Nursing Colleges Function Shift
Annual Nursing Education
Conference
04 September 2015
Hannelie van Rensburg
Director: University Academic Planning, Monitoring and Evaluation
1
Presentation Content
1. Joint Submission to the Minister of Health
and the Minister of Higher Education and
Training
2. Matters to be considered
3. Feasibility Study currently underway
4. What happens after the feasibility study?
2
Joint Submission to the Minister of Health and the Minister of Higher
Education and Training
(Heading)
• “JOINT SUBMISSION BETWEEN NDOH AND
DHET TO BOTH MINISTERS OF HEALTH AND OF
HIGHER EDUCATION AND TRAINING ON A
SUGGESTED MIGRATION STRATEGY FOR
PROVINCIAL PUBLIC NURSING COLLEGES TO A
NATIONAL COMPETENCY UNDER THE
NATIONAL DEPARTMENT OF HEALTH”
• First Draft: 30 September 2014
• Revised: 20 March 2015
• Final: 23 April 2015
3
Joint Submission to the Minister of Health and the Minister of Higher
Education and Training (3) - Background
• Summit in 2011 that culminated into a Nursing Compact
• Minister of Health appointed a Task Team on Nurse Education and
Training
• Recommendations in Joint Submission based on assertion that the
primary aim of nursing education and training is to provide
adequate numbers of competent, service oriented and career
focussed nurses to meet the health needs of the country.
• One of the strongest and most urgent recommendations: NCs to be
declared higher education institutions, in compliance with the
provisions of the Higher Education Act (Act 101 of 1997 as
amended in 2008)
4
Joint Submission to the Minister of Health and the Minister of Higher
Education and Training (3) - Background
• Failure to do so will result in:
– NCs being unable to continue offering nursing
education and training at NQF Level-5 and higher
beyond 30 June 2018 (it was 2013, then 2015 –
SANC Deadlines)
5
Joint Submission to the Minister of Health and the Minister of Higher
Education and Training (4) - Background
• MTT recommended that Nursing Education and Training be regarded as a
national competency accounting directly to the Director General of
Health.
• Recommendation would have addressed:
–
–
–
–
–
–
provincial inequalities,
decrease fragmentation
improve clinical training,
enhance social accountability,
eliminate ‘fly by night’ nursing training institutions
and improve quality, through setting of national norms and standards for
nursing education
• This approach informed by sections 51and 52 of the National Health Act,
61 of 2003, that enables the National Minister of Health to “establish
educational institutions to educate and train health care personnel”
• NB: In terms of the Constitution the overall mandate for HET is with the
Minister: DHET.
6
Initiatives taken to address options and preferences
• Meeting of delegates representing the NDoH, SANC
and the DHET: 08 Sept 2014.
• Purpose of meeting:
• Development of strategy for migration of PNCs
from provincial to a national competency under
the NDoH.
• Intention of Joint Submission:
• (a) To initiate a process to reach an agreement
between the two Ministers on the migration
strategy.
7
Intention of Joint Submission-continued
(b) Explore other options/ arrangements between the
NDoH and the DHET besides incorporation of NCs into
the HE sector.
In effect NCs remain the primary production platform
of nurses in SA, support is sought from the two
Ministers to approve that NCs as a national
competency be mandated under the NDoH in
collaboration with universities under the DHET.
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DISCUSSION
• The future of nursing education offered at
PNCs unclear since 2002 when the National
WG recommended their incorporation into
UoTs or universities.
• The recommendation was not acted uponnegative impact on the development of NCs.
• Currently, a NC is a relatively autonomous
entity under the jurisdiction of a PDoH.
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Discussion-continued…
• NCs buildings, strategically positioned
adjacent to hospitals to facilitate WIL/ clinical
practice are the property of the DoH funded
by a PDoH.
• In 2009 the NDoH commissioned an audit of
all PNCs to inform HR planning and financial
investment to improve infrastructural
requirements for nursing education.
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NATURE AND TOTAL NUMBER OF NURSING EDUCATION
INSTITUTIONS: Source: 2014 SANC Statistics
NATURE OF NURSING EDUCATION
INSTITUTION
TOTAL NUMBER
Higher Education institutions
22+1 Private Higher Education institution.
Active Public Nursing Inst. Incl. 3 Military
Hospitals.
135
Private Nursing Education Institutions
101
Inactive Sub-campuses
84
TOTAL
343 sites
Active: 259
Non-Active: 84
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Discussion continued…
• Based on the recommendations of the Van
Wyk Commission Report of 1986 (as quoted
from the Strategy) education programmes
offered by the NEIs include:
o 4-year programme- registration with SANC as a PN
o Currently this could be a 4-year Diploma or a
Degree
• Main difference between the two is the focus
of preparation.
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• The diploma focuses on technical skills and the
degree on science, art and research.
