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Draft plans for 'radical' overhaul of nurse education include over 70 technical skills


More than 70 technical skills that newly qualified nurses should be competent in, including nasogastric tube insertion, injection of intravenous drugs, and urinary catheterisation, have been laid out in draft education plans being developed by the Nursing and Midwifery Council.

The list of skills in the new set of pre-registration education standards also includes blood component transfusion, interpretation of blood analysis, venepuncture, management of electrocardiograms, and recognition and management of sepsis.

“We have worked closely with stakeholders to develop draft pre-registration nursing standards and we are currently engaging with professionals and the public”


Meanwhile, a range of more than 20 communication skills covering different patients, such as those who are depressed or have dementia, plus how to interact with other team members, and deal with uncertain or changing situations, have also been set out.

It marks a change from the NMC’s current education standards – last revised in 2010 – which do not provide such a detailed list of capabilities that nurses must have.

The change comes after the regulator found there was a perception among the profession that nurses were qualifying with varying skills.

However, it is not yet clear whether registrants across all four fields of nursing will be expected to be trained in each of these areas, and whether more will be added for each specialty.

As previously revealed by Nursing Times, the draft document also states that all newly-qualified nurses must be trained to supervise students, and it suggests they will be able to prescribe from an “agreed formulary”.

In addition, they must understand how to influence policy, show developing political awareness and, must be able to delegate appropriately to others providing care.

The draft plans, seen by Nursing Times, have not yet been published and may still change before they are put out to public consultation, said the NMC.

The group of 95 skills are included within two annexes entitled “communication skills” and “nursing skills for patient-centred care”.

The annexes have been drawn up to “provide clarity” about what a new registrant should be able to do in order to meet the 78 outcomes in the main body of the document – covering accountability, public health, care planning, evaluation, leading teams, improving safety, and coordinating care.

“The outcome statements included in the standards have been designed to apply across all current fields of nursing practice and all care settings…The technical annexes to the standards will give some indication of potential field-specific content,” states the document.

“These standards are at draft stage and some sections are not yet fully complete. Further changes will be made”


The NMC was unable to confirm whether nurses across all four fields of nursing – adult, children’s mental health, and learning disability – will have to be competent in all 95 skills listed.

When asked by Nursing Times, the NMC also did not confirm whether it intended to add further annexes that looked at the specific skills required by each field of practice.

However, an NMC spokesman stressed that the plans were still in draft form and that “further changes and additions will be made” with “specific input from field-specific stakeholders, ahead of a full public consultation in the spring”.

There has been growing concern that the NMC’s education proposals will see a move to more generic training before specialising, which some parts of the profession have warned could see adult nursing prioritised.

Following speculation that the fields of nursing registration might be removed, the NMC recently confirmed that it was required by legislation to ensure all four existed and that it was not looking at this as part of its current review of the standards. 

But it did not rule out the possibility of this happening in the future when legislation is altered to allow nursing associates onto the register.

In response to the draft education plans, an NMC spokesman said: “The health and care landscape is changing at an unprecedented rate and nurses and midwives are being asked to undertake more complex roles across a range of health and care settings.

“We are currently undertaking a radical review of our pre-registration nursing and midwifery standards, thinking about what the public need from nurses and midwives now and in the future,” he said.

“We have worked closely with stakeholders to develop draft pre-registration nursing standards and we are currently engaging with professionals and the public across the four countries on these,” he added.

“These standards are at draft stage and some sections are not yet fully complete. Further changes and additions will be made, with specific input from field-specific stakeholders ahead of a full public consultation in the spring,” said the NMC spokesman.



Readers' comments (16)

  • Many of those if not most were all expected from SRNs trained by GNC. Ivdrugs and prescribing two exceptions, though flagyl was given and infused by students just like any other infusion. Having staff nurses unable to do essentials by the time they qualify is ludicrous. Staff nurses unable to do IM injections or pass NFL or catheters a joke! My Sisters are probably turning in their graves!

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  • Please just do us a favour and take nursing out of higher education and stop pretending we want to educate professionals if all we really want is to train them to perform a list of tasks. None of these require a salary above Band 3 to do this so we will save loads of money pursuing this reductionist model.

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  • I am a little unsure as to what 'Anonymous 15 march,2017 8:50pm' is actually saying. What exactly do you see as the role of the professional registered nurse? By the way, please do not give me any I/V medication as you obviously see it as a simple 'task'; presumably you do not see it as a simple task to prepare and give medication that if not carefully checked, knowing all the side effects and risks associated, could kill me, or do you?

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  • Rosemary Gondwe Mazhandu

    What kind of Nurses has the country been producing at Degree level? Iam really shocked that Nurses have not had training in the subjects mentioned like, catheterisation, naso gastric, IV drugs, prescribing. All this was done during my training in 1980- 83.

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  • This is just how we trained under GNC ..,we were expected to have our green books signed off when we had completed such skills
    Perhaps we should not have taken this very valuable part of training away .
    Great we are thinking about skills being put back into nurse training
    We have made our nurses very unsure and lacking in confidence in their skill set

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  • There is no better training than hands on training with real people, With real illness, injury and diseases. A book just doesn't give you the real deal. Let's face it if you don't know what to do with a real person when you are qualified we in trouble and that is very evident today with poor care. This is where the NMC comes in with its cautions and judgements and rulings. Academia and degrees are lovely. But when a sick person needs care they need a nurse and carers who know what to do. There are some fab nurses who are and have been uni trained whom I have met over the year but their stories are the same. They don't get real skills until they are qualified!!!! What a shame , what a waste of 3 years ???

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  • Anthony Johnson

    So we're going to make Registered Nurses a Band 6 right? Because I would argue that this increase in skill set means we are now at a similar level to Midwives and should see it reflected in our pay packet.

    We can't allow ourselves to become more skilled for no pay increase.

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  • Anthony, I was doing all of the above, apart from prescribing, in 1978 (and yes, that includes administration of IV medications.) It is not, therefore, an increase in skill set but a re-visiting of skills lost or set aside in the pursuit of academia.

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  • When I first moved to the UK I was shocked by how little newly qualified nurses, or indeed many experienced nurses could do; having come from a background in Sweden where the nurse works more patient centred and focussed using the skills listed in the article above. I got incredibly frustrated having to wait an hour for an SHO to prescribe paracetamol for my patients in pain, or not being allowed to catheterise a patient with acute urinary retention in agony, because it was a 'doctor's job'. Although I have now, after six years in the UK managed to recoup most of my rights and abilities, I still feel I have to go back to the Nordics on a regular basis to keep my skills up.
    One question though, the reason, I thought for student nurses not learning any skills was because of fear of them making mistakes on live patients and risking the registration of both student and mentor. I was told that universities actively discouraged mentors from letting the students be hands on due to the litigious nature of our modern patient cohort. How is this being addressed?

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  • Well said Nurse 57!

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