The Nursing and Midwifery Council is facing opposition to a number of its proposed changes to nurse education, early findings from its consultation have revealed.
Many nurses responding to the consultation on pre-registration training do not believe all students should be taught the same core skills regardless of field of practice, and also do not believe simulation activities should be used to replace time spent on clinical placements.
“There is a widely held conviction that simulation should not be seen as a substitute for hours spent in practice”
NMC council papers
There is also widespread opposition to the NMC’s plan to remove the requirement for assessors and supervisors to have completed a training programme approved by the regulator.
In addition, a significant proportion do not want the regulator to remove its medicines management standards, according to results from a second consultation.
However, NMC leaders have stressed the consultations were not set up like “the X Factor vote”, suggesting it will not be altering its plans purely on the basis of their popularity among the profession.
Instead, the regulator may need to “hold the line” and stick to its original proposals to ensure nurses are trained in a way that is fit for changes to services in the future, they said.
NMC council papers discussed at a meeting yesterday revealed the first set of findings from the NMC’s consultation on its major overhaul of standards for training and assessing student nurses, which had 1,932 responses.
“We aren’t just consulting and then ignoring people’s views - but this is not the X Factor vote either”
They also included some responses to its separate consultation on prescribing and its proposal to withdraw its medicines management standards and leave it up to employers to set their own policies, which attracted 706 responses.
The findings reveal the profession is “polarised” as to whether all student should have to be proficient in the same communication and relationship skills – across all four fields of nursing – that are laid out by the NMC in its new framework.
There are also “mixed” views on the regulator’s plan to increase the number of maximum hours spent on simulation – from the current 300, up to half of the 2,300 hours that students are required to spend in practice.
“Despite respondents citing benefits to simulation and support for initial competence being assessed in simulation, there is a widely held conviction that simulation should not be seen as a substitute for hours spent in practice settings,” said the papers.
While half of respondents said they agreed mentors should be replaced with new roles covering either supervision or assessment, most disagreed with the regulator’s plan to no longer require that they train through an NMC-approved course.
A total of 40% of respondents disagreed with the NMC’s plan to withdraw its standards for medicines management, while 27% agreed and 33% did not have a view either way.
“There is no doubt that there will be areas where we have to take a decision, bearing in mind our duty to protect the public”
There was “consistent and widespread agreement” that the Royal Pharmaceutical Society’s competency framework for all prescribers should be used as the basis for the NMC’s nurse and midwife prescribing proficiencies and training standards.
But there were mixed feelings as to whether nurses should be able to complete a community practitioner prescribing (V150) programme immediately after qualifying. Almost half of the organisations that responded agreed with the proposal, compared with only 28% of individuals.
“The main theme emerging from respondents’ comments was that a period of consolidation/preceptorship is required before a nurse or midwife can complete V150,” said the papers.
Meanwhile, the majority of respondents said the NMC should continue to limit how far nursing degrees can be shortened if students have prior healthcare experience – with half stating this should remain as a maximum of 50%.
The papers also reveal widespread support for all students to be assessed on placement by the same UK-wide practice assessment document.
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Presenting the findings at the NMC council meeting in London, the regulator’s director of education, Geraldine Walters, said: “When we drafted the standards we didn’t do this is a darkened room on our own.
“We’d already taken account of evidence, recommendations in national inquiries, and took the view of stakeholders and experts,” she said.
“This is an open consultation, we aren’t just consulting and then ignoring people’s views – but this is not the X Factor vote either. So if people don’t like things, but there’s a lot of evidence behind them, then we might have to hold the line,” she added.
NMC chief executive Jackie Smith later reiterated to Nursing Times that the NMC’s consultation was “not the X Factor vote”.
“There is no doubt that there will be areas where we have to take a decision, bearing in mind our duty to protect the public and our desire to set the standards that are not only relevant for today but for the future,” she said.
The NMC is now reviewing the responses to the consultation and bringing in experts to help it to decide whether to revise any proposals.
Ms Smith stressed that the NMC council would be provided with explanations about the reasons for keeping controversial proposals ahead of finalising the new standards.
The NMC council will decide in March at its next meeting whether or not to approve the revised standards.