Why bother with A levels if...

[Miljea]

... you can get on a health care degree apprenticeship with a couple of GCSEs, a 3 month local tech P/T level 3 'Introduction to Health Care' course (essays, no exam); and an additional 'Step Up' 8 hours of 'prep' coursework? Thence onto a degree course with all but no academic time (20% of the total time); 1 exam (end of Y1) and all the rest being 'assessments' and 'essays'- run by the uni who want the cash and have no skin in the game - or accountability- once you 'qualify'?

Why did I bother with three A levels, including a science? And then paying for my degree?

Am I a mug -or is the British Public in the dark about the tumbling standards needed to be a HCP?

EduCated- the Level 3 course that took 3 months to complete was in-house at my hospital Trust. It was their own 'bridging' course, done with the blessing of the uni that supplies HCP students to us. Set in-house, judged in-house. No exams. I can promise you that's true because I wasn't the only HCP rather surprised at the paucity of academic rigour necessary. Both HCAs also did 'functional maths' and 'English' as neither has GCSE let alone O levels in those subjects (these were at least both examined- though one person had to resit three times...).

And no, obviously A level holders can apply for the degree apprenticeships. My 'issue' is partly the massive reduction in academic time the apprentices have when compared to the uni students; but it is 100% the low academic achievement necessary to get onto these apprenticeships. If, for example, you want to do the uni degree in radiography, without the requisite A levels, you have to do a quite full-on Access year, that many do over two years as it's quite tough. And has exams.

The whole point I am making is why bother with the academic rigour of 2-3 A levels, or Access course (which requires actual level 4s in Maths and English GCSEs to enter) if the apprenticeship unis are going to take you on with a cobble together of what I've just described, earlier?

titchy I can assure you what I have described is what's happening. People are entering HCP degree courses who have sat no other exam apart from the Functional Skills I have described. Once in uni, they can almost not fail. Endless retakes.

As an aside, we as 'the staff' are heavily encouraged not to fail any of them at practicals! But that is another issue.

Yes, my training is 'old' but I do have a degree upgrade (2 years, distance but with several sit-down exams, done in 1998) and I have witnessed the changes in training over the years. In my opinion, a lot of HCP doesn't need to be a degree, but when theatre studies is.... and when you won't get paid professional wages without a degree entry, that's the direction it has had to go in.

Like all old timers, I rolled my eyes at the advent of the degree (and bear in mind, I had to have A levels to do my Diploma!); the first degree year where I was (in Queensland), halfway through their final, third year, had a Professional Development Year added to their degrees before they were allowed to be fully qualified, as too many of the hospital staff said they were 'theoried up', but lacked the very hands-on of the diploma course. As ever, The Truth lay somewhere in between!

But I have seen a lot of good come out of the degree course; deeper knowledge, deeper understanding, being smart enough to take advantage of career development like nurse practitioners, advanced practice radiographers, to name a couple.

However, now I'm seeing people who really, academically, aren't even really '8 GCSEs inc English and Maths', let alone A levels standard, being taken onto degree courses! I see the 'Ooh, I hate exams, glad I won't have to sit any!' -and I think- how do you cope under pressure? How do you think on your feet? How do you pull it out of the bag when the chips are down?

And how long before a government minister twigs that these 'degrees' are no longer A level standard entry, thus why are we paying professional wages?....

I can assure you what I have described is what's happening. People are entering HCP degree courses who have sat no other exam apart from the Functional Skills I have described. Once in uni, they can almost not fail. Endless retakes.

I'm well aware of the entry requirements for degree apprenticeships, including NHS ones. I'm just letting you know that the 'rigorous' entry requirement of A levels only applies to school leavers. Mature entrants have always been able to start nursing etc degrees withoit M and E GCSEs as long as they have functional skills. The entry requirements for the apprenticeships are the same.

If you have any evidence that the quality of on the job training that apprentices receive is substandard, or that the content is substandard, complain to the NMC. They devised the apprenticeship programme.

FWIW nursing was never meant to be a degree level profession. It was only made one because the Gov at the time saw it as an easy fix to the imbalance between girls and boys going to uni. It was always meant to be largely job based.

Titchy "I'm well aware of the entry requirements for degree apprenticeships, including NHS ones. I'm just letting you know that the 'rigorous' entry requirement of A levels only applies to school leavers. Mature entrants have always been able to start nursing etc degrees withoit M and E GCSEs as long as they have functional skills. The entry requirements for the apprenticeships are the same."

I'm not sure where to go with this. You have openly agreed with me.'Rigorous' academic achievement is only required of 18 year olds. Not quite sure what 'without M and E GCSESs' means, though. But you seem to be implying that 'functional skills' are all that are needed. Which is indeed the case. You are openly stating that you only need proof of academic ability, at 18. Thereafter, who cares?

Which is why I ask 'Why bother with A levels if the ability, for example, mathematically, to work out wallpaper requirements is good enough to become a professionally registered HCP?'

