can call RCN Direct on 0345 7726100 for further advice. 

NMC standards confirm that clinical simulation can be used to contribute towards a student's practice hours. 

This may be particularly helpful to students who have opted out of an extended paid clinical placement or have not been able to secure a placement during the COVID-19 pandemic. 

It is the responsibility of the education institution to ensure the safety of students, in line with government guidance.

Any educational practice must take place in line with the government guidance at that exact time. Full risk assessments should be undertaken and mitigations made in order to ensure that the guidance is addressed. The provider must ensure that all staff and students understand the risk assessment and mitigation prior to commencing any activity. 

If social distancing isn’t possible PPE will be necessary, with issues around the correct and appropriate use of PPE included in the risk assessment.  

Read the UK government guidance on PPE 

Read our advice guide on PPE

If you are concerned for your safety, speak in the first instance to your personal tutor and education institution. If you still have concerns, read our guidance on raising concerns below and contact RCN Direct on 0345 7726100 if you need further advice and support.  

Students should feel able to raise concerns without detriment and should receive timely feedback on their concerns. If your concerns remain unresolved, refer to:

• our raising concerns guidance
• PPE - are you safe?
• our refusal to treat guidance,

and speak to your supervisor/tutor as soon as possible.

If you have followed these steps and the issue is still not resolved, please call RCN Direct on 0345 772 6100. 

For tips and helpful information on successful distance learning and self-isolation for international students in the UK, see:

Tips for Successful Distance Learning During COVID-19
Coronavirus Information for UK International Students

The Education Skills Funding Agency (ESFA) have produced guidance with regards to apprenticeships during the COVID-19 pandemic. See: Department for Education, Coronavirus (COVID-19): apprenticeship programme response.

The ESFA guidance says that:

• Apprentices should receive the usual funding even if they cannot currently continue in learning or fall out of work as a result of COVID-19.  
• Apprentices to be able to continue and complete their apprenticeship, despite any break they need to take as a result of COVID-19. 

Further information and guidance documents can be found at:

HASO
Skills for Health
Unionlearn - Apprenticeships & COVID-19
The Institute for Apprenticeships

You can contact the Department for Education Coronavirus Helpline for education related queries on 0800 046 8687 (open 8am to 6pm, Monday to Friday) or by emailing DfE.coronavirushelpline@education.gov.uk.

If you are earning and paying tax, then you may be eligible to claim tax relief on:

• laundering your uniform
• shoes and socks/tights
• RCN membership fees
• Nursing Standard subscriptions

Once you are registered with the NMC, you could claim tax relief on your NMC fees too.

See the RCN’s page on Tax relief for more details and how to claim.

How will the extended paid placement impact on my Tax Credits?

If you already claim Child Tax Credits and income based legacy benefits, and you start work with enough hours to satisfy Working Tax Credit conditions, you can either remain on existing benefits with added Working Tax Credit or claim Universal Credit if you will be better off.

Please do bear in mind when making your decision, that once you move from Tax Credits to Universal Credit, you will not be able to move back to Tax Credits when you return to your course.

It is also worth noting that as you will still be in receipt of your student loan or grant income during the placement, you are unlikely to be better off on Universal Credit, as student funding income is treated less favourably for this benefit than it is under working tax credit regulations. However, every situation is different, so please seek advice if you are unsure.

How will the extended paid placement impact on my Universal Credits?

If you are currently claiming Universal Credit, then taking on a paid placement will mean your new income will be used to calculate your Universal Credit. Depending on your situation, you may however be entitled to the Universal Credit Work Allowance and you will no longer be subjected to the benefits cap, so you may still qualify for support.

To see more about how Universal Credit is worked out, see Calculating Universal Credit on the Entitled To website.

Can I claim childcare costs through Tax Credits or Universal Credit?

If you have childcare costs and are working sufficient hours, you can also make a claim for the childcare element of Working Tax Credit or Universal Credit, but only if you are not claiming childcare costs via Student finance; you cannot claim both.

What if I am not currently claiming any benefits? Will I be eligible if I start a paid placement?

Most new applications for benefits must now be made through the Universal Credit system.

If you are not currently getting benefits, it is unlikely that you will qualify if you start claiming when you start work, as your income will include both your current student funding and your salary. However, there will be some exceptions to this, especially if you have children and would qualify for the Work allowance.

If you're unsure about whether or not you would qualify, please seek advice by emailing the RCN Welfare Service.

The case studies below broadly cover some of the enquiries and financial concerns presented by students considering an extended paid clinical placement. However, it's important to note that all students will present with a slightly different set of circumstances. If you are still unclear about the impact starting a placement will have on your benefit entitlement, please email welfare.service@rcn.org.uk and an adviser will call you back to discuss your personal situation.

Case study 1: Single parent claiming Tax Credits

Cai is a second-year student nurse in London. He is a single parent with two young children. Cai is pleased to have been offered an extended paid clinical placement by his university to work on a medical ward. He is about to sign a contract to say that he will be paid at band 3. 

Cai has already arranged for his children to stay with their grandparents during his placement. This is huge change for the family. Cai has been financially independent and has been receiving his student funding as well as Child Tax Credit and Child Benefit during his course. He is now wondering what will happen to his benefits when he is doing his placement and what will happen when he returns to his course in his final year.

As Cai is currently receiving Child Tax Credit, once he starts his paid placement, he will need to ask the HMRC to recalculate his entitlement. Whilst his earned income will increase, since he is working more than 16 hours a week, he would also be eligible to claim to claim Working Tax Credit, so his entitlement wouldn’t necessarily go down.

His entitlement would depend on his income, on whether he is working more than 30 hours a week and how long his placement continues.

