Information for student nurses in Scotland 

The Nursing and Midwifery Council (NMC) have announced measures to expand the workforce to support the health and care services during the COVID-19 emergency.

A joint statement was issued on 19 March by the NMC, chief nursing officers, Council of Deans of Health, the Department of Health and Social Care, royal colleges and trade unions. This confirmed four actions:

• Once the UK government passed the legislation to enable the NMC to establish a COVID-19 temporary emergency register, inviting those nurses who have left the register within the last three years to opt in should they wish to do so 
• Encouraging those nurses who are currently on the NMC register but not working in clinical care to consider coming into clinical practice during this time
• Changing the nature of the programme for undergraduate nursing students so that they can opt to undertake their final six months of their programme as a clinical placement
• and, establish a specific student part to the register for students in the final six months of their programme, which would have specific conditions of practice to ensure appropriate safeguards are in place, if and when it was considered necessary to further benefit the health services and people who use them. 

A second statement issued on 25 March provides an update in relation to nursing and midwifery students in all fields, who are not in the final six months of their programme. 

In relation to the fourth action above, to establish a specific student part of the COVID-19 temporary emergency register for students, the NMC have issued a third statement on 7 May announcing they have decided not to establish this specific student part of the temporary register for nursing students.   

More information can be found on the NMC website.

The NMC have developed a set of emergency standards which allows more flexibility to be applied to the delivery of nursing and midwifery programmes. The objective of doing this is to enable students to make a valuable contribution whilst completing their studies, and to ensure that more junior students are appropriately deployed and adequately supported during this time. These standards are only in place for the duration of the emergency.

The RCN will provide expertise with and on behalf of members to inform guidance, negotiate employment terms and conditions within emergency measures, and support members who may be willing to return to clinical practice where appropriate.  The RCN are working hard to ensure that no students are disadvantaged in whatever decisions they make. 

New guidance has been published by the Scottish Government for students in Scotland, Coronavirus (COVID-19): medical, nursing and midwifery student support guidance which applies to all nursing and midwifery students across all Scottish universities.

A Q&A for the temporary employment of students during COVID-19 has been published on the Scottish Terms and Conditions Committee (STAC) website.

The following questions and answers provide information for nursing students. We are working hard in these challenging times to keep you updated and if you can't find what you are looking on this page for please see our Get help page or contact us and we will get back to you as soon as we can. Check also our COVID-19 advice pages for more information about studying and working during the pandemic.

• It is important for all students to remain in contact with their universities.
• Universities should be in regular communications with students, keeping you up to date with any changes as they arise.
• We expect students to have the opportunity to discuss individual circumstances and concerns with university staff in a timely way.

• You will continue with your studies and remain on your programme.
• Clinical placements will be paused but your academic studies will continue, with students spending 100% of their programme in theory/academic learning. 
• Academic studies will be delivered in line with the current programme via distance/online learning, as decided by your university.
• Students can volunteer or undertake paid work in a healthcare setting, alongside their academic study, if they wish. Volunteering or paid work will not count towards the practice hours and experience required to complete your pre-registration course.
• The NMC will work with your university to assess how students will be supported to achieve the required number of practice hours across the remainder of your course and to achieve the required academic and practice competencies within the original timeframe of your degree. Your university will answer your questions on this.  
• Financial arrangements will continue as you are remaining on your programme. This means if you currently receive a SAAS bursary it will continue, including any allowances.
• If students wish to take break in their studies, this should be discussed directly with your university.  Continuation of your bursary will be dependent on the reasons for the break and following the same conditions as now. 

