Access to HE diplomas for nursing and healthcare

An Access to Higher Education (HE) diploma is a one-year college course, usually for adults aged 19 and over, that replaces A levels for university entry. A health-focused Access diploma is the most common route into nursing, midwifery, paramedic science and other NHS degrees for people who left school without the qualifications. In England you can pay for it with an Advanced Learner Loan, and that loan is written off if you go on to complete a higher education course.

What the diploma is

Access to HE diplomas are level 3 qualifications, the same level as A levels. They are run by further education colleges and some adult education centres, and are regulated through the Quality Assurance Agency. Each diploma has a subject theme, and for health careers you want one called something like Access to HE Diploma (Nursing), (Health Professions), (Midwifery) or (Health Science).

The course mixes subject units (biology, health studies, psychology, sociology) with study skills such as essay writing and referencing. Units are graded, and universities often ask for a certain number of credits at Distinction or Merit. Each university sets its own entry requirements, so check the course page or ask admissions before you enrol.

Who it suits

It suits adults who have been out of education for a while and do not have A levels or a level 3 vocational qualification. Many people do it alongside work, often as a healthcare assistant, carer or in an unrelated job. Full-time courses usually take one academic year; part-time options take longer.

Most degree courses also want GCSEs in English and maths, sometimes science too. If you do not have them, many colleges let you take functional skills or GCSE classes alongside the diploma, but check whether your chosen universities accept functional skills for nursing. Some do not.

Choosing the right diploma

Before you enrol:

• pick two or three universities you might apply to and read their Access requirements
• confirm the diploma title is on their accepted list; a general science Access course may not be accepted for midwifery, for example
• check which units are included, especially biology or human physiology
• ask the college how many past students went on to health degrees

Midwifery and paramedic science are competitive and may ask for higher grades. Mental health, learning disability and children’s nursing each have their own course codes, so look at the specific field you want. Health Careers explains the four fields of nursing and the other professions open to degree applicants.

Paying for it

In England, if you are 19 or over and the course is approved, you can apply for an Advanced Learner Loan to cover the fees. It is not means-tested and you do not need a credit check. You repay it in the same way as a student loan, but only once your income passes the threshold. If you then complete an eligible higher education course, the outstanding Access loan is written off.

Some learners can get the course free or reduced, depending on age, income and existing qualifications. Colleges’ admissions teams can tell you what applies. In Scotland, similar courses run through the Scottish Wider Access Programme and colleges, with different funding. In Wales and Northern Ireland, colleges run Access courses with their own fee rules.

From diploma to degree

You apply to university through UCAS in the normal way, usually while you are part-way through the diploma. Universities make offers based on your predicted Access grades. Health degrees almost always include an interview, often values-based, and a DBS check and occupational health clearance once you accept.

Funding for the degree is separate. Eligible nursing, midwifery and many allied health students in England get standard tuition fee and maintenance loans through Student Finance, plus non-repayable support from the NHS Learning Support Fund. Students in Scotland, Wales and Northern Ireland have their own arrangements.

Once qualified, registered nurses in England start on NHS band 5, which is £32,073 from April 2026. The guide to changing career into nursing covers the full picture.

Other routes that skip the diploma

An Access course is not the only way in. If you already work in the NHS, a nursing degree apprenticeship lets you train while paid, though employers usually still want level 3 qualifications or equivalent experience. The nursing associate apprenticeship is another step that can later count towards a nursing degree. The guide on moving from healthcare assistant to nurse compares these.

Some universities accept relevant work experience plus evidence of recent study in place of a full level 3 qualification. Ask admissions directly, with details of your experience, before committing to a year of study.