Recommendation 186

Consistency of practical nursing training

Nursing training should be reviewed so that sufficient practical elements are incorporated to ensue that a consistent standard is achieved by all trainees throughout the country. This requires national standards.

The Nursing and Midwifery Council has already taken steps to address this.

The Nursing and Midwifery Council published new standards for all pre-registration nursing programmes in 2010 which must be followed at all the universities they approve to run nursing courses.  The previous 2004 standards were updated and strengthened as a result of the findings of the first inquiry and emerging evidence at that time. The first nurses to have followed programmes approved against the new standards will commence practice in 2014.

These national pre-registration nursing standards include the content and practice/study time ratios required by European Directive. All the nursing programmes last at least three years and require 50% of time to be spent in practice learning and 50% in academic study. The first progression point cannot be passed unless the student undertakes a period of practice learning and assessment. Currently formal learning and supervised work as a healthcare support worker can be counted through accredited prior learning routes.

The Nursing and Midwifery Council will be undertaking a full evaluation of these new education standards, commencing in 2014, and will have particular regard to these issues of caring and compassion. This will give a proper evidence base for any further revisions to these new standards, and the Nursing and Midwifery Council will consider this recommendation in parallel with their evaluation.

Although the overarching national standards are in place, the detail of the nursing curriculum is dynamic. Employers, service providers and universities are now brought together in local education and training boards, as part of the Health Education England system, to ensure all NHS funded courses are fit for purpose and reflect service needs.  We expect this new part of the system to recognise the importance of Compassion in Practice, the vision and strategy for nursing in England and the values and behaviours it describes in the ‘6Cs’ to be part of the local review of courses and incorporated into the detailed undergraduate nursing curriculum.

Health Education England and the Nursing and Midwifery Council will continue to collaborate on ensuring the undergraduate nursing curriculum meets patient need.


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 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.