She told Nursing in Practice: ‘In terms of patient protection, patients should know exactly who they’re seeing and know the level of qualification that these practitioners have. Nurse Practitioner and Advanced Practice Roles are developing globally. Ms MacLaine was among a team of researchers from London South Bank University alongside Alison Leary who found in 2017 that due to the lack of regulation, hundreds of unqualified staff were working under advanced nurse titles. By Gemma Mitchell. currently required to maintain their NMC registration as is suggested by the consultation, these two roles must be regarded as being of that nature. Lack of regulation poses difficulties for national governments and for society due to uncertainty in advanced practice … In September 2012, the chief nursing officer for England introduced the “5Cs for nursing”: compassion, competence, communication, courage and commitment. Higher level of practice: regulation • Core standards across all groups: allow educational economies of scale • Bespoke elements: recognise current specialisms • Potential to move community nursing into regulated advanced practice: high value • Aims to meet the needs of employers to support delivery of new models of care in the community One thing that came out loud and clear was the desire for the NMC to regulate advanced practice nursing, with some believing this was more crucial to safety. The Nursing and Midwifery Council (NMC) has said it will look at its role in regulating advanced practice later this year. SCPHN is a protected title and encompasses health visitors, school nurses and occupational health nurses. Fellow of the Faculty of Perioperative Practice RCSEd ‘Currently, because the title is not protected, you can go out and do – for example – a minor injuries course and call yourself a nurse practitioner. Over the past few years, the advanced nurse practitioner (ANP) role has been implemented widely in primary and secondary care. “Many participants were concerned about the impact on the profession and the fragmentation, dilution and loss of quality of post-registration education if the SPQs/SCPHNs were withdrawn and the NMC stopped regulating this aspect of post-registration education,” the review found. “If something is different you can’t try and make it the same, and I think that’s been the problem,” said Dr Adams. because the NMC has been so slow to recognise the 4 generations of nurse SCP’s over the last 25 years of its perioperative care pathway development! Respondents gave “mixed views” about extent to which the standards provided protection to the public. Standards for SCPHNs such as school nurses and nurses with SPQs such as practice nurses have not been updated since 2004 and 2001 respectively. ‘The government needs to learn its lesson and learn it quickly’, 12 June, 2019 “This is certainly an issue of public safety.”. The lack of regulation has resulted in a ‘patchwork’ of advanced practice education across the UK with each country establishing their own standards and frameworks, participants reported. The lack of regulation of advanced nursing is a “major concern for public protection”, according to those involved in training staff for such roles. The commitment to consider advanced practice regulation was welcomed by Katrina MacLaine, an ANP, associate professor in advanced practice and chair of the Association of Advanced Practice Educators. ‘Our recommendation for the ICN nurse practitioner network is that countries looking to develop these roles set up the appropriate regulation.’. They are just not nurses. The NMC has announced that it is reconsidering the role it plays in regulation beyond initial registration of nurses, midwives and nursing associates. “There are repeated calls from across all stakeholder and registrant groups for the NMC to widen the discussion and become involved in the regulation of advanced practice,” said the review. Several months lat… The lack of regulation has been a concern for ‘many, many years’, added Dr Rogers. As part of a wider programme of work to update its standards, the NMC commissioned consultancy firm Blake Stevenson to evaluate its current post-registration frameworks. Meanwhile, Dr Crystal Oldman, chief executive of the QNI, said there was a “clear role” for the NMC in regulating post-registration education in the absence of structures that existed in medicine where specialist royal colleges carried out this function. The NMC will explore its role in the regulation of advanced practice following a major evaluation into its post-registration standards. As there is currently no regulation of specialist advanced nursing practice in the UK employers and post holders drive the labelling of posts. Alternatively, a registrant can be noted on the register as having a specialist practitioner qualification (SPQ) in nine different areas including district nursing and general practice. As a Surgical Care Practitioner in orthopaedic & trauma surgical care, I am likely to lose my nurse identity as it appears the GMC will now take over my regulation & registration: Why? ‘We will continue to explore what it is people think professional regulation should be doing. “We will continue to explore what it is people think professional regulation should be doing,” said Ms Trotter. The Nursing and