Advanced Nurse Practitioner Regulation : UPDATE

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Advanced Nurse Practitioner Regulation UPDATE

• Katrina Maclaine
• RCN Nurse Practitioner Adviser
• Principal Lecturer - Advanced Nursing,
• London South Bank University

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NP developments Primary Care

• General Practice settings, alongside GPs and
  Branch surgeries
• PMS (Personal Medical Services) sites GP-led or
  Nurse-led
• NHS Walk-in Centres
• Homeless/refugees/asylum seekers rural health
  care provision
• GMS contract
• Out of hours services
• Nurse-led initiatives
• NP Limited !

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NP developments Secondary Care

• Stimulated by
• European Working Time Directive
• Lack of continuity of patient care
• Need for acute assessment units
• Fast growing area
• Isolated development
• Examples NPs in AE/MIUs, Night NPs,
  Childrens NPs, NPs in Cancer care, respiratory
  etc etc

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Widespread misuse of the title Nurse
Practitioner

• Lack of consensus definition in UK
• Education varies from nothing to MSc
• No regulation of use of title
• NONPF (National Organisation of Nurse
  Practitioner Faculties) generic NP competencies
  (2001)
• RCN definition, competencies and guidance (1996,
  2002)
• RCN accreditation of NP programmes

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NMC activity on Advanced Practice

• RCN lobbied the UKCC, then NMC
• Consultation on a framework for the standard for
  post-registration nursing (closed February 2005)
• Purpose to address public protection issues
• Positive response from nurses and patient groups
• Issues raised by key stakeholders

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NMC Council decisions (up to December 2005)

• Creation of a new sub-part of the nursing
  register for Advanced Nurse Practitioners
• Periodic re-registration process
• A set of generic competencies were agreed as the
  standard for entry onto this part of the register
  
• Based on NONPF /RCN competencies, KSF mapping and
  Masters level descriptors

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Domains of ANP Practice

• Assessment and management of health/illness
  status
• The nurse patient relationship
• The education function
• Professional role
• Managing and negotiating health care delivery
  systems
• Monitoring and ensuring the quality of Advanced
  Health Care Practice
• Respecting Culture and Diversity

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Accommodation of existing practitioners

• Nurses who have completed
• Programmes that were based on the proposed
  competencies since 2002
• Programmes were similar but ran before 2002
• Programmes in advanced clinical practice
• And Nurses who profess to have achieved the
  standard through range of activities

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Why are we waiting ??

• NMC decisions made in December 2005
• Privy Council approval requested
• Then came the outcome of the Shipman inquiry !

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Why are we waiting ??

• Consultation on Non Medical Regulation Foster
  Review
• Trust, Assurance and Safety The regulation of
  health professionals in the 21st century (DH,
  2007 www.dh.gov.uk)

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White paper conclusions

• The Government believes that existing
  professionals should be subject to a system of
  regulation that is proportionate to the risks and
  benefits entailed (p81)
• Supports standards for higher levels of practice
  for advanced practice in nursing, AHPs and
  healthcare scientists.
• Specifically mentions working with NMC on the
  outcome of their consultation to agree next
  steps.

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White paper conclusions

• UK working party to develop criteria to
  determine which existing and emerging professions
  should be regulated in future
• Potential for development of a formal mechanism
  to consider the national need for new roles
• Now discussing implementation
• Re-validation is key area

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Whats the RCN doing ?

• Maintaining close working relationship with NMC
• Representation on White paper implementation
  steering group
• Revised RCN ANP competencies (July 07)
• Updating RCN guidance on NP role, scope of
  practice and standards for accreditation
• Active within Modernising Nursing Careers
  discussions
• Promoting need for joined up thinking
• Expert Nurse resolution / Future Nurse Future
  Workforce

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In the meantime ??

• Monitor NMC website for updates
• Self-appraise against the ANP standard
• Any specific queries to NMC ANP lead
  Susan.Aitkenhead_at_nmc-uk.org
• Can access information on local NP programmes via
  Association of Advanced Nursing Practice
  Educators (AANPE) website www.aanpe.org.uk

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My hopes .

• MNC recommendations specifically advise the
  inclusion of ANPs within workforce planning
  priorities and service design
• Value of ANPs is recognised by employers,
  commissioners of education and health departments
  across UK
• Services of ANPs are increasingly available to
  patients wherever they access care
• ANP services dont cease due to poor succession
  planning
• ANPs with vision dont have to self fund their
  ANP education

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My hopes .

• NMC regulation of ANPs is established
• RCN NP Association continues to be a vibrant,
  pro-active forum, which members use as a means of
  engaging with the RCN and participating at a
  local, country and UK-wide level in the future
  development of ANPs

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• Thank you .