Update on the education strategic programme Anne Trotter - - PDF document

01/04/2017 1

Update on the education strategic programme

Anne Trotter Assistant Director, Education and Standards 31 March 2017

Topics for discussion

• Brief overview and context of education

programme

• Development of the future nurse

standards for proficiency

• Outline proposal for the future nurse

technical and communication skills annexes

01/04/2017 2

Health, care and education policy contexts

• Continuing economic pressures
• Increasing patient complexity
• Workforce and staffing challenges
• Introduction of new roles – e.g. nursing

associate and physicians associate

• Introduction of new apprenticeship routes to

nurse registration

• Move from bursaries to loans

What needs to change?

• What do stakeholders want?
• Critical thinkers, leaders, able to work safely in a variety of settings

(knowledge of mental and physical health and illness)

• Confident and competent in terms of ‘technical ability’
• What is the view of the current position? (IFF

research)

• Actual pre registration standards – content not controversial, but not

future orientated

• Vulnerability around learning in practice
• Insufficient clarity around technical skills at the point of registration
• Implications for:
• Standards for learning and assessment in practice, four fields

coverage, hours in practice, nature of preceptorship, use of simulation, new routes into nursing.

01/04/2017 3

Education Programme

Future Midwife Proficiencies Other standards Education Framework Future Nurse Proficiencies Quality assurance of education

Communications and engagement

Education framework

01/04/2017 4 Current standards Comparisons

Ref Standard NMC current HCPC HCPC

pro po sed

GDC QAA Code Standards Requirem ents

1

Accredited Prior learning 8 1 1

2

Assessment 18 6 5 5 4 13

3

Equality and diversity 6 1 4 1 1 1

4

Good Health and Character 4 2 2

5

Governance 1 2 5

6

Learning + assessment in practice 7 3 4 2 1

7

Managing interuptions 5 3

8

Practice Learning 22 1 10 6 4 3 2

9

Programme Content 15 1 5 5 5

10

Programme design and delivery 9 3 4 4 4

11

Programme length 6 2

12

Programme outcome 4 1 1 1 2

13

Progression 12 5 1 1 2

14

Protected learning time 5 2 1 2 1

15

Public protection 7 1 8 1 2 3

16

QA 4 3 4 3 2 12

17

Reference to EU Directives 7

none although ref to legal compliance

1 1

18

Selection and admission 8 1 4 6 2

19

Student engagement 1

20

Teaching and practice support 13 4 15 7 7 9

21

Theory-practice distribution 3 1 3 SUMMARY 164 10 77 49 48 13 50

Pre-Registration Nursing- current standards Comparison with other regulators

GMC 87

Proportionate transformation

12 sets of standards – 164 S/R

12 se12 sets of standards – 164 S/R12of standards – 164 S/R

12 sets of 164 standards and requirements

Proposal: a single education framework

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Education Framework- Justification for standards V8.5

External reports, working assumptions and design principles

Legal/EU Directive Shape of Caring IFF Evaluation Francis Report

Evolving and transforming to deliver excellence in care: A workforce plan for nursing and midwifery in Northern Ireland 2015-2025

North Wales

Extraordinary Review

Guernsey

Extraordinary Review

Keogh Report IFF Evaluation NHS Maternity reviews

Health professional education investment review

NES Nursing and Midwifery strategy NMC Nursing proficiencies

Education Framework Standards Requirements Legal/EU Francis report IFF evaluation Keogh Report Shape of Caring Health profession al education investmen t review The NES Nursing and Midwifery Strategy 2014-17 NHS Maternity Review Design principles

S3.2 Students are empowered and supported to become reflective and lifelong learners working in inter- professional and multi- agency teams. Focus on multi- professional working; understanding roles and responsibilities Action 8.5 Greater emphasis on inter- professional learning

5.2 Isolation: A lack of multidisciplinary working, leadership, and good quality teaching and mentorship programmes within the hospitals contributed to

• verall poor

care . Theme 1 recommendation 2: Enhance the voice of the patient and the public Paragraph 25: importance of multi- disciplinary teams in the planning and delivery of healthcare- through education and training Recommendation 5: The Nursing and Midwifery Council and the Royal College of Obstetricians and Gynaecologists should review pre- registration education to ensure that it promotes multi- professionalism and that there are shared elements where practical and sensible. Enhanced