I get you’re angry but please just clarify what’s “the healthcare degree” actually IN?

Nursing?
Operating Practice whatsit?
Health & Social Care?

What?

FWIW nursing was never meant to be a degree level profession. It was only made one because the Gov at the time saw it as an easy fix to the imbalance between girls and boys going to uni.

Is that what project 2000 was in aid of?

Level 3 Access courses into higher education have existed for years and years. An inexperienced young person straight from school, sitting A levels and then going on to uni is very very different to someone who has gone straight into the workforce aged 16 (sometimes through no choice of their own), gained a large amount of experience and knowledge through years in the workplace and then made a life changing decision to study nursing. These people often already live an adult life paying bills and mortgages, young families to support and aspirations of a second career. These people bring life experience to the table.

I'm sure they do.

But I don't think one should be allowed onto a HCP degree course without even GCSE level Maths and English. Let alone the proven track-record of holding 2-3 actual A levels.

I can see that some universities are complicit in this as their sole interest is £28k in fees. Once unis became businesses and degrees became commodities, this was always going to be the case.

However, you can have all the 'life experience' you like, but if you need a bit of paper to work out how to split 100mls of fluid equally into 3 lots, I would challenge your suitability for a HCP degree course. That you are now in the first year of.

But I don't think one should be allowed onto a HCP degree course without even GCSE level Maths and English. Let alone the proven track-record of holding 2-3 actual A levels.

Well clearly the regulatory bodies and employers disagree. And given that mature students have NEVER needed M or E (Maths or English) GCSEs, and I'm not aware of huge swathes of incompetent nurses I'm not entirely sure what your problem is.

Left school at 16, didn't do A levels? Not a barrier to becoming a nurse now, wasn't a barrier 20 years ago. Nothing's changed.

I can see that some universities are complicit in this as their sole interest is £28k in fees. Once unis became businesses and degrees became commodities, this was always going to be the case.

And unis offering nursing etc degrees have to be regularly assessed by the relevant professional bodies. So again, if you have a problem with this, complain to the NMC.

Finally (!) just because the fees are now paid by the students, doesn't mean uni income has increased - fees were paid by Gov before, students now. But same amount. So if they were 'all about the money' now, they always were.

Yes, 'regulatory bodies' have changed.

Why the assumption 'for the better'?

If these people can work at L3 then they are prime candidates for a HCP degree having both the intellectual capacity and bonus skills/experience of previous work.

HCP needs to be accessible to a wide range of people. The future of the NHS depends on accessing the right staff and would be shooting them selves in the foot only taking 18 year old A level students

My uncle, father of two children went into nursing aged 41 after being in the workforce for years.

The NMC oversee every course which leads to being a qualified nurse. Every course is validated by them, so a thorough pre course inspection where stuff like entry qualifications, curriculum and assessment is signed off.

It’s not just a rubber stamp process, come courses aren’t validated.

So your governing body must be happy with the course.

This might allow my niece to level up. She didn't complete her degree for mental health reasons. She's worked ever since as a carer, and then in a hospital. It would be great if she could eventually qualify as the nurse she always wanted to be. She's excellent.

I'm well aware of the entry requirements for degree apprenticeships, including NHS ones. I'm just letting you know that the 'rigorous' entry requirement of A levels only applies to school leavers. Mature entrants have always been able to start nursing etc degrees withoit M and E GCSEs as long as they have functional skills

Not just mature entrants. Plenty of younger students do poorly in their GCSEs so do an access course rather than A levels. They can do functional maths/English at the same time if necessary. Students who get 2s and 3s in their GCSEs then go onto get 45 distinctions on their access course. 🤷‍♀️ Does make you wonder how robust the access course is. Maybe I’m being unfair, I suppose some students will flourish more in a subject they’re interested in and also do better with essays rather than exams. I do think exams are a shit method of assessment.

I’m a qualified HCP and university lecturer. When I was a student I crammed for various exams, thinking specifically anatomy and physiology stuff. I’d say I forgot the majority of what I revised within a few months, the evidence shows this is true for the majority of people. And in 15 plus years I haven’t needed to know it at the level I had to know it to pass exams. Obviously stuff which I need to know for the actual job sticks in your head because you’re being exposed to it frequently.

The whole point I am making is why bother with the academic rigour of 2-3 A levels, or Access course (which requires actual level 4s in Maths and English GCSEs to enter) if the apprenticeship unis are going to take you on with a cobble together of what I've just described, earlier?

You do not need GCSEs for an Access course, that' the point of them, that you are prepared for uni.

For nursing and teaching access courses you do have to take the relevant GCSEs alongside the course.

For my FE teaching qualification I had to prove I was still able to use level 2 maths and English so we sat functional skills exams, for my PGCE I also had to do a version of FS for teachers.

Nursing is one area that has seem massive changes in both the training and the roles available to nurses.

