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The Chief Nursing Officer’s action plan for the profession


Dame Christine Beasley, the Chief Nursing Officer for England, writes for Nursing Times on a time of excitement and opportunity for the nursing profession

Nursing Times reported in depth on the new commission to advise the government on the future role of nurses and midwives. In setting up the commission, the Prime Minister recognises that nurses and midwives are central to the transformation of care and play a key role in the delivery of high-quality care.

I see the work of the commission as an opportunity to bring together and build on the good practice, progress and achievements to which nurses and midwives have already contributed, much of which I saw first-hand during my visits across the NHS over the past few years. I have no doubt that the commission will be looking for more new ideas and bolder ways of improving services, aiming to remove barriers that I know can be frustrating. It should provide nurses and midwives with greater potential to increase their impact in the delivery of high-quality care in a range of innovative ways.

To respond to the changing needs of patients and changes in how services are delivered, we need to change the style and content of pre-registration programmes.

To equip the profession for a complex and more demanding future, we need to work towards degree-level registration that in no way devalues the skills, experience and knowledge of nurses already on the register. Nursing today requires an intricate interplay between fundamental care and high-level technical competence, bio-medical knowledge and decision-making skills, and the ability to develop therapeutic relationships based on compassion, and holistic and intelligent care.

The NMC is already taking forward the development of new standards for pre‑registration education to develop the new nursing degree programmes. They will consult on these standards with a view to publishing them in September next year.

‘Nursing today requires an intricate interplay between fundamental care and high-level technical competence. We need to change our pre-registration programmes’

The Department of Health is leading a review of student support that will address the anomalies in the funding of degree and diploma courses before implementing degree-level registration, to ensure equity for all nursing students. We plan to consult with stakeholders - including prospective students - on options in the summer and announce the changes in March 2010.

The earliest possible implementation will be for students starting courses in September 2011 but this will depend on the chosen option - some options will require more implementation work than others.

To make sure the move to degree-level registration goes smoothly, we have been talking with the NMC, strategic health authorities and other key stakeholders about the timing and pace of the transition and the ‘state of readiness’ of trusts and universities. We propose to consult on transition options and announce a transition timetable for England in autumn this year.

We want to ensure that we recruit the right people to the new programmes. We want people who demonstrate the values required to become a caring and compassionate nurse as well as the academic ability to become a graduate practitioner. Overall, we want to ensure that there are routes into nursing for all, regardless of starting point. The transition plan involves developing a framework that sets out how people can enter the new programmes through a range of academic and vocational access routes.

The drive to modernise nursing careers also continues. Having set the direction and consulted on the framework, we are now modelling pathways so, by the end of 2009, we will have a clear view of how they might work. Additionally, new clinical academic training pathways have been launched for those wishing to develop careers in research.

Mandatory preceptorship, to enhance the confidence of the newly qualified in moving from student to autonomous practitioner, is supported by the NMC. We are keen to establish a framework for preceptorship so that nurses can develop their potential and consistently deliver high-quality care and make high-level decisions in increasingly complex situations. There will be greater investment in preceptorship and we will announce in the autumn how the framework will be constructed.

These changes are about equipping nurses with the skills and confidence right from the outset of their careers so that they are central to delivering high-quality care and promoting health and well-being for all in healthcare settings and in patients’ homes. They will be powerfully placed to improve the experience of patients, the quality of care and health outcomes and embrace new roles as practitioners, partners and leaders.

You will have an opportunity to build on many of these developments through the Prime Minister’s Commission on the Future of Nursing and Midwifery. We want to make it as easy as possible for you to contribute,
so the commissioners will work through professional and strategic health authority networks, regional and local events, the web and, of course, Nursing Times.

You will have ideas and thoughts on how nurses and midwives can improve the experience of patients, the quality of care and health outcomes. I encourage you all to become involved in the work of the commission as the opportunities arise.

Dame Christine Beasley DBE is Chief Nursing Officer for England


Readers' comments (5)

  • Am in total agreement with this change. We must ensure that pre reg nurses are also exposed to maximal clinical time and experience

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  • Nursing needs to remain focussed on the delivery of high quality patient centred care, and feel able to challenge other health care professionals/ managers who expect paperwork and adminsitration to be part of the nurses role. This is particularly noticable in senior nurse posts.

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  • You really have completely mssed the point. Nurses do not need a degree to be able to nurse. They need to be able to care for their patients.
    You don't need to do a research paper, or 'reflect' on previous learnings.
    This is what is going on in the NHS. This is why patients are not getting nursed. This is why the elderly are developing malnutrition and bed sores. This is why Clostridium Difficile and MRSA are rampant.

    Battalions of nurse-specialists run round with clip-boards annoying medical staff by asking them if they have washed their hands, but there is no one to clean up the patients lying in wet, soiled beds.

    This isn't just my view. Have a look here:

    Thre are lots of stories similar to this. Even some in this forum.

    Read them, take note and act.

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  • I think that it is about time that nurses sorted out who they are and what they do - certainly we have to adapt to new working environments and caring for patients is crucial at bedside level and at planning level, I feel that it is NOT enough that a nurses is competent at bedside tasks - she does need to be equipped with these but her role should be in the support training and management of Care assistants who can deliver these tasks at a very high level providing they have support, if we want to be treated as professionals then we have to behave as such and professionals tend to have higher level skills - of practice and thinking and adapating and contributing to devloping knowledge. If nurses do not want that then perhaps they should retrain - as HCAs

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  • I personally think the degree level of nursing is a pointless outlay of getting nurses to do a junior doctors job, and completely forget that we as nurses are there to look after the patients in our care ensuring that all their basic needs are met. At the end of the day you can not create a nurse it is a profession that requires a high level of vocation, you either have the ability to do it or you don't, similar to the role of nun's and monks. As a nurse you are commited to doing the utmost for your patients and not what the books or a degree level nurse, doing this will destroy the whole ether of what being a nurse is about

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