The Nursing and Midwifery Council has said the four fields of nursing will not be removed as part of its current education review due to legal requirements, but has not ruled out the possibility of it happening in the future when legislation is altered to allow nursing associates onto the register.
Responding to an enquiry from Nursing Times, the regulator was able to confirm that adult, children’s, mental health, and learning disability nursing would remain as separate registrations for the time being, despite fears from some nurses that they were under imminent threat.
“The NMC’s legislation specifies that nurses are registered against a field of practice”
There has been growing speculation among the profession about whether the NMC will introduce a single registration for nurses, sparked by a national review of education in 2015 that recommended more time was spent on general training before specialising.
Earlier this month, a petition was launched to “save” the children’s nursing degree as a response to concerns that this area of specialist nursing would be lost if nurse education became more generic.
Mental health nurses have also expressed fears, with academics in the field warning any moves to a less specialist form of training could “backfire” due to fewer nurses with high-level mental health skills being available to employers.
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In addition, a wide-ranging report on mental health nursing from the Foundation of Nursing Studies charity, due to be published later today, will refer to concerns of potentially moving to a single registration.
It will highlight the “particularly skilled work” of mental health nurses who work with people who can be “distressed, withdrawn, depressed, uncommunicative and sometimes aggressive”, and point out that these are not “low-level’ generic skills”.
However, the regulator has now confirmed to Nursing Times that it is currently required by legislation to provide the four fields of adult, children’s, mental health, and learning disability nursing registrations.
As a result, it said the revised standards it was developing for nurse education would still set out what is required of programmes leading to registration within each field.
But, at the same time, it also confirmed that the current legislation would need to be changed in order to introduce the new nursing associate role onto the register, which Nursing Times understands could provide an opportunity to review the fields at the same time.
However, the NMC maintained that it was too early to say what kind of changes would need to be made to the Nurses & Midwives (Parts of and Entries in the Register) Order of Council (2004) to regulate the new role, which is intended to act as a “bridge” between healthcare assistants and nurses.
A spokeswoman for the NMC said: “The NMC’s legislation specifies that nurses are registered against a field of practice. We have been developing new standards of proficiency for nursing that apply to all four fields, on the basis of feedback that we need to ensure all nurses, regardless of field, have better skills and knowledge in areas such as mental health and learning disability.
“We are working closely with the Department of Health to determine what shape the legislation for nursing associates will take, in order to allow for this non-field-specific approach to the role”
“The specific programme requirements will still set out what is required of programmes leading to registration within each field.,” she said. “As the four fields are currently set out in legislation, any changes to these fields would require a full public consultation and there are no plans to include this in the consultation on our new nursing standards in the summer.”
The spokeswoman added: “The nursing associate is intended to be a generic role, with pathways into nursing for those with the ability and desire to progress.
“We are still in the early stages of our thinking and we are working closely with the Department of Health to determine what shape the legislation for nursing associates will take, in order to allow for this non-field-specific approach to the role.”
A major assessment of nursing education in 2013 – the Shape of Caring review – recommended that nurses spend more time being trained in general skills, including both physical and mental health, before specialising.
It was one of many recommendations that Health Education England and the NMC have since been exploring.
One of the other key recommendations of the review was to introduce a “bridging” role between HCAs and nurses, which has ultimately led to the creation of nursing associates.
Last month, the NMC agreed to the Department of Health’s request to regulate associates, but is still unclear whether the role, which was announced by ministers in England, will be used in other UK countries.
Nursing Times reported earlier this month that a “degree of hostility” existed towards the new role in Scotland, Wales and Northern Ireland.