The document outlines a 10-year plan to develop nursing staff from apprentice level to advanced practitioner. It proposes a pathway where apprentices could become registered nurses within 4 years, and then continue their education to become advanced clinical practitioners or take on leadership/management roles over 10 years. It also describes BHRUT's current nursing workforce challenges, such as high vacancy rates, and initiatives to grow their own nurses through apprenticeships, nursing associates, and graduate nurse programs. The goal is to develop a sustainable nursing workforce with the right skills to deliver high quality patient care.

1. DNA OF THE FUTURE
NURSING WORKFORCE:
NHS NURSING WORKFORCE
MODELLING WORKSHOP
Kathryn Halford
Chief Nurse
Kenye Karemo, Deputy to Chief Nurse
Workforce Development, Education and
Professional Standards

2. BHR TODAY – CARE CERTIFICATE PHOTO

3. VISION FOR NURSING
• A centre of excellence for ‘Growing-Your-Own’ with specific expertise in
motivating, inspiring and developing healthcare support workers to
become registered nurses
• Centre of excellence in the attraction, recruitment, education and
retention of registered nurses
• Centre of innovation in developing nurse practitioners skilled and able to
lead and implement care new models of care
• An ‘Employer of Choice’ for registered nurses in North East London
• A sustainable nursing workforce

4. 10 YEAR PLAN: APPRENTICE TO ADVANCED PRACTITIONER IN TEN
YEARS
General Level Practice
18 – 24 months
(general & rotational
programmes)
General Level Practice
18 – 24 months
(general & rotational
programmes)
Change pathway:
Education
Research
Advanced Clinical
Practice
Change pathway:
Education
Research
Advanced Clinical
Practice
COMPETENT LEVEL:
General Level Practice
COMPETENT LEVEL:
General Level Practice
PROFICIENT LEVEL:
Advanced Level Practice
PROFICIENT LEVEL:
Advanced Level Practice
EXPERT LEVEL
Advanced Level
Practice
EXPERT LEVEL
Advanced Level
Practice
BHRUT/HEI Post-registration Infrastructure and Delivery Model
Year 4 - 10
BHRUT/HEI Post-registration Infrastructure and Delivery Model
Year 4 - 10
Advanced Practice I
12 – 24 months
(foundation specialist training)
Advanced Practice I
12 – 24 months
(foundation specialist training)
Advanced Practice II
24 – 48 months
(speciality training)
Advanced Practice II
24 – 48 months
(speciality training)
Staff Nurse
Band 5
Staff Nurse
Band 5
Advanced
Practice III
Corporate Leadership and
Management
Advanced
Practice III
Corporate Leadership and
Management
BHRUT/HEE Pre-registration
Education Delivery Model
Year 0 – 4
BHRUT/HEE Pre-registration
Education Delivery Model
Year 0 – 4
Care CertificateCare Certificate
Nursing
Associate
training 24
months
Nursing
Associate
training 24
months
Graduate Nurse
Training
18-36 months
Graduate Nurse
Training
18-36 months
NOVICE LEVEL:
Foundation Level Practice
NOVICE LEVEL:
Foundation Level Practice
Matron
Divisional Nurse
Deputy Chief Nurse
Advanced Clinical Practitioner
Band 8-9
Matron
Divisional Nurse
Deputy Chief Nurse
Advanced Clinical Practitioner
Band 8-9
Senior Sister/
Charge Nurse
Band 7
Senior Sister/
Charge Nurse
Band 7
Junior Sister
Band 6
Junior Sister
Band 6
Change pathway:
Education/Practice
Development
Research
Advanced Clinical Practice
Leadership
Change pathway:
Education/Practice
Development
Research
Advanced Clinical Practice
Leadership
Newly Registered Nurse
Return to Practice
Newly Registered Nurse
Return to Practice

5. INTENDED OUTCOMES
• Ensure all staff have the right skills, knowledge and experience to deliver
their very best for patients, carers, colleagues and the Trust
• Provide an environment and culture where learning and development
flourishes and drives improvement in all we do
• Enable a safety culture; one where the habit of open questioning and
communication, learning from experience and application of best practice
is accepted, valued and practised by all staff