• You will be asked if you wish to opt-in to a revised programme structure which will involve spending no more than 80% of your time in clinical practice with 20% of your time in academic study. The clinical hours worked will count towards the total practice hours required for completion of your programme.
• Opting-in is voluntary. You can choose whether or not to go onto clinical placements under these conditions – and you should not feel pressured to do so.
• Your university is expected to contact you to discuss the revised programme.
• You should be supported by your university to consider the options available that best meets your needs, with consideration to individual circumstances.
• Universities will continue to support students during this emergency period and keep in contact with you. It is expected they will work with the NMC and Council of Deans of Health Scotland to assess how to support students’ academic course work requirements and within the original time frame of your degree, particularly given the substantial change to the time spent in clinical practice
• Scottish Government has confirmed you will be paid the remainder of your bursary as you will be required to continue to study to complete your course. Bursary allowances you currently receive will be paid in addition.
• Students will be paid for their actual hours worked in clinical practice. This pay is in addition to any bursary currently received, not a top-up to the bursary payment. Pay will be in line with the terms and conditions of the organisation you are placed in and national guidelines (e.g., Agenda for Change) in line with a Band 3 role description and you will be paid at the first pay point of Band 3.
• The hours you work cannot exceed 37.5 hours per week and must take into consideration time off required for academic study; as determined by your university programme. 
• You will not be able to claim travel expenses during this period of employment for journeys to and from your place of work.  Students who are deployed to Community settings and are expected to undertake travel as part of their work duties will be entitled to claim travel expenses reimbursement for the work-related travel.
• Students will receive a contract of employment under the terms and conditions of service of Agenda for Change (AfC) from the Health Board in which you have been deployed.  This complies with all the working hour protections, pay arrangements and annual leave entitlement of the organisation in which you will be working.
• Students will be employed by NHS Scotland for the duration of their deployment.
• Students in clinical practice will not be supernumerary during this emergency period but must be supervised by a registered healthcare professional and will be expected to work within an appropriate delegation framework.
• All students should receive support, supervision and assessments in line with the Standards for Student Supervision and Assessment (SSSA, 2018).
• Students should not accept duties they are not assessed as competent to undertake.
• Students who choose to opt-in to work in clinical practice will expect: to work with their university to identify a placement area; to have this information passed to the NHS who will identify an appropriate organisation, which will then make contact directly to discuss the deployment in more detail – Scottish Government guidance advises that in the majority of cases students will be placed in the placement that had been previously arranged, or in an organisation where they have been on placement previously; to need to register on the NHS portal.
• Students who do not feel able to opt in or who choose not to opt-in to work in clinical practice can expect: support from your university to discuss alternative options including the continuation of the academic elements of your course; that opting out of the paid placement is not stepping off the programme; to continue with your study programme if you are unable to opt-in for shielding reasons – which include a variety of reasons – please see What if I need a shielded placement?; if you choose to take an authorised break of studies, this will be part of your university’s current process around suspension of studies. Scottish Government guidance outlines that a continuation of bursary to be dependent on reasons for the break, under the conditions as at present. You should discuss this with your university.
• Students must be safely deployed into the workforce, whilst protecting their student status.
• For any students who are deployed to one of Scotland’s Regional Medium Secure Units, the recruitment and retention premium will apply.
  

