Nursing and Allied Professions

The NHS was founded in 1948 to provide free healthcare to everyone in the UK according to individual need, and regardless of income. It has a workforce of more than 1.3 million people, of whom 84 per cent have a hands-on patient role. Of more than 750,000 people qualified to practise as nurses, nearly 700,000 are on the Nursing Register and more than 400,000 work in the NHS. Another 60,000-plus allied health professionals also work in the NHS. Just 10 per cent of nurses are male, with 80 per cent of all nurses working in adult nursing, 12 per cent in mental health, 5 per cent with children and 3 per cent with people with learning disabilities.

There is generally a shortfall of full-time nurses in the NHS, and recruiting is down by one-third on figures for the late 1980s; since many nurses work part-time, the actual shortage is worse. It is unlikely that there will be full employment in this field in the foreseeable future, as people live longer and improvements in medical science mean that more can be done to help them. The private medical sector is also a major employer of medical staff. Health spending is due to continue to rise over the next five years, and these two factors mean that the demand for nurses is likely to rise.

There is no such thing as a ‘typical’ nurse; they are employed in a wide variety of roles and in many different places. Nurse consultants are highly qualified and experienced individuals. Some Registered Nurses (RNs) will be close to nurse consultants in terms of specialisation and employment, while others will be newly qualified after a three-year course. Health care assistants also play a huge role in delivering health care, and the system would collapse without them.

Nursing in the Services

All trained Service nurses are qualified RNs at least, and enlist with similar entry qualifications to their civilian counterparts. After recruit training they undertake the full three-year diploma training or, depending on their qualifications, the four-year degree at the Defence School of Health Care Studies, University of Central England in Birmingham. They can then take post-registration courses in a number of different subjects, and apply for a commission after a minimum of two years as a staff nurse.

Service health care assistants and medical attendants could gain entry into a nursing course through one of the routes described later in this article, or they could apply to transfer into their Service’s nursing branch. Qualification and entry requirements are the same as for applicants from outside the Services.

Health care assistants

Health care assistants are not necessarily professionally qualified although they will have completed secondary education, and will have numeracy and literacy skills. Many will hold or be working for NVQs at Levels 2 or 3. Work environments will vary from acute hospitals, including large district general hospitals, community hospitals, work in the community – perhaps attached to a GP’s practice – and nursing homes. The role will include delivering basic nursing care, supervised by qualified staff.

Professions allied to medicine (PAM)

PAMs are not nurses, but work alongside them to benefit patients. They include physiotherapists, radiographers, occupational therapists, chiropodists and dieticians. Hospital pharmacists, and speech and language therapists are slightly different again. Universities and colleges run courses for people who are looking to become qualified as PAMs; a little research will soon provide information about entry standards, but they are broadly similar to those for nursing. PAMs in the Services are medical branch specialists and each specialisation has its own entry criteria; most require people to be qualified before joining.

Becoming qualified in nursing

The Nursing and Midwifery Council (NMC) does not set specific educational entry requirements for entry to nursing programmes. However, it requires that approved educational institutions ensure that all applicants provide evidence of literacy and numeracy sufficient to undertake the pre-registration programme, and that they are of good health and good character. Institutions set their own educational entry requirements according to the academic level of the qualification they are offering. The NMC specifies that this must be at a minimum of Diploma of Higher Education.

All RNs have qualified at either Diploma of Higher Education or degree level. Both qualify people for registration, with a mark indicating in which one of the four nursing branches (adult, mental health, learning disability or child health) they have successfully achieved competence.

Nursing programmes are divided equally between theory and practice. The pre-registration programme comprises a 12-month common foundation programme, including core issues and topics in a wide variety of care environments relevant to each of the branches they could enter, and then two years in a specific branch programme, concentrating on specific branch subjects and containing practice placements. Potential students will need to be clear about the area of nursing in which they wish to work, since branch choices generally need to be made before the start of the course. These programmes also allow for Accreditation of Prior Learning so that people with relevant qualifications or knowledge may be able to undertake a shorter programme. To become a midwife (as a first qualification) requires a separate three-year diploma or degree. An 18-month programme may be taken only by RNs in the adult branch.

Anyone looking to enter a nursing programme should contact NHS Careers or the equivalent, or look through the prospectus of any trust or university of interest. Application should be made through the Nursing and Midwifery Admissions Service (NMAS), which will also provide information about all nursing HE courses.

Degree pre-registration programmes, like Diploma programmes, combine practice-based learning with nursing theory or healthcare studies. Entry requirements may be considerably higher than for the Diploma. Nursing students undertake a longer academic year in order to complete practice placements. Nurses do not have to pay tuition fees, and those on Diplomas receive an annual tax-free bursary of at least £4,600 a year (more in London), and other allowances for older people and those with dependants. Degree students can apply for a means-tested bursary and a student loan.

Second-level nurses (formerly Enrolled Nurses) can undertake a course to become a first-level nurse. The length of the programme depends on their education and experience since their initial qualification. Financial help may be available. People who are already trained nurses but who have taken a career break can take an NMC-approved ‘return to practice’ programme of at least five days (most are longer).

Employment as a nurse

No nurse should have any difficulty finding employment. Even if a permanent job is not available or not wanted, part-time positions and job-shares are now very common. Most hospitals and a number of nursing homes run nurse banks – a useful way of testing the environment while also earning – while a number of employment agencies specialise in nursing and allied professions.

All professional nurses registered with the NMC are legally required to re-register every three years, and must also confirm that they have updated their knowledge and skills base.

The Royal College of Nursing (RCN) is the largest nursing union in the UK and is effectively ‘the voice of nursing’. It represents all levels of the profession, and it works with government, patients’ organisations, other unions and professional and voluntary bodies.

UNISON is the major trades union involved in healthcare, and many nurses belong to it as well as or instead of the RCN. It also represents other grades of health worker as well as a wide range of public employees in other sectors.

Pay rates

Nursing and PAM salaries were calculated for years under the Whitley scale. New pay scales have now been introduced under a programme called Agenda for Change. Starting pay for nurses is now £18,698 with all NHS jobs placed into one of nine pay bands on one of two spines with annual salaries varying between £11,135 and £83,546, depending on a number of factors considered by the evaluation team. Each band also has a scale to reflect the experience and expertise of the individual. All employees will be paid more in London and most will earn money extra for working unsocial hours.

Contact details

Nursing careers

Nursing and Midwifery Council, 23 Portland Place, London W1B 1PZ Tel: 020 7637 7181 Website: www.nmc-uk.org

NHS Careers, PO Box 376, Bristol BS99 3EY Tel: 0845 606 0655 Website: www.nhs.co.uk/careers

Qualifications

Degrees and Diplomas: Universities and Colleges Admissions Service, Rosehill, New Barn Lane, Cheltenham GL52 3LZ Tel: 01242 227788 Website: www.ucas.com

Nursing and Midwifery Admissions Service, Rosehill, New Barn Lane, Cheltenham GL52 3LZ Tel: 01242 544949 Website: www.nmas.ac.uk

Associations

Royal College of Nursing, 20 Cavendish Square, London W1G 0RN Tel: 020 7409 3333 (RCN Direct: 0845 772 6100 (members only)) Website: www.rcn.org.uk

UNISON Health Group, 4th Floor, Mabledon Place, London WC1H 9AJ Tel: 020 7388 2366 Website: www.unison.org.uk

Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED Tel: 020 7306 6666 Website: www.csp.org.uk