COVID-19 advice for students and trainee nursing associates

The Secretary of State for Health and Social Care has formally asked the NMC to reintroduce the emergency education standards for nursing and midwifery education to support the COVID-19 response. RCN Council has outlined its position on student nurses in paid placements.

These standards will apply to England only at this stage, but may be adopted, in whole or in part, in the other countries of the UK.

It is important to note that the emergency standards are optional for local areas to enact so they are likely to be a range of different options provided across the regions.

 

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.

How the extended paid placement impacts your Tax Credits

If you have undertaken a paid placement, you may have already seen an impact on your Tax Credits.

Tax Credits are an annual benefit and you should alert the HMRC that you are in paid employment. If you have not done so yet, you will need to do this as soon as possible to avoid any overpayment of benefits in the 2020/2021 tax year.

When your paid placement ends, you will again need to alert HMRC to your new situation. If your paid hours have reduced to below the Working Tax Credit threshold, then this element of your entitlement will no longer be paid and your tax credits will be adjusted accordingly.

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 new Universal Credit entitlement. HMRC will have alerted Universal Credit to your new pay situation and recalculations will be done automatically.

Depending on your employment situation after the paid placement ends, you may no longer be entitled to the Universal Credit Work Allowance and you may again be subjected to the benefits cap.

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

What if I am not currently claiming any benefits? Would I be eligible if I started 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 started claiming when you started work, as your income will include both your current student funding and your salary.

However, there are 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 qualified, please seek advice by emailing the RCN Welfare Service. Please note there are strict backdating rules for benefits applications, so please do not delay in contacting the service.

Help and support

As the situation with students during the COVID-19 paid placement period was a new and complex one for the benefits agency, there have been instances where mistakes and miscalculations have been made. If you feel that the way your benefits entitlements have been treated during or after placement have been incorrect, please get in touch with the RCN Welfare Service and we will be happy to look at the calculations and assist with lodging an appeal if there appears to be errors. 

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.

The case studies below broadly cover some of the enquiries and financial concerns presented by students on extended paid clinical placements. 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 third-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. 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 funding 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. 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.

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 third-year student. 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 a 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.

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.  

It is important to note that both AEIs and placement providers should carefully risk assess students to ensure that those at higher risk are properly protected. Nursing students need to feel protected when going onto clinical placements during COVID-19. Therefore, it is important that all nursing students have access to life assurance (often called death in service) benefits should they die as a result of exposure to COVID-19 whilst on clinical placement.

The NHS & Social Care Coronavirus Life Assurance Scheme provides additional financial protection for frontline staff who are employed to deliver care for people and work in environments that carry an increased risk of contracting Coronavirus. The scheme pays a £60,000 tax-free lump sum. This includes healthcare students.  

Clinical placements are governed by formal agreements between universities and the host organisation. Eligibility for this payment is work-related and requires the Secretary of State for Health and Social Care to be satisfied that coronavirus was contracted in the course of performing duties.

Students on paid placements may also join the NHS Pension Scheme, which provides additional death in service benefits.

For more information please see NHS & Social Care Coronavirus Life Assurance Scheme and as both England and Wales students are eligible please see:

• NHS and Social Care Coronavirus Life Assurance Scheme 2020 England | NHSBSA for England students 

• NHS and Social Care Coronavirus Life Assurance Scheme 2020 Wales | NHSBSA for Wales students

• In Scotland, the Scottish Government provide cover to students on placements in all health and social care settings. This scheme provides a single lump sum payment of £60,000 to the next of kin of any student of an HEI in the event of a COVID-19 related. See Information for student nurses in Scotland.

Finally, we expect employers, universities and, in Scotland, further education colleges, to work closely with the affected students’ families following any student death.

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

In specific geographical areas, UK governments and devolved administrations have applied localised restrictions in response to increases in COVID-19 cases. You can find an up to date list of areas subject to additional restrictions in England, Northern Ireland, Scotland and Wales.  

