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Increasing public protection: moving beyond the register

Increasing public protection: moving beyond the register. Roger Thompson Director Nursing and Midwifery Standards and Policy 2 November 2010. Advanced Practice. Registered Nursing & Midwifery Practice. Support Workers. Health care support workers. NMC’s initial perspectives.

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Increasing public protection: moving beyond the register

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  1. Increasing public protection: moving beyond the register Roger ThompsonDirector Nursing and Midwifery Standards and Policy2 November 2010

  2. Advanced Practice Registered Nursing & Midwifery Practice Support Workers

  3. Health care support workers

  4. NMC’s initial perspectives • Expansion of roles • Inconsistency in application • Public protection – unregulated activity • Impact of the review of pre-reg nursing • Targeting regulation – specific levels • Research by NNRU King’s College London

  5. The review had three objectives • Assess the evidence of risks presented to public protection from an unregulated healthcare support workforce. • Identify and consider key questions to be addressed in developing models of regulation. • Make recommendations for further work required in taking healthcare support worker regulation forwards.

  6. Assessing risk and benefits • lack of controlled admission to the workforce through a centralised register. • provision of care by a workforce for which education and training is not mandatory and that which is available is not standardised in terms of content, assessment and accreditation. • provision of care which should be supervised but is not always in practice

  7. Themes within the research • Taking forward the assistant practitioner role in nursing • Developing roles and competencies • Choice of regulator and regulatory procedures • Providing and accrediting education • Professional and workforce implications of regulation • Risks from processes and outcomes of regulation

  8. Taking forward the assistant practitioner role in nursing • Should assistant practitioners be regulated as senior healthcare support workers or as second level nurses? • Development of competency frameworks

  9. Deciding on a regulator • should HCSWs be regulated by a national body and/or local employing organizations? • which of the current national regulatory organizations are most appropriate for regulating HCSWs? • might different organizations be appropriate for regulating different levels of HCSWs? • what factors should inform the development of regulatory mechanisms?

  10. NMC’s current perspectives • Focus on assistant practitioner roles • Those working under delegation of nurses • Use existing legal framework • Strengthen position in respect of delegation • Initiate project at NMC

  11. Advanced nursing practice

  12. Practice beyond initial registration • Advanced practice • Specialist practice • Regulation • Recognition

  13. Practice beyond initial registration • Freedom to practice • Public protection • Clinical careers • Awarding bodies

  14. Regulate or not….? • Added values vs burden • Proliferation of job titles • Inconsistencies in training and experience

  15. Revalidation

  16. Revalidation • “Real time” confirmation of fitness to practise throughout career • Major challenge for all regulators • NMC initiating programme to engage and deliver transformational change

  17. Revalidation • Modernising PREP • Focussing on risk • Whole UK, all sectors • Link to appraisal

  18. Investigating systemic failure

  19. “joining up” regulation • Regulating individuals • Regulating providers • Bridging the gap

  20. Guidance for raising and escalating concerns • To enhance public protection by acting as a tool to support nurses and midwives to raise concerns • To provide a clear, step by step process which nurses and midwives can follow

  21. Guidance for nurses and midwives • Act in a timely manner to safeguard the public • Seek independent, confidential advice • Present concerns in a constructive way • Where possible follow employer’s policy or local safeguarding policies • Ensure appropriate steps taken to protect patient confidentiality • Keep accurate records of actions and responses

  22. Guidance for managers • Investigate promptly and objectively • Keep the employee who raised the concern advised of progress • Ensure action is monitored and recorded • Follow your employer’s policy or local authority safeguarding policy • Ensure patient confidentiality protected • Seek advice or support if unsure

  23. Thank you roger.thompson@nmc-uk.org

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