• You will be asked if you wish to opt-in to a revised programme structure which means opting into an arrangement where you will be in clinical practice for this emergency period.
• The clinical hours worked will count towards the achievement of practice hours required for completion of your programme.
• It is expected universities will contact students to discuss the revised programme and options
• It is anticipated placements will be in a clinical area that had already been arranged for you, or an area where you have undertaken a placement before.
• You should be supported by your university to consider the options available to you that best meets your needs, with consideration to individual circumstances.
• Opting-in is voluntary. You can choose whether or not to go onto clinical placements under these conditions – and you should not feel pressured to do so.
• Universities will continue to support students during this emergency period and keep in contact with you. It is expected your university will work closely with NES to assess how to support students’ course requirements and within the original timeframe of your degree.
• Scottish Government has confirmed you will be paid the remainder of your bursary as you will be required to continue to study to complete your course. Bursary allowances you currently receive will be paid in addition.
• Students will be paid for their actual hours worked in clinical practice. This pay is in addition to any bursary currently received, not a top-up to the bursary payment. Pay will be in line with the terms and conditions of the organisation you are placed in and national guidelines (e.g., Agenda for Change) in line with a Band 4 role description and will be paid at the first pay point of Band 4.
• You may work up to a maximum of 37.5 hours per week, however, this will need to take in account any time required for academic study. 
• You will not be able to claim travel expenses during this period of employment for journeys to and from your place of work.  Students who are deployed to Community settings and are expected to undertake travel as part of their work duties will be entitled to claim travel expenses reimbursement for the work-related travel.
• Students will receive a contract of employment under the terms and conditions of service of Agenda for Change (AfC) from the Health Board in which you have been deployed.  This complies with all the working hour protections, pay arrangements and annual leave entitlement of the organisation in which you will be working.
• Students will be employed by NHS Scotland for the duration of their deployment.
• Students in clinical practice will not be supernumerary during this emergency period but must be supervised by a registered healthcare professional and work within an appropriate delegation framework.
• All students should receive support, supervision and assessments in line with the Standards for Student Supervision and Assessment (SSSA, 2018).
• Scottish Government guidance confirms the expectation that support could also be offered as an extension to the pastoral care and clinical support your university offers.
• Students should not accept duties they are not assessed as competent to undertake.
• Students who choose to opt-in to work in clinical practice can expect that: your university will work with you to identify a placement; this information will be passed to the NHS who will identify an appropriate organisation, which will then make contact directly to discuss the deployment in more detail. Scottish Government guidance advises that in the majority of cases students will be placed in the placement that had been previously arranged, or in an organisation where you have been on placement previously.  You can ‘opt-out’ at a later stage, if you wish, via your University and your employer who can support you.
• Students who choose not to opt-in to work in clinical practice can expect: your university to discuss alternative options including the continuation of the academic elements; that opting out of the paid placement is not stepping off the programme; to continue with your study programme if you are unable to opt-in for shielding reasons – which include a variety of reasons – please see What if I need a shielded placement?; if you choose to take an authorised break of studies, this will be part of your university’s current process around suspension of studies. Scottish Government guidance outlines that if you choose to take a break of studies, continuation of bursary will be dependent on reasons for the break, under the conditions as at present. You should discuss this with your university.
• Students must be safely deployed into the workforce, whilst protecting their student status.
• For any students who are deployed to one of Scotland’s Regional Medium Secure Units, the recruitment and retention premium will apply.

• The CNO wrote an open letter to all 3rd year honours students on 5 April which your university is expected to have shared with you. Your university will have additional information to enable full discussion with you on what the options are, including clarifying the appropriate pay band should you choose to opt-in.
• Within Scotland there are two different honours programme structures. This relates to the timing of academic achievement and skill acquisition. As a result, there are variances between universities across Scotland regarding the practice skills students will have and the level at which students will be able to work in clinical practice.
  - Programme structure 1: Students complete NMC skills and competencies within three years, often alongside non-honours students, with the potential for NMC registration after three years. Scottish Government has confirmed this applies to third year students who opt-in from Robert Gordon University, Glasgow University, Abertay University, Stirling University, and single field honours students at Glasgow Caledonian University. Students who opt-in will be paid in line with a Band 4 role description at the first pay point of Band 4.  Please see What should I expect if I am in the final six months of my pre-registration undergraduate programme?’ as this same guidance applies.
  - Programme structure 2: Students are not ready for NMC registration after three years with skill acquisition taking place across all four years. Scottish Government has confirmed this applies to third year students on 4-year honours programmes at Edinburgh University, Queen Margaret University and dual field honours students at Glasgow Caledonian University. Students who opt-in will be paid in line with a Band 3 role description at the first pay point of band 3. Please see What should I expect if I am not in first year and not in the final six months of my pre-registration programme? as this same guidance applies.
• All students should expect to work at a level appropriate for their experience
• Universities will advise what this means to individual students given the programme structure and stage of study.
• If you are in receipt of a bursary this will continue, along with any allowances.
• Students must be safely deployed into the workforce, whilst protecting their student status

• Nursing students can choose whether or not to go onto clinical placements under these conditions – and you should not feel pressured to do so.
• Your university is expected to contact you to discuss the revised programme, and you should be supported by your university to consider the options available that best meets your needs, with consideration to your own individual circumstances.
• If you are concerned about your health, are pregnant, immunosuppressed, have health problems or are a primary carer - the Scottish Government guidance advises against taking up patient-facing clinical work and suggests there are non-patient facing roles or alternative options including the continuation of the academic elements. Your university should fully discuss these alternative options with you. The RCN expects proper diligence in these discussions to reflect the realities of this complex decision for students.
• Throughout this emergency period, the expectation is that support could also be offered as an extension to the pastoral care and clinical support your university offers.
• During these challenging times, for tips and resources on self-care and looking after your mental health during the COVID-19 outbreak see COVID-19 and your mental wellbeing for more details.

