Modernising
Nursing Careers
Delivering the Vision
Pauline Watts – Project Director (DH)
Global challenges for healthcare and society
Ever
higher
expectations
Changing
NHS and
Social Care
workplaces
Advances
in
treatments
Demand
driven by
ageing
Health in an
information
age
Changing
nature of
disease
Workforce – to enable local vision
NHS Next Stage
Review
NHS Constitution
A High Quality
Workforce
‘… Change – locally-led, patientcentred and clinically driven….’
“…ambitions for the workforce can hardly be
faulted…” Will Hutton CEO, The Work Foundation
Modern careers
We are on a journey
Coming from…
Going to…
•Hospital based care
Community-centred
•Single point of entry
Multiple entry points
•NHS as employer
Alternative
•Advanced skills not defined
employers/models
•Role dictated by title
•Hierarchically managed
•Outdated image
Standardisation of
advanced skills
Needs of patients
Self-directed, multiprofessional
Opportunity and diversity
Nursing today…
Requires an intricate
interplay between
fundamental care and highlevel technical competence,
bio-medical knowledge and
decision-making skills and
the ability to develop
therapeutic relationships
based on compassion and
holistic and intelligent care.
We have set the stage…
October 08
Four Country Approach
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Role, Image & Recruitment
Degree level registration
Preceptorship Career Pathways
Career Framework
Advanced Practice
Clinical Academic & Educator
Careers
Skills Passport
Metrics
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Midwifery Careers
Transforming Community Services
Action on Health Visiting
New Horizons
Introduction of new Pre-registration
Education Standards for Nursing
Changing health care
• Need for Independent practitioners
• Higher levels of decision making
• Autonomous Practitioners
• Leading and developing services from start of career
NMC review
• NMC announced principle of new programmes (including degree level) in 2008
• New pre-registration standards in Sept. 2010
• Programmes from 2011 onwards
Emerging trends
• Increasing numbers of pre-registration programmes are at degree level (25%
commissions in England - ranges 10% - 40%)
• At least 30% of existing registered nurses have a degree or above
Transition timetable
• HEI’s to have new programmes implemented by 2013.
• Scotland, Wales and NI have or are making the shift (but fewer HEIs/commissions)
Pre Registration - Progress and
Issues
• NMC have agreed the Principles of the new standards
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Degree registration
3 years
2 progression points
Generic and field specific competencies
50% clinical practice
• Changes to student support arrangements: consultation:
www.dh.gov.uk/en/managingyourorganisation/Humanresourcesandtr
aining/DH _097475
• Practice placements, focus on Community
• Teaching Learning and Assessment Framework
• Assessment and support needs
• State of Readiness assurance tool
Preceptorship Framework
‘A period of transition for newly registered nurses during which time they will be
supported by a preceptor to develop their confidence as autonomous professionals,
refine skills, values and behaviours and continue their journey of life-long learning’
Context:
• Policy Drivers
• Modernising nursing careers
• Next stage review
• Associated Policies
• Confidence in caring
• NHS constitution
• Agenda for change
• NMC - potential regulatory
requirement by April 2010
Preceptorship Framework
Purpose:
– to act as guidance and a resource for the organisations who
employ newly registered nurses, including non-NHS sector
– by providing a structured approach that facilitates transition from
student to fully autonomous professional,
equipping nurses with the skills & confidence
required at the beginning of their career
– to facilitate equity of access to preceptorship
and standardised content of preceptorship,
value for money and benefits realisation
– Nurses then powerfully placed to deliver high quality care,
promote health and wellbeing in healthcare settings and patients’
homes
– Aid recruitment and retention and contribute to reducing variability
in practice and the improving the image of nursing
Preceptorship Framework
Framework document structure:
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Background
Definitions - what preceptorship is and is not
The elements of preceptorship
Benefits
Sets out a preceptorship standard
Guidance on implementing preceptorship
• Design, content & outputs
• Benchmarking current practice
– Ensuring equality
– Outcome measures: realising the benefits
• Sets out how we expect preceptorship to be delivered
through pledges.