6. APPRENTICE TO REGISTERED NURSE STATUS IN 4 YEARS
(ROAD MAP TO NMC REGISTRATION)
Foundation Level PracticeFoundation Level Practice
Care CertificateCare Certificate Graduate Nurse training
18 – 36 months
Graduate Nurse training
18 – 36 months
BHRUT/HEE Pre-registration
Education Delivery Model
BHRUT/HEE Pre-registration
Education Delivery Model
Healthcare
Assistant
Healthcare
Assistant
Nursing Associate
training
24 months
Nursing Associate
training
24 months
Nurse AssociateNurse Associate Graduate entry
Student Nurse
Graduate entry
Student Nurse
Healthcare
Assistant
Healthcare
Assistant
Nursing ApprenticeNursing Apprentice

7. THE CHALLENGES ON ONE PAGE
• Band 5 registered nurse
• 1000 wte (entry grade to registered workforce)
 Vacancies - 338 wte (34% vacancy rate) Band 5 registered nurses
 Retention challenges
• Healthcare Assistants (mostly Band 2 ; very few Band 3 HCAs)
 Vacancies – 135 wte (16%) Band 2 (mostly)
• Geographical location
 Not London, not quite Essex ….. located in zone 6

8. TALENT PIPELINE – OPPORTUNITIES TO ‘GROW’
FUTURE REGISTERED NURSES
• Student nurses: 200 per year
• Overseas trained nurses (NMC registered): 50 per year
• Trainee Nursing Associates: 60 per year
• Nursing Apprentices: 30 per year (5 currently)
• Overseas trained nurses (non-NMC registered): 15 per year (future
cohorts TBC)
• Increased focus on retention e.g. Innovative Preceptorship for registered
staff, Senior Intern Programme (sponsored by HEE)
• IN DEVELOPMENT: Exploring opportunities to develop fast-track programmes for
experienced HCAs to APEL

9. NURSING ASSOCIATE TRAINING PROGRAMME

10. HEE
Nursing Associate
Framework 2017
LSBU/Academic
Curriculum
PRIDE WAY
Nursing
Associate
Training
Framework
NURSING ASSOCIATE DEVELOPMENT FRAMEWORK
BHRUT
Trainee Nursing
Associate ‘Curriculum’

11. ENSURING SAFETY & GOVERNANCE
• Approval and review by Executive Board, Quality Assurance Committee
and People & Organisation Development Committee
• Dedicated Implementation Project Board - Chaired by Chief Nurse
• Multidisciplinary membership – representation from Divisional Nurses,
Senior Sister/Senior Charge Nurses, Education, People & OD,
Workforce Systems (e-Roster), Pharmacy and Communications
• Dedicated patient representation (Patient Partner)
• Project Board supported by multidisciplinary operations focused working
groups (Ward Managers, Practice Development Nurses, Workforce
Information, HR Admin)

12. PROGRAMME STRUCTURE
Supervision in Practice Requirements (25% of placement time)
•‘Line manager’ - Band 7, Senior Band 6 (typically)
•Named Supervisor – Band 6, Senior Band 5 (typically)
• Months 1 – 6: BHR rotations (home ward and internal rotation)
• Months 7 – 18: Combination of Community (NELFT) AND Quality &
Safety* rotations (BHR focused)
• Months 19 – 24: BHR (home ward)
*Include delivery of Quality & Safety Project linked to Trust’s Quality Improvement plan and
corporate Quality agenda

13. SPOT THE TRAINEE NURSING ASSOCIATE

14. OUR TRAINEE NURSING ASSOCIATES
–
KEY FACTS & STATS

15. KEY STATS – WORKFORCE STATS
• Gender
 Female: 45 (80%) Male : 11 (20%)
• Length of Service
 Less than 1 year: 3 (5%)
 1 - 5 years: 35 (63%)
 5 - 10 years: 15 (27%)
 More than 10 years: 3 (5%)