• Challenge: Policy directives ito of the HEQSF: 4year diploma no longer exist as a qual type.
o Other nursing quals include a 2-year Diploma in
Nursing-registration as Enrolled Nurse.
o One year Certificate in Nursing- registration as an
Auxiliary Nurse
o One year Midwifery Certificate- reg. as a Midwife
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o Two year Diploma in Nursing: Bridging Course
to cater for nurses with a 2-year Diploma-reg.
as General Nurses (GN), need to take a 1-year
Midwifery to register as a GN and Midwife.
• The graduates from both 4-year programmes
have same scope of practice, job descriptions
and remuneration.
• Challenge: Retention of graduates skilled in
clinical areas
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• Noted: On average 80% of nursing cadres are
produced at PNCs and 20% at universities,
annually.
• The Nursing Education, Training and Practice
Strategy (2012-2017) is based on the following
integrated framework:
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• Historically there was a dialogue between the
Minister of Health and the Minister of Education
and the Department of Health
• A formal decision about the future of college
based nursing education was never determined.
• This decision is more pressing now within the
context of the delivery of the new nursing
qualifications that falls within the higher
education section of the NQF in terms of the
HEQSF.
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New Nursing Qualifications Framework aligned to the HEQSF
OLD Qualifications
NEW Qualification
Qualification
Duration
SANC Reg.
HEQSF Level
Qualification
Duration
SANC Reg.
Post-basic
Course
(Specialisation)
1
Register in area
of
Specialisation
8
Postgraduate
Diploma (120Credit)
1
Register in area
of
Specialisation
Degree
4
GN & Midwife
8
B-degree (480credit)
4
PN
Diploma
4
GN & Midwife
-
-
-
-
Midwifery
1
Midwife
7
Adv Dip
1
Midwife
Bridging
Course
2
General Nurse
6
Diploma (360C)
3 Years
Staff Nurse
Diploma in
Nursing
2
Enrolled Nurse
-
-
-
Auxiliary
Nursing
1
Auxiliary Nurse
Higher
Certificate
1
Auxiliary Nurse
5
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In terms of Student Enrolments the 259 active NEIs had a
total headcount enrolment of 37 810 students in 2012.
Headcount enrolments by qualification type in 2012 is as
follows with the following split:
• 18 244 (48%) for the 4-year diploma and degree
enrolments leading to registration as General Nurse, with
specialization in Psychiatry, Community Nursing and
Midwifery;
• 6 561 (17%) enrolments in the Bridging Course;
• 3 297 (9 %) enrolments in Enrolled Nursing;
• 6 290 (17%) in ENA;
• 1 457 (4%) in the one year Diploma in Midwifery
• 1 952 (5%) enrolments in post basic courses.
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• SANC has issued a circular indicating the
implementation date of the new framework as 2015.
• NCs affiliated to universities commenced with
preparations to offer the higher education
programmes through continued collaboration with
the universities.
• This included conducting audits regarding the state
of readiness of NCs to offer new qualifications.
• An infrastructure audit is in place as well as a plan to
conduct a profile of nurse educators to ensure that
plans are in place for capacity development.
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• In this regard there has been a concerted
effort with injection of financial resources
from the National Department of Health
towards the refurbishment of the
infrastructure in the public sector colleges
since 2010
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Matters to be considered
• The offering of nursing education outside the
domain of the DHET has a number of funding
implications.
• These include that the students will not have
access to NSFAS;
• or the Clinical Training Grants
• Colleges will not be able to benefit from
Foundation Provision Grants, Infrastructure
Development Grants and Teaching and Learning
Development Grants to name but a few funding
envelopes provided by the DHET to public
providers of higher education.
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Matters to be considered
• Implications of the new Qualifications
Framework – who will QA if under NDoH?
• Qualifications of staff at NCs
• If under DHET what is the impact on
enrolment planning and block grant funding?
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A model on how NCs should engage with Higher Education
Institution is suggested:
• NCs will require to have a Memorandum of Understanding (MoU) with a
University in order to offer Higher Education Qualifications in Nursing
Sciences Education;
• MoUs should be between the University Council and the Nursing College
Council and not with the academic department of Nursing in the
University (as it is the case at present);
• Upon graduating from a programme a graduate will receive a qualification
certificate issued by the University, with reference made to, or cobranding with the NC in accordance with the MoU, on the qualification
certificate;
• The NCs will have to adhere to the 19 Criteria of CHE (Programme
Accreditation Criteria). It was clarified that CHE accredits programmes and
the SANC also accredits the education and training institution;
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Model Continued…
• Colleges will function as autonomous bodies with their own Legal
Boards, as required by the Higher Education Act;
• Depending on the qualifications of academics in NCs, there may be
a need for co-teaching with university staff until the academics in
the nursing college meet the requirements and are competent to
teach higher education qualifications ;
• The university will monitor quality of nursing education
programmes;
• As a transitional arrangement NCs should plan to systematically
phase out old qualifications and phase in new qualifications so as to
not negatively affect the production of nurses;
• There should be a legal arrangement between the students and the
academic institutions regarding the transitional arrangements;
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Model Continue…
• Nursing students should have the status of a full student
(rather than employee)
• They should receive funding support for tuition, books and
study materials, and living costs which should be paid
monthly,
• Tuition fees should be paid directly to NCs.