• Copies can be found on the DH Website
Preceptorship Framework
Next steps:
• Invite feedback through online
survey:
http://survey.westmidlands.nhs.
uk/index.php?sid=33282&newt
est=y
• Survey closed 14th January
2010
• Update following feedback and
adapt to include AHPs,
Midwives and SCPHNs
• Revised framework published
Spring 2010
Children,
Family and
Public Health
First Contact,
Access and
Urgent Care
Acute and
Long Term Care
Critical Care
Mental Health and
Psychosocial Care
9
8
Senior Registered Nurse
7
advanced practice - delivering total care packages or complete episodes
6
Registered Nurse
5
leading care delivery, care coordination and case management
4
Associate
3
supporting health, self care and care delivery
2
1
Nursing Career Framework
Mapping the Nursing Career
Framework
• Taking forward consultation recommendations on the postregistration framework
• Modelled the framework across a number of pathways:
• Health Visiting (Children & Families)
• Ill & Disabled Child
• Learning Disabilities
• Cancer Nursing
– Collaborative approach with SHAs, HEIs, providers,
professional organisations/other key stakeholders
• Incorporated concepts of: Practitioner Partner & Leader
• Graphic map to support Career Framework model will be
published in November
• Integration into quality road map (to be published in November)
• E-tool to be developed with good practice guide (Spring 2010)
• Aligned with rest of the UK & NHS Career framework
Our final visual design for the Nursing Careers
Framework
Next steps
•We want to familiarise people with the image and test it’s appeal
• PDFs of the posters are available on CNO website for downloading
locally
• Feedback and comments to be sent to:
– Chris.caldwell@dh.gsi.gov.uk
•We want to use it to update the image of nursing
• we will work with NHS Employers, NHS Careers, Universities and
others to build it into marketing and recruitment
•We want teams, groups, organisations and communities to use it
• We will develop it into an interactive tool which can be added to,
individually populated and developed for workforce and service
planning, curriculum development, career planning
Skills Passport
• DH England working with Skills for Health (on behalf
UK MNC Coalition) to develop the Skills Passport for
nursing
• The Skills Passport is to be piloted in Nursing first but
could be rolled out for the whole Health sector –
AHPs particularly interested
• ‘ Purple Passport’ developing the product
• Time frame:
– July to Aug. ’09 Co-produce skills passport
– Oct to Dec ’09 Pilot & refine
– Jan to March ’10 Final Training package & skills passport
agreed, Evaluation, Learning event
Marketing Nursing as a Career: Enhancing the
Image of Nursing
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Role, Recruitment & Image…
Develop a role profile of an ‘ideal’ Registered Nurse
– Values, skills, attributes, behaviours
Understand what will attract the right people with the right values into the
profession
Understand what the patients want
Work in co-production with stakeholders, identifying recruitment / retention
best practice e.g. CoDs, NHS Employers
Market Nursing from inside out…
Develop a Marketing campaign for Nursing to coincide with the Commission
report
Aim:
– Enhanced recruitment of undergraduate nurses
• Reduced attrition rates
• Increased conversion rates
– Enhanced recruitment of qualified nurse to difficult areas e.g. LD, MH &
HV
• Improved retention rates
– Enhanced image of Nursing
“Our greatest
responsibility is to be
good ancestors”
Jonas Salk
American Microbiologist
1914-1995
CONCLUSION
•
Modernising Nursing Careers will enable nurses to:
– Be increasingly independent & innovative, exercising higher levels of
decision making
– Assess and apply effective, evidence-based care safely
– Lead and develop services, working across service boundaries
– Deliver high quality healthcare within a complex health environment
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Modernising Nursing Careers enables nurses to contribute towards
the changing healthcare environment in a flexible & innovative way
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Modernising Nursing Careers allows Nursing to be explicit about its
contribution to healthcare by:
– Allowing practitioners and teams to measure the impact, outcomes
and experience they have on patients
– Allows change to happen locally for improved quality
– Gives leaders at the top tables a voice to promote the value, scope
and impact of the care of nurses and midwives from the Point of Care
to the Board
THIS IS AN OPPORTUNITY TO MAKE A REAL
DIFFERENCE
QUESTIONS?
We are happy to come and talk to individual
health economies / organisations. Please
contact:
Pauline.watts@dh.gsi.gov.uk