Midwifery Council (NMC) will explore its role in the regulation of advanced practice following a major evaluation into its post-registration standards. ‘As part of this, it is right that we consider our role in regulating advanced practice as we have heard some people are keen there is additional regulation for advanced practice, while others don’t think that’s necessary or appropriate. advanced level practice in nursing to support employers and commissioners to establish good governance arrangements. “If you are complete provider of care, if you are making a decision you have got to be able to be safe to do that, and know your limitations, and unfortunately the difficulty is that people might be going into situations where they haven’t been adequately prepared,” said Ms MacLaine. Through this review it was seeking to address “several long-standing issues” relating to SPQs annotations and SCPHN registration. With the exception of the district nursing SPQ, the number of nurses and midwives gaining these specialist qualifications had declined over the past two to three years, the review found. In addition to 38 survey responses from approved education institution, the 291 individuals surveyed as part of the evaluation included employers, registrants, students, stakeholders and service users from across the UK. However, the ANP role has lacked consistency in scope of practice, training and regulation. Dr Crystal Oldman, chief executive of the QNI, said she was “delighted” to hear the NMC had changed its direction of travel. Care was later included as a sixth. “They are going out for searching for health needs, nurses have health needs sitting in front of them and they respond to them,” she added. Regulating advanced nurses was a public safety issue and leaving it up to employers to manage was not sufficient, Ms MacLaine told Nursing Times. Therefore, insofar as registered nurses are already undertaking SCP and ACCP roles as part of the broader range of advanced nursing practice roles now in Many participants “expressed concern and at times frustration” about the lack of regulation of ANPs, and felt it was being left to local employers to decide who delivered care in what role. The Association for Perioperative Practice (AfPP), UK Colleges of Surgeons and individual 400 + SCP’s have collaborated to develop the patient focussed role, that provides continuity and consistent for surgical patient’s across all surgical specialities. Nursing & Midwifery Council The NMC and advanced practice Our statutory framework The NMC was created by the Health Act 1999, and is governed by a number of pieces of secondary legislation. In addition, the programmes integrate research and evidence-based practice in each module, with the Extended Acknowledgement This publication is the result of a collaborative project involving key stakeholders. To facilitate a common understanding and guide further development of these important roles, ICN, through the expertise of its International Nurse Practitioner/Advanced Practice Nursing Network, has developed a definition and characteristics of a Nurse Practitioner/Advanced Practice Nurse. The NMC has recently commissioned an external consultant, Abigail Masterson, to do a literature and policy review related to the regulation of advanced practice in nursing and midwifery. Advanced Level Nursing Practice: Introduction. Cheryll Adams, executive director of the Institute of Health Visiting, called for health visitors to be regulated as a sole profession, like they had been before the NMC was formed. “There is a patchwork of education of advanced and specialist practice across the UK and there is the opportunity to draw this together and rationalise under the leadership of the regulator,” it said. The evaluation, led by consultancy firm Blake Stevenson, called on the NMC to reconsider its role with participants raising concerns that unregulated areas of advanced practice put the public at greater risk. No. 10. “Their feeling was that there is likely to be a greater risk to the public from those practising in the unregulated area of advanced practice,” it added. “As part of this review, it is right that we consider our role in regulating advanced practice”. Reg. ‘There are so many variations in terms of the advanced practice training and we need to make sure that it’s standardised across the UK.’. Towards a Framework of Advanced Nursing Practice for the Clinical Research Nurse in Cancer Care Joanne Bird RN BMedSci Marilyn Kirshbaum RN BSc MSc PhD ABSTRACT Background The Nursing and Midwifery Council (NMC), the regulatory body in the UK, is in the process of opening a new part of the register for Advanced Nurse Practitioners. This paper reflects on the potential contribution of regulation of advanced nurse practitioners (ANPs) in professional nursing practice in the UK. The NMC will now start an engagment process with external stakeholders on the findings of the review before taking any plans forward. Cheryll Adams, executive director Institute for Health Visiting, Asked what the implications would be if the existing standards were dropped, Dr Adams said: “I think the real danger is you would lose the specialist practice skills, they would start to get diluted.”