A FORMER NHS director has called for an end to the “professionalisation” of nursing by opening up the career to those with college qualifications as the health services grapples with a looming retirement time bomb and increasing numbers of long-term vacancies.

Professor Alan Boyter, who retired from NHS Lothian last year after almost four decades, said the health service was missing out on a “huge potential talent pool” by restricting entry into nursing to those who had completed a four-year university degree.

Herald View: Why the future of the NHS really is in our own hands

He said that care graduates qualified on HNC and HND courses should be able to enter low-level nursing posts to carry out “badly needed” tasks such as feeding, washing, toileting and caring for elderly patients on geriatric wards.

That fresh influx would help free up higher-skilled and university-qualified nurses to perform more complex work.

The controversial proposal comes as the NHS struggles with an ageing crisis even more acute than the trends in society, with 38 per cent of the NHS workforce in Scotland aged over 50 compared to the 20 per cent of the general population who are aged 50 to 64.

More than one-third of nurses and 41 per cent of midwives in Scotland are aged over 50, leaving the NHS facing a “demographic time bomb”, which will see hard-to-fill posts, especially in remote and rural areas, lying empty longer and the costs of agency staff – already up from £82 million in 2012 to £175m in 2016 – balloon further.

Herald View: Why the future of the NHS really is in our own hands

Prof Boyter, who worked for 25 years as a human resources director at NHS Lothian, said: “Before 2000, nursing was a diploma and originally it was an apprenticeship. Those nurses who are reaching retirement now would not have been university educated and would anyone suggest that they are less capable of the job? And yet if they were starting out today, perhaps they would not have the qualifications needed to get on to a university nursing course. The statistics show that around 25 per cent of the population in Scotland have university degrees.

“If we are only recruiting from 25 per cent of the population, then I would argue that we are excluding a huge number of the potential labour market at a time when we are struggling to fill a lot of nursing posts, especially in remote and rural areas. Do you need to go to university for four years to be a good nurse?

“There are a lot of areas of nursing which could be done by HNC and HND-qualified care graduates, but at the moment there is a big resistance to that within the profession and from trade unions.

“It’s seen as dumbing down. I want to be clear that what I’m saying is not anti-nursing.

“I think it’s great that we have nurses who are highly educated and qualified, but by rethinking how we recruit and train people into the profession I think we would open up a fresh talent pool that is currently excluded. At the moment, no matter how hard-working and able the college graduates are, they have no opportunity to get into nursing or move up the ranks without completing a university degree. But does every area of nursing really require a university education?

“What I’m suggesting would fill those lower level posts and free up the university-educated nurses to do the more complex, more interesting jobs. It’s not about replacing a nurse; it’s about augmenting them, and having the right number of people with the right skills in the right place.”

Herald View: Why the future of the NHS really is in our own hands

The most recent figures from ISD Scotland, the Government’s health statistics body, show that – despite record staffing levels – nearly 740 vacant nursing and midwifery posts in December 2016 had been unfilled for more than three months, up nearly 34 per cent in a year. At the same time, the country’s ageing population is spurring an increased demand for hospital services.

Prof Boyter, who is now director of the organisational and human resources consultancy, Dignity HR, said the budget constraints meant the NHS could not recruit thousands of care graduates on top of the nursing workforce, but that the wave of retirements offered an opportunity to reconfigure how hospitals are staffed.

He said workforce planning in the NHS has previously been “hamstrung” by the Scottish Government’s pledge to never have any fewer nurses than when they came to power.

Prof Boyter added: “The NHS workforce is ageing and ageing faster compared to the general population. We know the population is becoming increasingly elderly and with that comes a huge burden of costs and care.

“Demand for staff will increase, and if we don’t modernise and start looking to different ways of doing things our ability to deliver patient care will be lost.”

Herald View: Why the future of the NHS really is in our own hands

Ellen Hudson, RCN associate nurse director, said increasing pressure on hospitals meant more highly skilled nurses were needed to alleviate the strain.

She said: “Registered nurses are clinical decision-makers, with considerable experience of caring for people with multiple or complex conditions. They also supervise more junior staff. So it is essential that they have the best possible preparation in their education to carry out such a complex role.

“That’s why it is important that our registered nurses are educated to degree level.”

A Scottish Government spokesman said: “Under this government, the number of qualified nurses and midwives has increased by 4.9 per cent. Having a highly educated graduate nursing workforce is vital and saves lives – which is why we have committed to an extra 1,000 training places for nurses and midwives.

“We do of course also value the skilled healthcare support workers who make an important contribution across varied roles.”