16. KEY STATS – PRIOR EDUCATION
• Care Certificate (100% completion)
• NVQ Health & Social Care Level 2/3
• A Level (Grade A - E)
• AS Level
• GCSE/GCE (Grade A*, A, B or C)
• Level 2 Functional skills
• BTEC/National Diploma Level 3
• None/unavailable to evidence
• Other: Access to Higher Diploma (Nursing, Midwifery and Health
Studies); Level 4 Certificate of Higher education (CertHE)

17. KEY STATS - DIVISIONAL SPREAD
• Acute Medicine – 24 (includes A & E. Assessment Units)
• Anaesthetics & Critical Care - 1
• Cancer & Clinical Support - 3
• Corporate Services – 3 (Outpatient Departments)
• Specialist Medicine - 19
• Surgery - 5
• Women’s & Children - 1

18. 10 YEAR PLAN: APPRENTICE TO ADVANCED PRACTITIONER IN TEN YEARS
General Level Practice
18 – 24 months
(general & rotational
programmes)
General Level Practice
18 – 24 months
(general & rotational
programmes)
Change pathway:
Education
Research
Advanced Clinical
Practice
Change pathway:
Education
Research
Advanced Clinical
Practice
COMPETENT LEVEL:
General Level Practice
COMPETENT LEVEL:
General Level Practice
PROFICIENT LEVEL:
Advanced Level Practice
PROFICIENT LEVEL:
Advanced Level Practice
EXPERT LEVEL
Advanced Level
Practice
EXPERT LEVEL
Advanced Level
Practice
BHRUT/HEI Post-registration Infrastructure and Delivery Model
Year 4- 10
BHRUT/HEI Post-registration Infrastructure and Delivery Model
Year 4- 10
Advanced Practice I
12 – 24 months
(foundation specialist
training)
Advanced Practice I
12 – 24 months
(foundation specialist
training)
Advanced Practice II
24 – 48 months
(speciality training)
Advanced Practice II
24 – 48 months
(speciality training)
Staff Nurse
Band 5
Staff Nurse
Band 5
Advanced Practice III
Corporate Leadership
and Management
Advanced Practice III
Corporate Leadership
and Management
BHRUT/HEE Pre-registration
Education Delivery Model
Year 0 – 4
BHRUT/HEE Pre-registration
Education Delivery Model
Year 0 – 4
Care CertificateCare Certificate
Nursing
Associate
training 24
months
Nursing
Associate
training 24
months
Graduate Nurse
Training
18-36 months
Graduate Nurse
Training
18-36 months
NOVICE LEVEL:
Foundation Level Practice
NOVICE LEVEL:
Foundation Level Practice
Matron
Divisional Nurse
Deputy Chief Nurse
ACP
Band 8-9
Matron
Divisional Nurse
Deputy Chief Nurse
ACP
Band 8-9
Senior Sister/
Charge Nurse
Band 7
Senior Sister/
Charge Nurse
Band 7
Junior Sister
Band 6
Junior Sister
Band 6
Change pathway:
Education/Practice
Development
Research
Advanced Clinical Practice
Leadership
Change pathway:
Education/Practice
Development
Research
Advanced Clinical Practice
Leadership
Newly Registered Nurse
Return to Practice
Newly Registered Nurse
Return to Practice

19. THANK YOU FOR LISTENING

20. WORKSHOP ACTIVITIES – 15 MINUTES

21. CLAIMS
• What positive statements can you make about the Apprentice to
Advanced Practitioner Model?

22. CONCERNS
• What concerns or negative statements would you make about the
Apprentice to Advanced Practitioner Model?

23. ISSUES
• What questions do you have about the Apprentice to Advanced
Practitioner Model?

24. SO WHAT ABOUT THIS MODEL ….
• What are your thoughts about this Model, compared to other Nursing
Career Development Models?

25. ANYTHING ELSE?
• Do you have any other questions or comments?