Is it time for us to rethink field-specific training?
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Is it time for us to rethink field-specific training?

Edward Purssell Associate professor in Children’s Nursing, Anglia Ruskin University, Chelmsford
Rohit Sagoo PhD candidate, University of Bedfordshire, Luton

A return to generic training can broaden nurses’ experience and prepare students for clinical situations

Nurse training in the UK is unusual compared with countries such as Canada, Ireland and New Zealand in that it is field-specific from the first day. But it has not always been that way. Before the phased introduction of the changes to nursing, midwifery and health visiting training in Project 2000 in 1989, most adult and children’s nurses qualified as general nurses before specialising.

Nursing Children and Young People. 35, 2, 12-12. doi: 10.7748/ncyp.35.2.12.s5

Published: 02 March 2023


Picture credit: iStock

Project 2000 replaced the general nursing qualification with field-specific ones. At first the new qualifications included an 18-month common foundation programme (CFP), which gave students some experience in each field of nursing.

Over time the CFP was cut, leaving us in the situation we have today, where many students have little or no experience in the other fields of nursing. Although some universities offer dual registration degrees, such as ‘adult and mental health’ – if you are not doing one of these you will probably not gain experience in these areas. This arrangement does not make for good care or meet the needs of the population. Although nursing may break the population down into discrete groups of children and adults, life does not.

The NHS Long Term Plan suggests a selective move to a ‘0-25 years’ service. Young people do not move from child to adult at the same age, which begs the question, who is actually qualified to look after people of 16-24 years? Neither a specific children’s nor adult nursing qualification gives significant experience of this age group.

Removing the general aspect of training also makes the UK workforce inflexible. This was exposed during the acute phase of the COVID-19 pandemic, which largely affected adults, when children’s nurses looked after adult patients with whom they had little or no previous experience.

While the fundamental principles of nursing remain unchanged, scenarios such as this have the potential to compromise care, as nurses are required to go beyond the scope of their training.

The Nursing and Midwifery Council (NMC) revealed in response to a freedom of information request last year that it had not held any specific discussions on children’s nurses working in adult areas during COVID-19. This is worrying because the NMC has not discussed how children’s nurses will work with adults in a 0–25-year-old service, as envisaged by the NHS Long Term Plan.

After all, if the UK’s system of nurse education is so good, why does no one else follow our lead?

Practical experience

In the past, generic training offered students a chance to try working in different fields before making a lifelong decision about specialising. This lead to a nursing workforce with practical experience in all areas of nursing practice.

Generic training could also reduce student attrition rates for specialised preregistration programmes and could attract mature students, who have an established way of thinking – problem solving combined with experiential learning – that allows them to adapt to different environments.

Generic training in nursing could provide a multi-skilled nursing workforce in a challenging world where the demand for nursing care is soaring across the lifespan. It would also increase the number of opportunities for ongoing professional development. A generic nursing programme would enhance clinical decision-making skills, critical thinking and generic competencies from a holistic perspective. This would allow nurses to move freely between caring for children and adults.

The fundamental principles of nursing care apply across all fields of nursing. A generic nursing programme would prepare students for a variety of clinical situations. It could consist of a general nursing qualification with a nuance of specialised practice that could be developed post-registration.

The time for generic training and a nursing workforce with broad experience is now.

This is an abridged version of an article at

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