. Views were gained from universities delivering these courses; nurses holding the qualifications and students working towards them; employers; stakeholders from nursing organisations and government bodies; and members of the public and patients. Leading nurse professor Professor Leary, who has just been awarded an MBE in Queen’s birthday honours list, also welcomed the development. Year of publication 2017. In the current climate of increased regulation, nursing must maintain control of practice regulation. The review concluded: ‘There is the opportunity to draw this together and rationalise under the leadership of the regulator.’. Conclusion: The lack of consistency among certifying agencies and the lack of documented impact of certified advanced nursing practice can negatively affect the value placed on certification as an advanced practice credential. Katrina Maclaine, chair of the Association of Advanced Practice Educators , said some nurses who were dismissed from university courses for failing to meet standards continued to call themselves advanced nurses and remain in their jobs. The NMC has now announced that it will review its role in regulation of post-registration standards, including of advanced practice. However, the overhaul could result in the NMC withdrawing its standards that underpin the education and practice of specialist community nurses such as health visitors and district nurses. The Nursing and Midwifery Board of Ireland acknowledges the work of the Working Group for Advanced Practice in the development of Advanced Practice Nursing Standards and Requirements. Anne Trotter, assistant director of education and standards at the NMC, said: “Our review of post -registration standards is part of our wider education change programme, which also includes our work on the Future Nurse Standards and Future Midwife Standards. This intended review into the advanced clinical practitioner roles that RN’s now deliver within the NHS is long overdue! Many participants “expressed concern and at times frustration” about the lack of regulation of ANPs, and felt it was being left to local employers to decide who delivered care in what role. Dr Melanie Rogers, International Council of Nurses (ICN)/Advanced Practice Nurse Network chair, welcomed the commitment from the NMC. Nursing organisations have recognised advanced nurse practice by regulation in some countries and by voluntary certification in others.Conclusions Research has … Advanced nurse practitioners are highly skilled nurses who can: Some of our publications are also available in hard copy, but this may entail a small charge. “Specialist practice can extend from some healthcare assistants working in a very specialist way,” she added. NMC (2008) states that you have to recognise your own limits when working and not to practice anything you are not competent in without supervision. The review found two examples of the SCPHN part of the register being used to raise fitness to practise issues. One thing that came out loud and clear was the desire for the NMC to regulate advanced practice nursing, with some believing this was more crucial to safety. In a report attached to the findings, the organisation admitted there was ‘little regulatory oversight’ around existing advanced practice career and employment frameworks. 30 Additionally, dual registration may be required and this could lead to confusion for the individual and the public. Regulation of advanced practice nursing does not occur in many countries. Anne Trotter, assistant director of education and standards at the NMC, said: ‘Our review of post registration standards is part of our wider education change programme, which also includes our work on the Future Nurse Standards and Future Midwife Standards. In a report to accompany the review findings, the NMC admitted that the way the register was currently structured and annotated was “confusing and complex”. 2147432, A third of all Covid hospital admissions in January, Government has ‘mountain to climb’ to vaccinate social care staff by deadline, Wider range of symptoms linked with Covid-19, shows large study. The CNO said: “I believe these five areas define nursing as a profession and, by focusing on these values, we can achieve our aims of improving care for our patients and strengthening the profession”(Cummings, 2012). The debate about advanced practice regulation has been ongoing for many years but previous attempts to make this happen have fallen at the final hurdle. Immediate Past President of AfPP “From the QNI perspective, these include those roles which have a high degree of autonomy and authority in combination with specialist knowledge and skills in relation to assessment, diagnosis, prescribing and care delivery, including the management of risk in environments of care which may not be within the control of the clinician,” she told Nursing Times. To register with the Nursing and Midwifery Council (NMC) you need to be able to carry out competences to state that they meet the required skills to be able to practice professionally and safely. However, the SPQ annotations were considered to be of limited help because the register did not hold any information about the specifics of the qualification achieved. “We are talking about practitioners who are going to be working at the maximum level of autonomy”. A new app, developed by Abbott’s UK-based nutrition business, has already seen…, Nottinghamshire Healthcare NHS Foundation Trust, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. ... • NMC & HCPC largest regulators (692,550 & 341,745 registrants) Models of regulation Ireland is currently in the minority in regulating advanced practice at a national level. Nursing has continued to adapt to this challenging time. National regulation of ANPs has been repeatedly discussed since these roles first emerged, but this has never been implemented. On the possibility of introducing a protected title for advanced practice, Dr Rogers said: ‘From an international perspective, it would bring it in line to what pretty much every other country globally has done. Ethically, there is a major issue.’