• Your education and career are important, and it is vital you are supported in your learning.  The RCN is committed to ensuring that students must be fully supported, whichever choice you make.  We have presented student views to Scottish Government and influenced the guidance on changes required to the course requirements.  Both the Scottish Government and NMC are clear that current programmes must be adapted.
• The Scottish Government guidance clearly states for nursing and midwifery students not in first year, and not in the final six months of your pre-registration programme: “Given the significant change in time spent in clinical practice consideration will need to be given to how students can be supported to meet the academic course requirements. The NMC will work closely with the Council of Deans of Health and universities to assess what this means for students and how they can be supported to achieve the course requirements across the remaining period of their studies, and within the original timeframe of your degree. Where this requires ongoing changes to the structure of programmes, NHS Education for Scotland, on behalf of the Chief Nurse, will monitor the impact at universities to ensure that outcomes are achieved. Each university will have its own arrangements as all programmes are different, and your university will answer questions you have on this.”
• And for nursing and midwifery students in the final six months of your pre-registration programme: “NHS Education for Scotland and universities will work closely together to assess what this means for students and how they can be supported to achieve the course requirements across the remaining period of their studies, and within the original timeframe of your degree.”
• As programmes are different across universities, arrangements will differ - however, your university should support you and answer your questions on adaptions to course requirements within the timeframe of your degree.

• We know that nursing students have had many questions about what these changes will mean in practice. In particular what options are open to them during the current crisis and what this will ultimately mean for their education, completing their degree and gaining their NMC registration.
• Scottish Government student support guidance applies to all nursing and midwifery students across all Scottish universities.
• Your university should be regular communications with you, keeping you up to date with any changes as they arise.  It is important for all students to remain in contact with their university.  
• We expect students to have the opportunity to discuss individual circumstances with university staff in a timely way.  
• Scottish Government guidance confirms the expectation that support could also be offered as an extension to the pastoral care and clinical support your university offers.
• As programmes are different across universities, arrangements for course work deadlines and assessments may vary - however your university should support you and answer your questions on adaptions to course requirements within the timeframe of your degree.
• There are two different programme structures for honours students - if you are an honours student please refer to 'What should I expect as an honours degree student?'.

• The Scottish Government guidance confirms you will be paid the remainder of your bursary as you are required to continue to study to complete your course. Bursary allowances you currently receive will be paid in addition, which includes Dependents Allowance, Single Parent’s Allowance, and Childcare Allowance for Parents  
• The Scottish Government has also published guidance on who will count as key workers for the purposes of on-going educational provision, including flexibility to address local priorities. The RCN expects the Scottish Government to ensure that the provision of childcare through the school system for key workers will apply to all staff working in health or social care settings, including staff in GP surgeries, those providing services for the NHS through the independent sector providers and staff employed by health-related arms-length bodies - as well as public health staff working for local authorities.  We expect this to include nursing students who opt-in to placements during COVID-19. Your university should be able to support you with evidence to support you with discussions with your school or childcare provider.

• During these challenging times, for tips and resources on self-care and looking after your mental health during the COVID-19 outbreak see COVID-19 and your mental wellbeing for more details.
• If you are concerned about your health, are pregnant, immunosuppressed, have health problems or are a primary carer - the Scottish Government guidance advises against taking up patient-facing clinical work and suggests there are non-patient facing roles that may be discussed as part of the options available to you.  Your university should discuss this with you.  Remember you can choose whether or not to go onto clinical placements in this emergency period – and you should not feel pressured to do so.
• To minimise the risk of onward transmission of COVID-19 compliance with standard infection control and transmission-based measures is vital. This includes: Personal protective equipment (PPE): see RCN guidance and Health Protection Scotland guidance; laundering of uniforms: see RCN guidance and NHS Scotland guidance.
• What if I get sick while working in clinical practice? For COVID-19 related sickness - students will entitled to full pay for a maximum period of 6 months. This period of absence will be recorded as Special Leave within COVID-19 recording arrangements; For non-COVID-19 related sickness - students will entitled to the standard sick leave arrangements based on length of service.

