20. Advance regulation for advanced nursing (resolution)
Emergency Care Association
That this meeting of RCN Congress asks RCN Council to lobby the NMC to resolve the lack of regulation of advanced nursing practice.
On this page:
- Watch the debate
- Read the progress report
- Read the debate report
- Read the background information
20. Advanced regulation for advanced nursing(R)Progress report
Council Committee: NPPC
Committee decision: Covered by existing work
Council member/other member/stakeholder involvement: Tracey Budding, Gaynor Jones, Jane Bovey
Staff contact: kim.manley@rcn.org.uk , geraldine.cunningham@rcn.org.uk , steve.jamieson@rcn.org.uk
The RCN already has a clear position on the regulation of advanced practice. The views expressed during the Congress debate will feed into work being led by the Nursing Department.
Debate report
Claire Picton of the RCN Emergency Care Association urged Congress to support this resolution to introduce standardisation in the way Advanced Nurse Practitioners (ANPs) are regulated.
Speakers identified the benefits of such regulation as improved patient care and safety. Wendy Fairhurst-Winstanley of the RCN Advanced Nurse Practitioner Forum recounted an anecdote in which a friend had been treated by an ANP and although she had received good care, she was confused about who was treating her; if it was appropriate and safe for them to do so; and what training they had. “Regulation is the only way to address patient concerns over who is delivering their care,” she said.
Wendy Hughs of Gwynedd Branch raised points made at this week’s fringe event with the Chief Nursing Officer for Wales, where issues such as how the register of ANPs would work and who would bear the cost were discussed. She insisted that extra qualifications must be supported by the employer.
Gloucestershire branch member Genevieve-Gold Flight summed up the debate stating, “The role of the ANP cannot be over emphasised. Regulation is long overdue.” The resolution was passed by a significant majority.
FOR 323 – 80.95%
AGAINST 76 – 19.05
ABSTAIN 11
Background
The government supports the development of UK-wide standards for advanced practice in nursing, allied health professionals and health care scientists. The RCN views advanced practice as a level of practice within the career framework – a position informed by the modernising nursing careers work stream, the advanced practice element of which has been led by the Scottish Government Health Directorate.
The Council for Healthcare Regulatory Excellence (CHRE), in its 2009 UK-wide report, concluded that advanced practice was not a regulatory issue, and highlighted that:
- risks to patient safety come from professionals taking on roles and responsibilities for which they are not competent, or because of inadequate safeguards
- employers and commissioners need to ensure that robust organisational governance is in place to manage risks to patient safety from individuals in relation to competence and safeguards
- core standards of the regulatory body emphasise the individual‘s role and responsibility as well as their accountability to the regulatory body when taking on activities for which they are capable of doing safely and effectively; generic standards should only be developed if a need is identified around a specific patient safety issue
- revalidation provides an opportunity for regulatory bodies to enhance governance of professional practice, by risk assessing high risk activities and contexts and then identifying the evidence required for revalidation (note, this could be argued to be the regulator’s responsibility)
- professional bodies have a role in developing governance schemes to support the profession development of members and signal to employers the skill level a member has attained; and should issue additional guidance to members to assist them with ethical and practice issues which may arise – benchmarked against the regulator’s code – especially if members are applying their knowledge and skills in new settings and contexts.
The CHRE report stated the main issues around patient safety relate to practitioners not being competent or employers not providing safeguards, and concluded that a workforce that periodically demonstrates fitness for practice is more likely to be up-to-date and fit for purpose.
Competences for advanced practice have been identified by the RCN and endorsed by the NMC. At the Nurse Practitioners Conference 2009 the RCN unveiled its position statement on advanced practice and is currently clarifying its role in relation to revalidation.
References and further reading
Council for Healthcare Regulatory Excellence (2009) Advanced practice: report to the four UK health departments, London: CHRE.
www.chre.org.uk/satellite/116/
Royal College of Nursing (2008) Advanced practitioners: an RCN guide to the advanced nurse practitioner role, competencies and programme accreditation, London: RCN.
www.rcn.org.uk
The Scottish Government (2008) Supporting the development of advanced nursing practice: a toolkit approach, Edinburgh: Scottish Government. www.aanpe.org/LinkClick.aspx?fileticket=giFsLijsCRwpercent3D&tabid=1051&mid=2508&language=en-US