This Is What 3 Student Nurses Have to Say About COVID Contracts Ending ‘Early’

Claudia Canavan
Photo credit: Yulia Reznikov - Getty Images

From Women's Health

Amidst ever-rising death tolls, this April, just shy of 30,000 student nurses tugged on PPE and entered hospital wards all over the country. They did so after answering a call to be a part of the NHS England response to the coronavirus pandemic, working to help the nation navigate the most profound health crisis of our times – one which, in the UK alone, has claimed upwards of 40,000 lives to date.

Those in their third years were given the chance to work at the COVID-19 coalface and be paid to do so, giving up their supernumerary status for the duration. Second years were later allowed to join, under extra restrictions. Student nurses must complete 2,300 hours learning in clinical practice to qualify, and normally, these hours are not remunerated. The option to decline this offer and continue in education remained.

What is the controversy over student nurses?

Last week, a Facebook post from one such student nurse went viral. In it, some heavy claims were made. Namely, that third year students had been promised six month-long paid contracts and that Health Education England, who arranges placements, had renegaded on this deal, and they would now be finishing on the 31st July. As such, she alleged, many are set to feel the strain of financial hardship, having given up part time jobs to work in the wards.

This story applies solely to student nurses in England. Scotland, Wales and Northern Ireland have devolved health powers

This is a separate issue to the one spoken about on Good Morning Britain on the morning of Tuesday 23rd June, in which third year student nurse Jessica Collins (more from her, later) spoke about a response from Conservative MP and Minister for Care Helen Whately, with regards to a campaign from the former to have nurses' student debt, which winds up to the tune of £60,000 at the end of three years, cancelled.

What does Health Education England say?

In a statement given to Women's Health, Professor Mark Radford, Chief Nurse, Health Education England (HEE) refuted these allegations. He said that: 'Year 3 students will be paid till 31st of July and if they have completed hours and assessments can qualify and be paid as a full registered nurses.

'They will move from [NHS payment bracket] Band 4 to Band 5 and therefore increase their pay. Any Year 3 student who has hours [working in a hospital, on placement] to complete [and qualify as a registered nurse] will be paid until September to allow them to do this. Any Year 2 students on placement till July 31st will be paid and after this normal non-paid placements will be re-introduced along with Year 1 students.'

'We committed at the outset of the pandemic to ensure that these students complete their training and are able to qualify. It was always made clear to students who opted into paid placements the arrangements would need to come to an end at an appropriate point so that students could return to their supernumerary status to complete their registered nursing qualifications as quickly as possible to permanently enter the NHS workforce.'

What's happening now?

While welcome news, this clarification doesn't mean that the controversy is now over. Communications from certain universities and NHS trusts appear to have been hazy. In some quarters, this has sowed confusion. While these placements were initially spoken of as being six months long, some signed wound up being shorter, depending on the specific NHS trust that the student in question was working for.

Although 'year 3 students' have been told that they will be paid to September, thus completing their necessary clinical hours to qualify, this is not the case for a minority of students who started their studies at different points in the year – meaning that their academic calendar runs until the winter or spring. (HEE say that guidance given to people in the January to March 2018 cohorts stated that they would 'be classed as second-year students for the purposes of the pandemic,' hence the lack of payment.) It's also the case that some third year student nurses, who believed that they would be paid employees until September, are not starting full time roles until later in the year. They say this leaves a cash-free gap, in which they believed they would be making money.

As this conversation hums on, it's important to note something. Certain experts, including Prof. Alison Leary, Reader in Advanced Nursing Practice at London South Bank University, have expressed concern that a focus on payment for hours could, unintentionally, lead to: 'a return of "pay students for working" – i.e a return to the old, employed apprentice system which resulted in very variable levels of education, and a lot of exploitation.'

An alternative to this, that would focus on finances, would be to reduce or kill tuition fees and to offer enhanced student finance to those training as nurses – meaning that supernumerary status is retained, and therefore so is a focus on learning, as opposed to being a staff member.

To find out more, Women's Health spoke to three student nurses who signed up to tend to people suffering with COVID-19.

What do some student nurses say?

Jessica Collins, 27, third year student nurse (September 2018 cohort)

The statement from HEE sounds very inviting. However, for those of us that have academic work outstanding that was delayed slightly due to opting in to help on the frontline, it won’t affect when we qualify. We haven’t completed all of our assessments, and I’ve yet to find a year 3 student nurse that will have done so by July. We can’t go to band 5 until we get our Nursing and Midwifery Council pin through in October time, and so there will be a gap between when I personally finish my [paid] hours at the start of August, and when I undertake my qualified role in October. I signed a six month contract and put my trust in HEE to honour that.