My aunt became a 'cadet' at 15 with no qualifications and went on to do an SRN course. My brother and his wife both took hospital based routs to RMN and RGN respectively.

Most of the girls I was at school with who went into nursing did a 'pre nursing' course - at that time you needed 5 O Levels and the course taught 5 O Levels including English and maths.

And BTW what's wrong with wiping a bum if someone needs it?

if you need a bit of paper to work out how to split 100mls of fluid equally into 3 lots, I would challenge your suitability for a HCP degree course.

I'd like to see you measure 33.3333333333333333333333333333333... using paper or otherwise.

I'm going to jump in with a few random points:

• GCSE English language is pretty technical / esoteric. Not having a 4+ doesn't mean that someone's English comprehension and writing isn't perfectly OK. it might just mean they can't write creatively with loads of imagery, or talk coherently about the structure of a piece of text.
• There is more to life than exams. If someone can show by on the job practicals and verbal assessments that they have the required skills & knowledge, why should they be prevented from doing a job because for whatever reason they can't do exams
• Surely we need all kinds of levels in health care. Some nurses are highly skilled medical practioners these days - much more so than say 40 years ago. But patients still need the 'medically aware but have time to care' people to give the human touch, time to talk, time to encourage eating etc.
• Some people for whatever reason don't do well in the GCSEs first time around. My DD for one may come out with nothing this year as she has been unwell. Before the pandemic she was on track to pass all her GCSEs. It won't make her any less capable for her next steps because she hasn't got Eng Lit, or Drama or whatever.
• You aren't being very coherent in what degrees/diplomas you are talking about which makes following your argument difficult to say the least.

DD was a mature student on the nursing diploma course in the 90s. She didn't have A levels, just GCSEs. She had a care qualification, and had worked for several years before deciding to train as a nurse.

Years later, she studied, whilst working full time as a nurse, for her degree. She has gone on to further qualifications directly linked to her specialism and has built a good career.

Not everyone develops at the same pace, I'm pleased to see opportunities for people who may not have gone through the academic route in their teens.

AHP courses are accredited by HCPC and the relevant profession-specific professional body. Without that accreditation graduates can’t register as qualified professionals and can’t practice. To gain accreditation, programmes need to prove - via regular audit cycles and validation processes - that learners meet the required standards for education and training (SETS) and standards of proficiency (SOPS) as well as delivering on any profession-specific requirements, including set practice placement hours. This is a rigorous process and ensures that HCPs are fit for purpose and safe practitioners. Your suggestion that links between professional bodies and training programmes no longer exist is inaccurate. Entry requirements may vary but exit requirements do not, so if learners don’t reach the standards required whilst on the programme they won’t pass.

Can I just ask - did people pay to do nursing degrees in 1980?

Also why are GCSEs not as good as O-levels?

Are my GCSEs from 1995 not worth anything? Even grade As?

Also why are GCSEs not as good as O-levels?

O Levels were only taken by the 'top' 20% and were norm referenced so you had to get a certain % to pass, but that % changed every year so there were even numbers of A, B, C, D, E grades. Besides O Levels there were CSEs designed for the next 30%,that's right 50% of people left school with no qualifications.

CSEs were not norm referenced (I think) so it wasn't uncommon to sit a CSE and O Level in the same subject if you were borderline C/D at O Level.

Are my GCSEs from 1995 not worth anything? Even grade As?

I applied for a tutoring job, they wanted A or A+ GCSE or A, B or C O level so for some organisations yes they see O Levels as superior.

In reality if GCSEs are the only exam you were entered for then that's the only qualification you can get.

I think they were probably more in depth because it was normal to take 5 or 6, 10 was just about heard of but was rare. When GCSEs came in students were suddenly taking more qualifications, not just GCSES but BTECs and City and Guilds.

IMHO this was a better idea, it gave a wider education to everyone but Britain likes numbers, politicians like a 1950s education so GCSEs are now exam only and people count the numbers.

@StarCat2020

Can I just ask - did people pay to do nursing degrees in 1980?

Also why are GCSEs not as good as O-levels?

Are my GCSEs from 1995 not worth anything? Even grade As?

Nursing degrees were fee free in the 80s, 90s and even 2000s. And we got bursaries but could not apply for student loans. Fees were introduced in 2017.

Is this a regional issue? I only ask as the college I did my access course at wouldn't accept students without both English and maths GCSEs at C or above. Several students had retaken them (at the same college) the year prior to me starting there. Universities did seem somewhat flexible with mature students, although mine had quite strict criteria (diagnostic radiography) and would have preferred that my access course included physics, I did have to study that on the side to ensure I understood the basics before I started the course.

It's difficult really, there have to be minimum standards for all AHP careers, tempered with flexibility for those who may be taking a more unconventional route in.

covidcorvid "They can do functional maths/English at the same time if necessary. Students who get 2s and 3s in their GCSEs then go onto get 45 distinctions on their access course. 🤷‍♀️ Does make you wonder how robust the access course is."

Indeed.