Recommendation 188

Values-based aptitude test for aspirant nurses

Accepted in principle
The Nursing and Midwifery Council working with universities, should consider the introduction of an aptitude test to be undertaken by aspirant registered nurses at entry into the profession, exploring , in particular, candidates’ attitudes towards caring, compassion and other necessary professional values.

The government’s Mandate to Health Education England contained a requirement to ensure that selection into all new NHS funded training posts incorporates testing of values. In addition, NHS England is working with Health Education England and NHS Employers to support the introduction of values-based recruitment and appraisal for all registered and unregistered staff.

We believe that placing a strong emphasis on values at the outset of training potential staff is vital to embed the principles of compassion and caring from the very beginning in those who will one day provide care to patients. It is essential that the staff of tomorrow are able to demonstrate not only academic and technical ability, but also that they have the values of kindness and compassion that are needed to care for patients in an emotionally demanding environment.

The Nursing and Midwifery Council introduced new education standards in 2010.  These 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’s standards for competence reinforce this, identifying the knowledge, skills and attitudes students must acquire by the end of their programme.  For example, students must ‘practise in a holistic, non-judgmental, caring and sensitive manner that avoids assumptions, supports social inclusion, recognises and respects individual choice and acknowledges diversity’.

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, including the need for an aptitude test.


NHS Employers is working on a Values Based Recruitment project in partnership with Health Education England, to ensure that staff who are recruited into the NHS are recruited for values, to deliver the best possible care for patients. This includes a number of resources to support employers including good practice case studies and a model policy. Further resources including case studies and podcasts will continue to be developed during this financial year.

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.