Nurses: graduate entry

Your excellent coverage of the National Health Service Plan (Analysis and leader, THES, August 4) and its implications for higher education did not go far enough.

Universities are well able to deliver the new agenda, which mostly revolves around the pre-registration education of nurses. The problem is whether or not they will be able to achieve their teaching and research missions through these programmes.

With the Making a Difference agenda, the Department of Health has already severely diluted the education of nurses. With hardly a protest, those universities delivering pre-registration nurse education have been transformed into training agencies for their local NHS trusts. The emphasis is now on clinical skills to be acquired within the first year of training, rather than on education - without any acknowledgment that the proper application of skills first requires a sound education.

It is incongruous that the NHS Plan includes recommendations for an extended role, into medical practice for many nurses. You rightly draw attention to the possibility that nurse education may be deficient in this respect. The US and Australia have long since adopted the graduate entry to nursing approach, and Ireland is on the verge of adopting it. In the UK we are being left behind. Thankfully, many colleagues are working hard to maintain an element of proper undergraduate education that is capable of delivering the NHS Plan.

Roger Watson Professor of nursing University of Hull