The Royal College of Nursing (RCN) is today warning that a proposal to cut the number of practice learning hours for nursing students lacks evidence and puts the quality of learning and future care standards at risk.
In its consultation on ‘improving nursing and midwifery practice’, the NMC is proposing to reduce the minimum number of programme hours from 4,600 to 3,600. This represents a fall of over 20% on current levels.
In its response to the consultation, the RCN warns the proposals risk the quality of education, supervision and assessment in practice learning environments as well as the overall quality of learning when on placements. There is deep concern that reform is being shaped by capacity and affordability pressures rather than by the needs of nurse education and service users.
While the NMC is proposing to cut the practice learning hours for registered nurses, hours needed to become a nursing associate will be fixed at 2,300 (current levels). Reducing registered nursing hours while leaving nursing associate programme hours unchanged could narrow the gap between the two roles, weakening recognition of the registered nurse role, and increase the very real risk of nursing associates being used as substitutes for registered nurses.
The NMC consultation also proposes requiring all nursing students to have at least one community practice learning placement. While the RCN agrees with this proposal, which could encourage more people into community nursing, this must be mandated only once a definition of community placements is provided, along with quality assurance standards and a credible plan to scale up capacity in the community sector to provide quality practice placements.
In the field of midwifery, the NMC proposes extending pre-registration midwifery programmes from three to four years while retaining the existing 4,600 programme-hour requirement. The RCN, however, is concerned that the NMC has not adequately explained why quality concerns in midwifery are being addressed through an extension in the number of programme years, while quality concerns in nursing are being addressed through a reduction in overall programme hours.
The NMC is also proposing a series of measures to strengthen anti-racism, bias awareness, cultural safety and respect requirements across nursing and midwifery education. These are welcomed by the RCN, but they must translate into real protections for students, as many report experiencing racism and other forms of discrimination during placements. The RCN says the development of these standards cannot be a paper exercise and must be embedded in everyday teaching, supervision, assessment and complaints handling, with measurable impact for students.
RCN Chief Nursing Officer, Professor Lynn Woolsey said:
“We welcome the opportunity to contribute to this consultation as the largest nursing professional body and trade union in the world, but we have real concerns around the proposals to reduce the number of practice learning hours for nursing students.
“Our members have repeatedly highlighted the lack of evidence underpinning the suggested reductions and the risks of reform being shaped by financial pressures in the education sector rather than on the educational needs of students. This comes just as new NMC figures show the number of joiners to nursing is falling. Risking the quality of education is the wrong response.
“We urge the NMC to rethink. The College will be unable to support the proposals unless the regulator can provide strong evidence that reductions in hours will not damage the quality of learning, including providing for a greater infrastructure to support students, with binding assurance standards to help protect the future safety of care.
"Nurse education is already in the grips of a crisis with courses at risk of closure and nurse educators facing redundancy. It makes it more important than ever for the regulator to protect the quality of learning, the experience of students and, ultimately, patient care.”
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RCN - Proposals to change nursing and midwifery practice learning education standards