• While the Scottish Government has not issued specific guidance on what constitutes shielded placements or health conditions that apply, NES have confirmed that most universities have adopted a process developed by the NHS regarding health conditions. Students have been asked to risk assess themselves against this criteria. If you have questions about your classification or for example have further medical advice about the management of your condition that could re-categorise you into a low risk or no risk category – your university should discuss this with you and assist you by working with their Board partners to place you appropriately.
  
• Students have advised of instances where their university and board partners are struggling to find a shielded placement for them. The Scottish Government guidance refers to flexibility being offered, and every effort to be made to ensure that no student is disadvantaged. Universities and Board partners must therefore continue to work together to place students appropriately.
  

• Students should always receive supervision from a registered practitioner.
• Students who opt for a six-month final clinical placement will retain their student status and the responsibility for them lies with the University. 
• Induction to a new area of work will be required, to include health and safety and escalation of concerns.
• Supervision and assessment resources for students and their supervisors and assessors are available from NHS Education for Scotland.

• Any previous service with an NHS employer prior to this deployment will count as reckonable service in relation to terms and conditions relating to redundancy, maternity, sick pay and annual leave.  Any service with the NHS staff bank is included.
• All students will be paid at the first pay point of Band 3 or 4, as determined by year of academic study.

• Any student must raise this to the nurse in charge or registered nurse supervising their practice.

• Yes. Students remain accountable for the care that they provide, while supervised and under an agreed delegation framework.
• It is essential that students only undertake care that they are assessed as competent and confident to carry out. 

• Students undertaking clinical placements as either a band 3 or 4, as determined by your current academic year of study, will be working under supervision and any error will be addressed as part of the learning process and/or as part of normal university processes, depending on the severity of the mistake.

• Indemnity is provided by the employer
• This would be set out in the contract of employment issued when you commence work as a member of staff in the organisation.
• There is comprehensive indemnity cover for NHS nursing staff working across all sectors provided through the state-backed schemes of Clinical Negligence and Other Risks Indemnity Scheme (CNORIS) 

• The Student Awards Agency Scotland (SAAS) state that student accommodation providers, (including those in the private sector) have been written to by The Minister for Further and Higher Education on 27 March. The Minister has asked accommodation providers to be sympathetic to those students who need to extend their stay in student accommodation beyond their original agreements. If you have any specific issues or concerns around your student accommodation funding, please contact SAAS in the first instance.

• As students studying at FE Colleges are not yet undertaking a pre-registration nursing programme at university the NMC emergency standards do not apply.
• The guidance published by the Scottish Government for students in Scotland, Coronavirus (COVID-19): medical, nursing and midwifery student support guidance, is applicable only to those currently enrolled on the pre-registration undergraduate programmes at University. The RCN has therefore sought information from Scottish Government for further education students who intend to progress to university.
• The Scottish Government states it has not asked students at FE Colleges to work in clinical practice, in the same way year 1 pre-registration nursing students at university have not.
• The Scottish Government expects colleges to support students to complete their programme of study, enabling students for whom the intention, upon successful completion of the programme, is to articulate to University in September, to do so.
• NHS sponsored HNC students would be expected, upon successful completion of their programme of study, to articulate to year 2 of University, as would be the case out-with this emergency period. 
• Scottish Government expects universities to be flexible when considering the number of practice hours students have achieved whilst at college, given the hours obtained may be less than those usually completed out-with this emergency period Year 1 university students currently on the pre-registration programme may also be short on hours, and Year 1 university students and NHS supported HNC students who articulate into year 2 are to be supported to achieve the required number of practice hours across the remainder of their course.

NMC resources:

• Information for students and educators 

RCN resources:

• COVID-19
• Guidance on redeployment – COVID-19
• COVID-19 FAQs
• COVID-19 employment advice
• Employment and pay
• Healthy workplace, healthy you
• Raising concerns
• Student funding, tax credits and welfare benefits