Consistent training

Accepted in principle.
The Nursing and Midwifery Council is responsible for setting the UK-wide standards for all pre-registration nursing and midwifery education. These standards underpin all pre- registration nursing and midwifery education so that education programmes are comparable, and all nurses and midwives must meet the same standards. The Nursing and Midwifery Council set new standards for pre-registration nursing education in 2010. The standards require students to be tested for aptitude in literacy, numeracy and communication skills, and assessed as to health and good character on admission to programmes. Students must also pass all assessments at every progression point before they complete their programmes, and be assessed for good health and good character as to their fitness for award and fitness to practice. Education programmes are half theory, half practice, and education and training takes place as a partnership between a university and practice environment. Students must meet all theory and all practice requirements to complete a programme, and there is no facility to compensate for poor performance in one area with strong performance in the other.
The Nursing and Midwifery Council has committed to undertaking a full evaluation of its new education standards, commencing in 2014, and will have particular regard to issues of caring and compassion. This will give the Nursing and Midwifery Council an evidence base for any further revisions to these new standards.

The NMC considered this recommendation in line with its core role to regulate. In terms of assessment and examination, its role is to set and promote high education and professional standards for nurses and midwives across the UK, and nursing associates in England and quality assure their education programmes. It does not design or set curricula or, for example, have degree awarding powers.

With this in mind the NMC looked at the implications of setting an ‘aptitude test’. This involved reviewing best practice across the sector and similar regulatory tests used by other professional regulators. Research showed that aptitude testing in this area could be beneficial. Given the size of our register, the number of students involved (at the time c100,000 students) and NMC priorities at that time, affordability, scalability and cost to applicant / registrant were recognised as substantial barriers. Furthermore, the NMC recognised that the aptitude test failed to take account of the fact that for its students 50 per cent of learning takes place in theory and 50 per cent takes place in practice. Stakeholder feedback also supported its decision that this was not the right thing to do.

In 2016 the NMC undertook a comprehensive review of standards. Its pre-reg standards were updated in 2018 and 2019 which emphasise the importance of compassionate and person-centred care – its programme learning outcomes must reflect these, which students must meet in order to join our register - thereby negating the need for a specific aptitude test in this area. The NMC continues to regularly review its Code, standards and regulatory requirements as part of its governance cycle.

The NMC’s role in relation to assessment and examination, is to set and promote high education and professional standards for nurses and midwives across the UK, and nursing associates in England and quality assure their education programmes. It does not design or set curricula or, for example, have degree awarding powers. The NMC continues to regularly review its Code, standards and regulatory requirements as part of its governance cycle.

Please see our response to recommendation 187 for update on the NHS Long-term workforce plan.

The Nursing and Midwifery Council has commenced the evaluation of their standards for pre-registration education for nurses and midwives. Central to the evaluation are questions about the effectiveness of standards in preparing nurses and midwives for their professional roles and responsibilities which include care, compassion and leadership. The Nursing and Midwifery Council is in the final stages of appointing an independent evaluation supplier and they will proactively share any interim findings with Health Education England to tie into the Shape of Caring Review. The Nursing and Midwifery Council’s final report should be available in September 2015. The outcomes of the evaluation will provide an evidence base for future reviews of their pre-registration standards for education so that they can, where necessary, enhance the UK standards for nurse and midwifery competence and education.

This recommendation was accepted by the Government in principle.

In the January 2014 Hard Truths report, the Government’s view was that this was a matter for the Nursing and Midwifery Council. It is unclear how, if at all, this was considered or actioned by the Nursing and Midwifery Council.