Was I to know that they would turn around and say it would be withdrawn early – and my contract deemed worthless – then I never would have signed and instead focused on my theory work rather than trying to juggle it all at the same time. It’s not fair and there is no way to escape the fact that so many of us were mis-lead with false promises.

Hannah, 23, third year student nurse (March 2018 Cohort)

When I found out I could opt in, as a member of the March, as opposed to September, cohort, I was very unsure what my decision would be. Every inch of my nursing personality wanted to dive in – however I have a three year old daughter at home who’s wellbeing had to come first. After weeks of discussion with my partner, I chose to. My contract was for three months, from April-July. I was told, verbally, that I would be on a four weekly rolling contract after this, until normal, planned, unpaid placements could resume.

Our university and Health Education England informed us via an email that funding for student nurses would stop on July 31st 2020. However, they cannot tell us when normal, planned unpaid placements will start back up. I don't think it's right to all of a sudden remove us all because a period of emergency is over, to then sit at home and wait however many months until normal learning can take back up.

My university has said that, in the meantime, we will be offered theory and workbooks to replace patient-facing training until planned placements can go ahead. But I qualify in March 2021 – I wouldn’t feel safe to know I had been deemed competent via online workbooks. You can only learn the real thing through practice. [HEE say: 'The academic institutions authorised to run courses by the NMC have responsibility for making course adjustments to ensure students meet the NMC standards for qualification. It isn’t a HEE role or responsibility.]

This is why we've began the petition: To state that we want to remain in practice, paid, until normal education routine can resume and we can still get practical hours in.

Bear in mind we pay £9,250.00 per academic year in fees, plus have maintenance loans on top of this, because the government removed the nursing bursary. [In 2017, the Conservative government controversially scrapped nursing bursaries, replacing them with loans. In 2019, bursaries were reinstated, but student nurses continue to pay tuition fees.]

Hannah is involved with a a petition, started by NHS Million, a grassroots campaign run by NHS staff, for funding to carry on for paid hours, until the end of October.

Holly, 23, third year student nurse (March 2018 Cohort)

Initially, it was only the September cohort who were asked to join the COVID response. When I heard that the March cohort could join as well, I was keen to get out there and help. I've had very mixed messages from my university from the outset. First, we were told that we would have three or six month contracts, depending on the NHS trust we ended up at, that would roll over every four weeks. My personal contract at my specific trust ended up being for 12 weeks. I was told, verbally, by various people at my trust that they anticipated that I would be working beyond the 12 weeks, with my contract reviewed and potentially renewed ever four weeks. Some students at other trusts had contracts until September or October.

I had to quit my other job, working at an opticians, to take on the COVID work. I was under the impression that I would be needed for longer than until July, so I thought it would only be a small gap between finishing paid hospital work and qualifying.

My uni has said that people in the September cohort can carry on and have another two months, paid, in order to complete their outstanding hours [to take them to qualification and to become registered nurses.] But us in the March cohort won't have this. It means we will have months where it’s just online training, which isn’t what we signed up for. Practical experience this is key to doing this job successfully.

Some student nurses quit their part time jobs so that they could answer this call to work on the COVID response. I lost a family member during the pandemic and kept on working.

It’s just all been so disheartening.

Holly is involved with a a petition, started by NHS Million, a grassroots campaign run by NHS staff, for funding to carry on for paid hours, until the end of October.

Professor Mark Radford, Chief Nurse, Health Education England's statement, in full

We would like to thank all those students who were able to come forward to support the NHS at this challenging time. It has been hugely appreciated. To be clear it is absolutely untrue to suggest that student nurses and midwives are being made redundant, all student nurses and midwives are required to complete placements during their training.

These placements are normally unpaid but to recognise the special circumstances and as part of the response to Covid-19 these hours have been paid and will be until the end of summer. NHS England has been provided with the funding for student salaries as part of the response to Covid.

Year 3 students will be paid till 31st of July and if they have completed hours and assessments can qualify and be paid as a full registered nurses. They will move from Band 4 to Band 5 and therefore increase their pay. Any Year 3 student who has hours to complete will be paid until September to allow them to do this. Any Year 2 students on placement till July 31st will be paid and after this normal non-paid placements will be re-introduced along with Year 1 students.

We committed at the outset of the pandemic to ensure that these students complete their training and are able to qualify. It was always made clear to students who opted into paid placements the arrangements would need to come to an end at an appropriate point so that students could return to their supernumerary status to complete their registered nursing qualifications as quickly as possible to permanently enter the NHS workforce.

It was agreed by all partners, including the Nursing and Midwifery Council (NMC) and Council of Deans (CoD) and unions, to support these arrangements. This means any final year student who has been working in the NHS will receive funding until they complete their programme and then they will be able to register with the NMC and apply for a permanent role as a registered Nurse.

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