This consultation outlined the NMC’s proposals to establish a framework for the standard for a level of nursing practice beyond initial registration.
The purpose of these proposals is to protect the public by setting a standard that the public can expect of any nurse who is working at this level. The establishment of a regulated level beyond initial registration is intended to meet the concerns of the profession and the public that, currently no UK-wide standards for this level of practice exist or are enforceable by the NMC. Proposals for a regulated standard have, in part, been in response to the concerns of both the public and the profession of the rapid growth in the number of titles that suggest an advanced level of knowledge and competence. Although an aim, it is unlikely that introducing the standard will have an impact on this. Agenda for Change may lead to the harmonisation of titles, but this only applies to the NHS. Council has agreed to work closely with employers on the need to reduce the number of titles.
Feedback from this consultation illustrates overwhelming support for the suggested framework, with 94% of respondents in agreement for its implementation. Among concerns expressed were those about the future of specialist practice. The NMC is looking at a strategy to deal with this and will continue to record specialist practice qualifications.
As at February 2006:
A revision of the definition of advanced nurse practice so that it could be accessible to patients and the public
The approved definition of advanced nurse practitioner reads: “Advanced nurse practitioners are highly experienced and educated members of the care team who are able to diagnose and treat your health care needs or refer you to an appropriate specialist if needed.”
Whilst definitions are helpful they have their limitations. Therefore we think it would be helpful to expand the definition to provide patients, their carers and other health care professionals with more detailed information about what they can expect of an advanced nurse practitioner.
“Advanced nurse practitioners are highly skilled nurses who can:
- take a comprehensive patient history
- carry out physical examinations;
- use their expert knowledge and clinical judgement to identify the potential diagnosis;
- refer patients for investigations where appropriate;
- make a final diagnosis;
- decide on and carry out treatment, including the prescribing of medicines, or refer patients to an appropriate specialist;
- use their extensive practice experience to plan and provide skilled and competent care to meet patients’ health and social care needs, involving other members of the health care team as appropriate;
- ensure the provision of continuity of care including follow-up visits;
- assess and evaluate, with patients, the effectiveness of the treatment and care provided and make changes as needed;
- work independently, although often as part of a health care team;
- provide leadership; and
- make sure that each patient’s treatment and care is based on best practice.
Only nurses who have achieved the competencies set by the Nursing and Midwifery Council for a registered advanced nurse practitioner are permitted to use the title Advanced nurse practitioner. The title will be protected through a registrable qualification in the Council’s register.”
Aligning the competencies to the Knowledge and Skills Framework
Setting out a policy for accommodating existing practitioners
This was completed and approved by the Council at its meeting on 1 December 2005.
What happens next?
In order for the Council to open a further sub-part of the nurses' part of the register for advanced nurse practice, it has to seek permission from the Privy Council. The Privy Council has to give permission in order for legislation to be drawn up to open a sub-part of the register for ANP. A letter has been sent to the Privy Council and we are waiting for their reply. The development and approval of any legislation has to go through a number of stages and the earliest that we could anticipate that legislation will be in place is August 2006.
In the meantime, work is being undertaken to develop guidance for existing providers of programmes for advanced clinical practice so that once the legislation is in place we can then approve programmes. Once programmes are approved individuals from those programmes will be able to apply for registration. We are also developing guidance for applicants.