It is the responsibility of the educational provider to organise suitable clinical placements for their students, working in partnership with the practice learning partner in accordance with NMC standards in the event of local lockdown. 

It is the responsibility of the education provider to undertake robust risk assessments to protect students on placement. 

If you have any concerns, in the first instance you should raise them with your practice supervisor or assessor, or your university tutor. If you are still concerned and haven’t been able to resolve the issue please contact RCN Direct on 0345 772 6100 for advice. 

It is the responsibility of the educational provider to ensure that students complete the required number of practice hours. The NMC provides more information around clinical simulation which can be used towards students’ practice hours. Read more on the NMC website.

Further information from the RCN can be found here.

If you are on paid clinical placement, the hours you work will contribute to your overall programme to reflect the experience you will gain, during these challenging times.

If you have any concerns, in the first instance you should raise them with your practice supervisor or assessor, or your university tutor. If you are still concerned and haven’t been able to resolve the issue please contact RCN Direct on 0345 772 6100 for advice.

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 your practice supervisor and assessor. 

Students should work to the NMC code of conduct, preserving safety at all times. 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. Each educational provider should also provide their own raising and escalating concerns guidance to students. 

If you have any concerns, in the first instance you should raise them with your practice supervisor or assessor, or your university tutor. If you are still concerned and haven’t been able to resolve the issue please contact RCN Direct on 0345 772 6100 for advice. 

Safety on whilst on placement 

Any educational practice must take place in line with the country-specific guidance at that exact time. Full risk assessments should be undertaken in advance and mitigations made in order to ensure that the government guidance is addressed. It is your responsibility to ensure that you understand and are able to comply with the risk assessment and mitigation prior to commencing any activity.  

Mitigation may include the use of personal protective equipment (PPE). For more information please read our advice guide on PPE. Further information can also be found in the country-specific guidance on PPE.

Mitigation may also include testing for COVID-19 infection. This should be delivered in accordance with local infection prevention and control policies. 

If you have any concerns, in the first instance you should raise them with your practice supervisor or assessor, or your university tutor. If you are still concerned and haven’t been able to resolve the issue please contact RCN Direct on 0345 772 6100 for advice. 

 

if you have been overpaid, please see our Overpayment of wages guide. It includes a step by step process that you can follow, as well as example letters and templates.

Your educational provider is responsible for offering you a suitable placement which will consider your knowledge and experience around the environment you are asked to work in. A risk assessment will be undertaken prior to and on access to the placement. Once on placement you must discuss your assessment of competence and confidence with the nurse in charge.

You will not have supernumerary status. This means you will be a part of the workforce and included in the staffing and skill mix calculations.  You will be supervised in your practice and should only practice within your scope of confidence and practice. Support will be given to provide safeguarding for the student, existing workforce and patients.

You must ensure, whatever the pressure, that you continue to work to the NMC code of conduct, preserving safety at all times. You will remain accountable for the care that you provide.  It is essential that you only undertake care that you  are competent and confident to carry out. 

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.

RCN members who undertake extended paid clinical placements will receive full support and representation as student members whilst they are on these placements.

If you decide not to accept an extended paid clinical placement, for whatever reason, you should not be disadvantaged by taking this option. Your AEI 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.

For more information please visit the NMC website NMC statement: enabling student education and supporting the workforce.

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 – determined in accordance with 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 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.

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.

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

Not been given a written contract/job description?

This is poor employment practice and hopefully you will receive a written contract soon.  All employees wherever they work are entitled to receive a written statement of the terms and conditions of your employment.  This should be provided by your employer within two months of starting work.

The 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.

Where can I find more information?

Please see NHS Employers guidance on the deployment of final year student nurses along with the NHS Joint Staff council guidance on job descriptions and banding of nursing students.

January 2021

RCN expectations – student and patient safety

The NMC have amended their emergency education standards to allow for final year nursing students to take up paid placements and help respond to the COVID-19 pandemic. 

Individual Higher Education Institutions and placement provider organisations will be able to utilise these standards to implement paid final year student placements should they choose to.

