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Increasing public protection: moving beyond the register

Delve into the expansion of roles, addressing inconsistencies, and assessing risks in healthcare support worker regulation for improved public safety. Explore key questions, regulatory models, and the NMC's perspectives on advanced practice and regulation.

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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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