Enhancing publicprotection through theeffective regulation ofadvanced practice
Dickon Weir-HughesChief Executive and Registrar
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23 Portland Place
61 Aldwych, 1st floor
Our chosen definition
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‘An advanced practice nurse is a registerednurse who has acquired the expert knowledgebase, complex decision making skills and clinicalcompetencies for expanded practice, thecharacteristics of which are shaped by thecountry and/or context in which she/he iscredentialed to practice. A master’s degree isrecommended for entry level.’
International Council of Nurses 2002
NMC’s role
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•The NMC safeguards the health andwellbeing of people who use or need theservices of nurses and midwives
Nursing and Midwifery Order 2001
Some historical background
•2004/2005 NMC consultation on ‘advancednurse practice’
•2005 NMC Council decision to seek regulationof ANPs
•2007 White Paper, Trust Assurance and Safetyexpresses support for advanced practice
•2008 CHRE report highlights risk to public, therole of employers and the need to develop anevidence base
•2011 Command Paper ‘Enabling Excellence’
PM’s Commission (2010)
The Commission stated:
‘ The Nursing and Midwifery Council mustregulate advanced nursing practice, ensuringthat advanced practitioners are recorded assuch on the register and have the requiredcompetencies. Stakeholders must alsoconsider how to reduce and standardise theproliferation of roles and job titles in nursing.’
The Council are enthusiastic to resolvethe matter of advanced practice
•covers a range of specialist roles, includingmidwifery
•great interest to the profession
•very confusing for the public, evidenced byfeedback provided to the PM’s Commission
So what’s changed?
‘Enabling Excellence’
•In February 2011, the White Paper states:
‘the Government will not support the healthprofessions regulators in taking on anynew responsibilities or roles which add tothe costs to their existing registrantswithout providing robust evidence ofsignificant additional protection or benefitsto the public.’
‘Enabling Excellence’
•the White Paper also states:
‘the health professions regulators will needto demonstrate that … advanced practiceregisters, which has some professionalsupport but where a compelling case forfurther regulatory action has yet to bemade, are an appropriate andproportionate use of registrants’ fees.’
Interdependence with otherworkstreams
•specialist practice qualification
•specialist community public health nursing
•midwives rules and the question of whethermidwifery is ‘in’ or ‘out’ of advanced practice
•nurse prescribing
•all graduate RN programmes – concept ofgraduates in nursing
•education QA framework
Challenges for the NMC movingforward advanced practice
•developing the evidence base
•focus on patient safety and not career progression
•measurement of patient satisfaction and clinicaloutcomes
•link to revalidation
•fitness to practice issues
•protection of title
•using the stakeholder experience and lessons fromaround the world
•devolved country ‘buy in’
•governmental ‘buy in’
Questions andanswers
Professor Dickon Weir-Hughesdickon.weir-hughes@nmc-uk.org020 7333 6528