It is recognised that career progression is an important factor for registered nurses (RNs) working in the community and that there is a need to retain highly competent staff (NHS England, 2021). There is concern among those RNs without a degree that they will be left behind, should the programme become a masters-only level of study, as employers will miss out on developing some very competent practitioners. With the NHS England Long Term Plan (2019) focusing on delivering more care in the community, there could potentially be a massive barrier to effectively implementing the plan on a national and local level.
It is once again that time of year when Universities and practice partners come together to recruit new intakes for the Specialist Community Public Health Nursing (SCPHN) and Specialist Practice Qualified (SPQ) programmes which start in September so as to get the NMC registered/recorded qualification. The shortage of district nurses is palpable in health care services, and there is an increasing need for training community specialist practitioners (Queen's Nursing Institute (QNI), 2021). I am the Programme Leader for the SPQ District Nursing programmes, and along with three local practice partners, we annually recruit for Health Education England (HEE) and Apprentice Levy funded programmes. We are very fortunate to have held this position for the last three years, and appreciate all the opportunities that come along with it. The practice partners, if sending employees on the Apprentice programme, must find additional funding for paying the Apprentices for those two years, whereas additional finances are given to the employers to help those who are currently being funded by the HEE programmes. The variation in funding approaches has not deterred them from offering both funding streams and supporting successful applicants to commence the most appropriate programme for their career development (Bliss et al, 2019).
As the Programme Leader, I work closely with practice partners, start the recruitment cycle early, and offer places, subject to funding. We find that this provides students with an opportunity to prepare both personally and professionally. The recruitment and selection processes are the same for both, and a panel of Practice Educator, clinical lead, and an academic, forms the selection committee. The candidates are required to deliver an academic presentation on a topical subject. This year's topic was in reference to the newly published ‘Workforce Standards for the District Nursing Service’ - a report by Professor Alison Leary (QNI/International Community Nursing Observatory (ICNO), 2022), and other relevant academic citations, to answer ‘What factors drive workloads in the community and what impact does this have on the role of the District Nurse?’. Successful candidates are also required to produce a piece of pre-coursework on a topical subject related to District Nursing. A robust process, tried and tested over many years is applied; however, what we found this year is quite surprising. Only three PG Dip apprentices, including non-medical prescribing (V300), eight HEE BSc and nine PG Dip, including community nurse prescribing (V100), have been recruited. In addition, we will have five apprentices going into their second year. This gives us a combined cohort of a potential 25 students, while the practice partners had planned for, and were prepared to support more to take on the apprenticeship. The surprise being that even if they met the criteria, they are still opting for the HEE funded programme, in the hopes of continuing professional development (CPD) in the future to complete the non-medical prescribing later, post the SPQDN qualification. Is this just the area? Is it just because we can offer a choice? Other Universities already only have Apprenticeship and/or PG Dip on offer.
Going forward, if the NMC post-registration standards do say that non-medical prescribing will be core to specialist programmes and only available at the PG level of study (Bliss et al, 2020), the HEE might stop funding post-registration programmes. If this is so, the apprenticeship levy or self-funding might be the only options. We could then see a programme which is currently well accessed, equal, inclusive, and diverse, but which might be available to a select few, making it a non-viable proposition for universities to run.