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Professional standards: successful implementation requires leadership at all levels

New Nursing and Midwifery Council standards aimed at improving care through high-quality, safe education and training

New Nursing and Midwifery Council standards aimed at improving care through high-quality, safe education and training


New standards will replace mentorship with supervision and assessment.
Image: Charles Milligan

  • The Nursing and Midwifery Council's new standards came into force in January 2019.
  • Nursing students and staff need to be aware of these major changes.
  • Read this article to find out the changes, and follow the links for more details.

 

In January this year the Nursing and Midwifery Council’s new standards came into force.

It followed almost three years of work by the NMC on our education programme, launched in March 2016, designed to ensure that nurses and midwives are trained to meet the challenges of providing safe and effective care in an ever-changing population demographic and an increasing number of diverse settings.

What is needed now is leadership at all levels to ensure the successful implementation of these new standards, with special attention paid to the framework for education and the standards of proficiency for registered nurses.

In developing this programme of work the NMC aimed to:

  • Raise the ambitions of nurses and midwives, which will help them care for people better.
  • Make sure their training and education is safe and of high quality.
  • Deliver regulation that is fit for purpose, and not a barrier to employees or the services they help provide.

The first phase of this work was completed in March 2018, with the rest expected to be rolled out by March 2020.

After an extensive consultation and assimilation process, the following standards were published in May 2018 and came into effect in January this year:

  • Part 1: standards framework for nursing and midwifery education.
  • Part 2: standards for student supervision and assessment.
  • Part 3: programme standards for pre-qualifying nursing and for nursing and midwifery prescribing.
  • Future Nurse: Standards of Proficiency for Registered Nurses.

We also agreed to adopt the competency framework of the Royal Pharmaceutical Society for all healthcare professionals who prescribe medication.

Then, in July 2018, we became the statutory regulator for nursing associates in England, creating the programme standards and proficiency for this new professional role.

Parts 1 and 2 of the new standards apply to all NMC programmes:

Part 1

This is the standards framework for nursing and midwifery education for all our approved programmes, providing the high-level standards that educational institutions need to meet to progress to gateway 2 and programme approval.

Standards framework for nursing and midwifery education

Part 2

This sets out the standards for supervision and assessment, a new approach to support learning and assessment in practice and will replace mentorship.

Each student will be allocated a practice supervisor, who can be any registered health and social care professional. They will also be allocated a practice assessor and an academic assessor, with a different person in each role. All three will be appropriately prepared to support the student.

We will no longer approve preparation programmes for the supervisor and assessor roles, as we did for the roles of mentor, practice teacher and teacher. This will give education providers and their practice learning partners more flexibility to agree their own approach. While these are new roles, current mentors and sign-off mentors will have transferable skills to part fulfil these new roles and will be prepared in line with this agreed local model.

Such a major change requires strong leadership in education and practice to ensure there are suitable supervisors and assessors to support students when the new programmes come into force.

Standards for student supervision and assessment

Part 3

These standards provide all the detail relevant to individual programmes and outline the selection, admission and progression requirements. They also set out the standards to be met for the curriculum, practice learning, supervision and assessment, as well as the final qualification.

Standards for pre-registration nursing programmes

Future Nurse

As with all our new standards, the standards of proficiency for registered nurses are outcome focused rather than process driven. This means that educators and practice learning partners can develop their courses and practice learning in a creative and innovative way.

Standards of proficiency for future nurses

Standards of proficiency

The standards of proficiency are split across seven platforms, including two annexes comprising communication and relationship management skills, as well as the nursing procedures to be achieved.

  • Platform 1: being an accountable professional
  • Platform 2: promoting health and preventing ill health
  • Platform 3: assessing needs and planning care
  • Platform 4: providing and evaluating care
  • Platform 5: leading and managing nursing care and working in teams
  • Platform 6: improving safety and quality of care
  • Platform 7: coordinating care

 

These proficiencies apply to all four fields of practice – child, adult, learning disabilities and mental health nursing – with variable expertise and knowledge required depending on the field. The proficiencies have been developed with an eye on what people will require from nurses as care needs become more complex. There is a greater focus on relationship management and communication, with more emphasis on public health and leadership.

The proficiencies will also ensure that nurses at the point of registration will have gained enough experience of mental, physical, cognitive and behavioural health across all ages. Registered nurses will also demonstrate proficiency in a variety of skills, including intravenous administration, venepuncture, cannulation and mental first aid. Additionally, the proficiencies will also ensure that newly qualified nurses have the right assessment and pharmacological knowledge so they can undertake a prescribing course sooner.

'The standards are ambitious but are designed this way to allow nurses to meet future care needs'

Some students and registered nurses have raised concerns that they may not have all the skills to meet some of the enhanced proficiencies to teach and supervise students on the new programmes. This is understandable given the significant changes. Registered nurses should use the standards of proficiency as a tool to plan their own continuing professional development in line with their scope of practice as part of the revalidation process. This will ensure the standards, the Code and revalidation are considered as a whole, to improve the care nurses can deliver.

As part of the implementation process, education providers with their practice-learning partners are responsible for ensuring that there are learning opportunities and appropriate supervisors available to enable these skills to be achieved.

Empowerment from day one

Platform 5, which focuses on leading and managing nursing care and working in teams, is about building resilience and empowering students from day one. Elements of leadership also appear across the platforms and encourage nurses to take responsibility for their own learning so they can take part in academic debates and contribute to clinical decisions.

They will be given the tools to guide, support and motivate others, and to interact confidently with other members of the multidisciplinary team. Then, at the point of registration, newly qualified nurses will be able to make complex clinical decisions to deliver appropriate, evidence-informed care that is safe and centred on people.

The standards are ambitious but are designed this way to allow nurses to meet future care needs. As nurses, whatever our role, we all must be positive role models, leading on change to introduce the new standards and the new roles, to enable those with the right skills to supervise students. It is also important for nurses to focus on personal development: their own as well as that of their peers.

The responsibility to implement the new standards falls on everyone, no matter their grade, from strategic to operational, in education and in practice.

This means that nurses who are strategic leaders should influence and direct innovative ways to implement the new standards to help enhance practice. Each nurse or midwife must understand the standards and use them to inform their own development. Nurse educators and their practice partners will continue to lead on the curriculum and on planning appropriate practice-learning opportunities. They are also responsible for engaging those providing support and education, while ensuring that students provide safer, better care.

These are ambitious standards to take nursing and midwifery into the future. We all must embrace them, work through the detail and influence others for them to be successful.


  Sue West is senior nursing education adviser at the Nursing and Midwifery Council

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