• utcome based

requirements Future proof and agile Enables innovation with our partners

NMC Design principles NMC Midwifery proficiencies

Education Framework high level pillars

10

Learning environment and culture Pillar 1 Educational governance and quality Pillar 2 Student learning and empowerment Pillar 3 Educators Pillar 4 Curricula and assessment Pillar 5

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Development of future nurse standards for proficiency Design principles: Standards for proficiency (1)

We will separate standards for graduate registered nurses from the standards for institutions. The new standards will:

• embrace the values set out in the Code
• be outcomes focused and open to objective

assessment

• be sufficiently future proofed (2030 graduates)
• be accessible to the public
• be unambiguous, transparent and succinct

01/04/2017 7

Design principles Standards for proficiency (2)

• Standards should reflect increasing requirement

for higher order skills, knowledge and proficiencies

• Standards should be specifically worded so that

they are not open to interpretation, but be flexible in their application

• New standards should acknowledge increasing

fluidity across care settings, including mental and physical health

• Standards need to acknowledge increased

working in multi-disciplinary and multi- professional teams

Design principles: Standards for proficiency (3)

• A focus on the role of the nurse in the wider

public health agenda

• A stronger focus on clinical leadership and

managing complex care

• Additional focus on dementia, frailty and end of

life care

• Standards that emphasise the importance of

care being research and evidence led

• Focus on practice skills such as venepuncture,

managing intravenous infusions, drug administration and parenteral nutrition to ensure consistency in “output”

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Future nurse proficiencies

Demonstrate professionalism

Promote health

Assess needs and plan care Provide and evaluate care Lead nursing care and work in teams Improve safety and quality of care

Coordinate care

Draft Future nurse proficiencies

Four fields of nursing

• The four fields of nursing are currently set
• ut in legislation and any changes to these

fields would require a full public consultation.

• We will hold a full public consultation on the

new nursing standards in the summer, and there are no plans to include changes to the four fields in this consultation.

• The specific programme requirements will

still set out what is required of programmes leading to registration within each field.

01/04/2017 9

Future Nurse Annexes

Future nurse annexes

• States the technical/procedural and

communication competencies that all newly qualified nurses must demonstrate across the life span.

• It is expected that the demonstration of

competence will reflect application to each

• f the current four fields of practice.
• Demonstration will occur across a range of

practice settings in order to meet the proficiency outcomes.

01/04/2017 10

Future nurse annex one (1)

• Technical skills required for assessing,

planning, providing and managing evidence based nursing care.

• Procedural competencies for the

assessment, planning, provision and management of evidence based fundamental nursing care.

• Procedural competencies required for

evidence based medicines management and prescribing.

Use contemporary tools/approaches for the assessment of:

Mental health status and diagnosis of signs of distress – .e.g. anxiety, depression, self-harm. Cognitive health status and diagnosis of signs

• f distress – e.g. confusion, fatigue, delirium.

Behavioural health status and diagnosis of signs of distress – e.g. agitation. Physical health status and diagnosis of physical symptoms and signs of deterioration e.g. vital signs, ECG.

01/04/2017 11

Future nurse annex two: communication skills (1)

• Underpinning communication skills.

Skills for:

• Communicating with those living with

sensory impairments across the lifespan.

• Communicating with people with specific

mental, cognitive, physical and behavioural health challenges.

• Supporting people to manage their own

health care and decisions.

Future nurse annex two: communication skills (2)

Skills for:

• Working with people to help them improve

their health and prevent ill health.

• Supervision, teaching and appraising others

performance.

• Developing, maintaining and managing

Relationships.

01/04/2017 12

Timeline

Sep Apr Jun 2018 2019 Mar

Published standards Consultation Early adoption

Sep Jan

Adoption deadline

2020 Mar

Published standards Consultation Early adoption Adoption deadline

Sep Apr Jun 2021

Published standards

Jan

Early adoption Adoption deadline

Jul Jan Jul

Education Framework Future Midwifery standards Future Nursing standards

Thank you and any questions?

Anne.trotter@nmc-uk.org