. Many participants “expressed concern and at times frustration” about the lack of regulation of ANPs, and felt it was being left to local employers to decide who delivered care in what role. Visit our, NMC considers advanced nurse regulation as part of review, 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, ‘Major’ safety fears over lack of formal regulation for advanced nurse role, Extra regulation of advanced nurses would be ‘unwieldy’, Support staff working under ‘advanced’ nurse titles, reveals study, ‘There is little understanding of the many job titles in nursing’, RCN to pilot accreditation standards for ANPs, Advanced nurse register pilot started by RCN, First wave of advanced nurses receive RCN accreditation, Don’t miss your latest monthly issue of Nursing Times, Nursing Times survey reveals extent of Covid-19 workforce pressures, Winners of the Nursing Times Workforce Awards 2020 unveiled, Improving patient care as the use of telemedicine rises, Spire Healthcare steps up to support the NHS, Reducing the cognitive load on nursing staff, Creating an electronic solution for early warning scores, How best to meet the complex needs of people with interstitial lung disease, New blended learning nursing degree offers real flexibility, Analysis: How mental health law reforms could affect nurses, ‘Delight’ as nurse confirmed as acting US surgeon general, Mental health nurse and student die in winter surge of Covid-19, Tributes paid to nurses who have died in latest surge of Covid-19, CNO replaced as senior responsible officer in Southern Health inquiry, NHS reform plan promises clearer nurse staffing accountability, ‘Using the government consultation on abortion to advocate for women’, Mental health nurses demand end to delays to new patient restraint law, Join our Outstanding Ophthalmology team in Yorkshire, Senior Manager – Local Authority Inspection / Uwch-reolwr – Arolygu Awdurdodau Lleol, Team Manager – Adult Services Inspection / Rheolwr Tîm – Arolygu Gwasanaethau Oedolion, This content is for health professionals only. “We are talking about practitioners who are going to be working at the maximum level of autonomy, they’re making decisions and delivering care in many instances if you think about primary care very much they are the sole lead provider for many of the patients, and it’s absolutely imperative that [they] have been educated and signed off and assessed to do that,” she said. “It is absolutely the right decision to have been made by the NMC and is a move that will protect the public and provide a path to the future regulation of an advanced level of practice,” she told Nursing Times. However, those who had completed a SCPHN or SPQ said the course had been “transformational”. She continued: ‘The advanced nurse practitioner role is a very defined and specific role and, because of the level of autonomy and accountability, I think it is something that we should be regulating. 2015, Dr Katerina Kolyva, Director of Continued Practice, will be speaking at the Pracitical Guide to Nurse addresses non-medical prescribing and advanced levels of nursing practice See our full list of … The NMC will explore its role in the regulation of advanced practice following a major evaluation into its post-registration standards. However, the recent introduction of credentialing by the “The real danger is you would lose the specialist practice skills, they would start to get diluted”. “They felt the qualifications were prestigious, had more gravitas, were more legitimate and appropriately recognised their higher level of skills and knowledge,” the review found. In response to the ongoing Covid-19 situation, we’ve produced recovery and emergency education programme standards to enable our approved education institutions (AEIs) and their practice learning partners to support all of their nursing and midwifery students in an appropriate way. Advanced Practice, Regulation & Credentialing RLH Professional Nurse and AHP Forum Elaine Whitby ... • RCN Advanced Level Nursing Practice Credentialing . She backed comments made by respondents to the independent review for a direct entry route into health visiting to be established. The Council's principal functions are set out in Article 3(2) of the Nursing … A new commitment has been made by the Nursing and Midwifery Council to look at introducing a system of regulation for advanced nurse practitioners as part of a major review. One thing that came out loud and clear was the desire for the NMC to regulate advanced practice nursing, with some believing this was more crucial to safety.