• As students cannot receive medical aid and indemnity
insurance, these benefits will no longer be available, but
may possibly be utilised for funding support through a
different envelope.
• NCs should follow a differentiated approach in offering of
HEQSF Aligned programmes based on capacity and regional
need. This process is to be facilitated by the NDoH, with the
support of the DHET.
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Model Continued…
• The quality assurance function in terms of nursing as a
profession will remain the responsibility of the SANC.
• Quality assurance of the academic programmes will
remain the responsibility of the supporting university
in accordance with the criteria and guidelines of the
CHE.
• It follows therefore that the NCs will report to the
National Department of Health in terms of governance,
regulations and funding.
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PROPOSED APPROACH
1.
2.
3.
Collaboration at a national level between the
Department of Higher Education and Training and
the National Department of Health through the
offices of the respective Deputy Directors-General
responsible for nursing and higher education.
Collaboration at an institutional level between
individual universities and NCs, based on formal
Memoranda of Understanding in which the precise
role and responsibility of each entity is stipulated.
The Provincial Departments of Health remain
responsible for the provision and maintenance of
the clinical training platforms required for nursing
education.
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Approach continued…
4.
5.
6.
7.
It was decided that, pending approval from both
the Minister of Health and the Minister of Higher
Education and Training, the NDOH should:
Conduct a capacity audit of all the public NEI
currently under Provincial Departments of Health;
Determine the state of readiness of NC to meeting
national quality assurance standards
Conduct a mapping exercise by region of all NCs to
inform determination of collaboration with
universities based on geographical health needs,
programme offerings on the Universities’ PQMs
and availability of clinical training platforms
required for Workplace-Based Learning;
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Approach continued…
8.
9.
That SANC postpones the final teach-out
date of bridging programmes to at least
2018 and communicate this to the sector;
That, should the Ministers agree in
principle to the content of this submission,
a strategic planning session be organised in
which the sector’s stakeholders will be
informed on how to proceed forward.
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COMMUNICATION IMPLICATIONS
• In principle agreement to the proposed
strategy by the two Ministers will require an
official joint communiqué between the NDoH
and the DHET to be circulated throughout the
sector.
• Intensive sector liason
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LEGAL IMPLICATIONS
• According to Section 21 (1) of the Higher Education Act
101 of 1997 as amended the Minister of Higher
Education and Training may, after consultation with the
Council on Higher Education (CHE), and by notice in the
Gazette, declare any education institution providing
higher education as a university, technikon or college, a
subdivision of a university, technikon or college.
• In Subsection 21 (3) (a) (iii) the Higher Education Act
states that the Minister of Higher Education and
Training must consult with the responsible Minister if
the education institution is administered, controlled or
funded by an organ of state other than the Department
of Higher Education and Training. (DoD; SAPS; DIRCO
etc)
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RECOMMENDATIONS
• It is recommended that the Minister of Health and the
Minister of Higher Education and Training agree in
principle to the proposed strategy towards migrating
NCs from a Provincial to a National Competency under
the Department of Health and to offer HEQSF Aligned
nursing programmes in collaboration with selected
universities.
• To obtain in principle approval, the migration of NCs
(NC) from a provincial to a national competency under
the jurisdiction of the Department of Higher Education
and Training if above principal approval in paragraph
46 is not agreed to.
34
Recommendations continued
• The Ministers engage with each other on the
proposed strategy and jurisdiction as a matter
of urgency.
• The Ministers approve that the relevant
Deputy Directors-General of the National
Department of Health (NDoH) and the
Department of Higher Education and Training
(DHET) commence with the implementation
of the proposed strategy. (JHSEC)
35
Feasibility Study currently underway
• Minister of Higher Education and Training did not
approve the recommendations
• Reason: Needs a Feasibility Study
• Being done by DHET
– AUDIT OF THE CAPACITY OF NURSE EDUCATORS IN PUBLIC
NURSING EDUCATION INSTITUTIONS (Draft 2), 2014
– AUDIT OF PUBLIC NURSING COLLEGES AND SCHOOLS: A
QUANTITATIVE OVERVIEW 20 JUNE 2010
– AUDIT OF PRIVATE NURSING EDUCATION INSTITUTION
AND NURSING DEPARTMENTS OF UNIVERSITIES (31 May
2010)
– A further due diligence may have to be conducted other
than what's was already covered in the above reports.
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Thank You
Questions?
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