Aim. The aim of this paper is to discuss the opinions of the key individuals involved in implementing the integration of nurse education into higher education in the United Kingdom (UK) about why nurse education moved into higher education and why this happened when it did.
Background. In 1995 the last of the old-style schools of nursing in the UK was fully integrated into higher education and were detached financially, legally and organizationally from District Health Authorities. However, only 6 years before, when Working Paper 10 was produced, there were only a few nursing degree courses located within higher education. What made this move into higher education particularly noteworthy was that there was never a clear statement of intent from the government that this integration of health care education was intended. Despite the fact that this is one of the most significant changes ever to take place in nurse education, there has been relatively little empirical research about why the development occurred.
Methods. A qualitative approach was selected for this study and the methods used were policy analysis and interviews. A purposeful sample of 70 implementers involved in the integration process was selected and asked for their views on this issue.
Findings. Participants believed that integration had occurred because of a combination of complex factors, but there was a division between those who thought that it was centrally planned and others who felt that it was an accidental outcome of the particular events of the time.
Conclusions. It is not clear whether policy was influencing action or action influencing policy. Understanding of why this change occurred is needed if health care professionals wish to have greater control over future changes in education.