As tax credits are an annual means-tested benefit, Cai should notify the HMRC of a change in income both at the start and end of his placement. This will ensure he avoids a potential overpayment at the end of the financial year. He should also notify the HMRC within four weeks of any relevant change.

How to notify HMRC of relevant changes

You can notify the HMRC by post, email or phone. For further details of how to do this please see Report changes that affect your tax credits on the gov.uk website.

Case study 2: Student currently claiming Universal Credit

Sonja is a third-year student studying in Glasgow. Sonja has been offered an extended paid clinical placement. Sonja’s partner is caring for their young child whilst Sonja is at University and will continue to do so whilst she undertakes her placement.

Before she starts her placement, the family are keen to know what will happen to their benefit entitlement.

They are currently receiving Universal Credit to assist with their rent. Sonja wants to know if she will continue to receive this support, and if not, what will happen to her Universal Credit when she returns to her course.

Sonja will continue to receive her Scottish Bursary and if she decides to take up the placement, her new salary. As Universal Credit is a means-tested benefit and takes into account the family’s combined income, her Universal Credit would be recalculated. Depending on the hours she undertook in the assessment period her family might continue to receive a reduced amount of the housing element of Universal Credit, as she would now qualify for a Work Allowance element of Universal Credit.

For further details of the Universal Credit work allowance please see the government's guidance on Universal Credit work allowances on the gov.uk website.

If Sonja's income went above a certain threshold for her assessment period, she would lose her Universal Credit. She sought advice from the RCN Welfare team, who calculated that despite the loss, Sonja would still be financially better-off during her placement. This is because she would receive her salary as well as her student bursary funding. Based on these figures, Sonja decided to go ahead with the placement.

When her placement ends, Sonja may continue to receive Universal Credit. The rate she receives will depend on whether she starts work or has a break between her first substantive post.

How to notify Universal Credit of relevant changes

You can notify the DWP (Department for Work and Pensions) using your on-line journal. See Sign in to your Universal Credit account on the gov.uk website.

Case study 3: Single parent not currently claiming any benefits

Ingrid is a third-year student studying in Belfast.  She has been offered an extended paid clinical placement. Ingrid and her teenage daughter normally live with her parents, so only qualify for Child Benefit. 

However, due to her father having received a shielding letter, if Ingrid takes up the placement, she will need to move to a rented apartment near the hospital to protect her father.

Before she agrees to start her placement, Ingrid wants to know if she can apply for any financial support.

The Business Service Organisation Bursary Administration Unit has stated that third year nursing and midwifery students are not eligible to claim excess placement and accommodation costs for their COVID-19 clinical placement through the Bursary Scheme.

As Ingrid now must now pay rent, she was advised by the RCN Welfare team that she could make a new claim for Universal Credit. Universal Credit would take into account her student bursary income and her salary for the relevant period. However because she is a single parent and in work, she would qualify for the Work Allowance, and also some Universal Credit housing cost element towards her rent.

How to make a new claim for Universal Credit

If you believe your circumstances have changed so that you might now qualify for Universal Credit you can claim either online or by calling the DWP (Department for Work and Pensions). Due to increased demand on Universal Credit, it's strongly advised to Apply for Universal Credit online on the gov.uk website.

Case study 4: Parent with additional childcare costs

Tom is a second-year student studying in Swansea. He has been offered an extended paid clinical placement. Tom lives with his wife and their two-year-old twins.

Tom’s children only usually attend nursery for a few hours a week as they are usually looked after by his mother-in-law when he is on placement and his wife is working. But due to his mother-in-law currently shielding, if Tom takes up the placement, they will need to use a full-time nursery place for the twins.

Before he agrees to start his placement, Tom wants to know if he can apply for any financial support.

As Tom and his wife both work, one of the options they have is to apply for the childcare element of Universal Credit. They can only make a claim for childcare if they are not claiming NHS Wales Childcare Allowance. Universal Credit would take into account Tom's student bursary and reduced rate loan income, and the family's combined salary for the relevant period. Tom took advice from the RCN Welfare team, who calculated that he and his wife could still qualify for some Universal Credit due to their new childcare costs.

How to make a new claim for Universal Credit

If you believe your circumstances have changed so that you might now qualify for Universal Credit you can claim either online or by calling the DWP (Department for Work and Pensions). Due to increased demand on Universal Credit, it's strongly advised to Apply for Universal Credit online on the gov.uk website.

Student loans

This situation is unprecedented, and the Student Loans Company (SLC) have confirmed that students will receive their scheduled or next instalment of their maintenance loan at the planned start of their summer term, regardless of whether their university or provider has made alternative arrangements for teaching.

Students who have applied for student finance in England, Wales and Northern Ireland, please see Guidance for Current Students on the gov.uk website for frequently asked questions and answers.

Error regarding student loan repayments

Some students undertaking paid placements have had student loan repayments deducted from their first payslips in error. Please speak to your payroll department and seek written confirmation of the error for your records. We’ve been assured that the sums deducted are expected to be returned to you in the next pay round.

Maintenance grants

The government remains committed to implementing maintenance grants to the timescales previously announced. Eligible students will be notified of the application process in due course.
Additionally, the Department of Health and Social Care has confirmed that all Learning Support Fund, NHS Bursary and Social Work Bursary payments will continue to be paid during the period.
Eligible students should continue to apply for payments through the NHS Business Services Authority in the same way as they do now.

Student bursary in Scotland

Financial arrangements in Scotland for the nursing and midwifery student bursary continue. For students who currently receive this Student Awards Agency Scotland (SAAS) bursary including any allowances, please see advice from the Scottish Government: Coronavirus (COVID-19): student support guidance for medical, nursing and midwifery students. Please also refer to these FAQs developed by the RCN.