The RCN is clear that employers and educators must take full responsibility for the supervision, support and well-being of any final year students who choose to opt-in. Students must not be disadvantaged, either financially or in terms of their education, irrespective of their individual decision.

To support our student members, we have set out eight guiding principles: 

1. Any students being asked to provide support must be given the same rights and protection as all healthcare workers, including access to vaccinations and the right level of PPE.
2. Government must provide assurance no student will suffer any financial detriment due to changes or delays to education. 
3. The enactment of the emergency standards should only be undertaken when local areas have exhausted all other options to secure additional clinical support. 
4. The decision to opt-in is an individual choice and no student will be disadvantaged should they choose not to opt-in.
5. Higher Education Institutions and practice placement providers should implement robust risk assessments, which consider the safety of the student and clinical demands of the proposed placement area.
6. Students must be supervised and work under a delegation framework
7. Any paid placement to benefit from the same terms and conditions of employment as the substantive workforce including determination of the appropriate pay band for the role undertaken using the NHS job evaluation scheme.
8. Agreed standards of supervision and support to all students must be provided to enable delivery of safe care at all times

This RCN continues to support supernumerary placements for all nursing students to minimise further disruption to nursing education and timely graduation.  

In all situations the Approved Higher Education Institution (AEI) is responsible for working in partnership with their practice partners to make a decision around clinical placements and offers of an extended paid clinical placement, based upon local need.

Nursing students in their first year

Decisions based on local needs will be made about you being able to continue with your studies, with supernumerary status, when on clinical placement.

If clinical placements are not available, emergency standards are in place to allow you to focus on academic and online learning, rather than participating in clinical placements, while the system is under pressure due to the pandemic. As a result, supervision is not possible in line with NMC standards.

You will not be offered the option of an extended paid clinical placement.

See the NMC information for students and educators.

Nursing students in their final year

Your AEI may decide to implement the emergency standards. In this case, you can volunteer to undertake a paid extended clinical placement.  

Your AEI may decide not to implement the emergency standards and so you will continue with your studies, with supernumerary status, on clinical placement and continued supervision and assessment.

It remains the responsibility of the AEI to ensure you have met all of your learning outcomes and requirements necessary to complete your programme and join the NMC register.

Second year students, all other undergraduate students (including post-graduate diploma/masters students)

You will continue with your studies as planned and continue to have supernumerary status when on clinical placement.

You will not be offered the option of an extended paid clinical placement.

It remains the responsibility of the AEI to ensure you have met all of your learning outcomes and necessary requirements to complete your programme and join the NMC register.

See Health Education England (HEE) for more information.

Scotland

In Scotland full-time student deployment is not considered appropriate at this point in time, and extended paid clinical placements are therefore not being offered to final year students. The Scottish Government has confirmed the option of part time paid employment is available to healthcare students through NHS staff banks – this is separate from programmes of study or placement. For more information please see Information for student nurses in Scotland.

Wales

In Wales, at the current time there are no changes to the way your theoretical and practice learning is organised other than the same person fulfilling the role of practice supervisor and assessor. Your practice learning should continue as planned. Our priority is the timely registration of final year students, and we want you to retain your supernumerary status on placement. We will keep this position under continuous review. Therefore student nurses in Wales will not be invited to join the temporary register.

Northern Ireland

In Northern Ireland final year students will not current be offered the option of an extended paid clinical placement. For more information, please see the Chief Nursing Officer’s letter. 

Organisations must have effective procedures in place to allow nursing staff - including students - and their representatives to raise any concerns in relation to equipment, policies and processes for managing COVID-19 at the earliest opportunity.

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. 

Reasonable adjustments are an entitlement under law and should not be affected by changes to your education 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.  

Please note - this does not include students who are offered and choose to accept an extended paid clinical placement

To help staff support you during your clinical placement the emergency standards allow the same person to fulfil the role of practice supervisor and practice assessor. This is will only apply for the period of the emergency standards.

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.