Progress reports on 2009 agenda items
1 A uniform approach
2 Eat well, stay well
3 Nowhere to go
4 ISA — for better or worse?
5 HR — a positive contribution?
6 There they go!
7 Agenda for change, changed agenda?
8 Young hearts
9 It’s in the mix
10 RCN reps — what next?
11 HPV vaccine for all
12 Foundation for a healthy future
13 Leading change for nurse leaders
14 Green light for red light?
15 APs — who needs them?
16 NHS Ltd - worth the price?
17 Waste not, want not
18 Union matters
19 A word for dyslexia
20 Putting its house in order
21 Diversity equality, opportunity
22 Millennium goals or own goals?
23 Nurse or police officer?
1 A uniform approach
Resolution submitted by the RCN Association of Nursing Students
That this meeting of RCN Congress calls on RCN Council to lobby the Government to follow the example of Scotland, Wales and Northern Ireland and introduce a national uniform for all English NHS clinical staff to promote the professional image of health care workers and ensure patients can easily identify the staff caring for them
Work led by the Membership Representation Committee
Delegates at Congress 2009 were divided on the issue of a national uniform in England. Following the debate, the RCN undertook exploratory discussions with the Department of Health on the matter.
In January 2010 Dr Peter Carter, RCN General Secretary & Chief Executive, wrote to the Chief Nurse (England), informing her of the outcome of the debate at Congress and inviting her and Department of Health colleagues to engage with the RCN to consider whether, and how, a national uniform might be introduced.
However, the move by NHS trusts to foundation hospital status and the general trend for employers to institute their own ‘corporate image’ makes it difficult to envisage the achievement of an ‘all England agreement’ on this matter. Furthermore, NHS Employers - the representative body on workforce issues for NHS Employers in England - is reluctant to commit its members to national change commitments where there is no dedicated funding in place.
The RCN will continue to pursue and explore this issue with Department of Health representatives.
2 Eat well, stay well
Discussion submitted by the RCN Essex Branch
That this meeting of RCN Congress discusses how best to encourage people to make healthy lifestyle choices in the current economic climate
Work led by the Nursing Practice and Policy Committee
There is growing recognition of the need for UK-wide policies and initiatives to support people in making long term and sustainable lifestyle changes. Congress debated how nurses can influence lifestyle choices and how diet and exercise are key to this. In 2009 the RCN contributed to a review of the health and wellbeing of the NHS workforce in England, highlighting the importance of aligning staff health needs to wider public health priorities – increasing exercise, tackling obesity, reducing smoking, and improved mental health.
The RCN also continued to contribute to National Institute for Health and Clinical Excellence (NICE) public health consultations related to obesity and exercise. Its work to actively engage in tackling childhood obesity has involved ongoing liaison with the Food Standards Agency (FSA).
Throughout the year, the RCN monitored and contributed to UK-wide and country initiatives and policy discussions on lifestyle and health. These included the activities and recommendations of the Department for Environment, Food and Rural Affairs’ Council of Food Policy Advisors, the current obesity inquiry in Northern Ireland, and the Scottish Government’s National food and drink policy (June, 2009).
In Wales, stakeholder activities have been focused around the Food and well being: the nutrition strategy for Wales (2003) and the Welsh Assembly Government’s Food and fitness plan (2006) which promotes healthy eating and physical activity for children and young people. A nutrition network - created by the FSA Wales and the Wales Centre for Health - has been created to disseminate information to key players, which includes health professionals.
The RCN continued to build on its Nutrition now campaign to improve nutrition and hydration standards in hospitals and community health settings, providing nurses with tools and resources to make nutrition a priority in their area of work.
To enable a fitter, more aware workforce, in 2009 the RCN initiated its own organisation-wide Health and wellbeing programme and has been educating staff on the benefits of the Eat well, stay well approach to healthy living.
3 Nowhere to go
Resolution submitted by the RCN Adolescent Health Forum
That this meeting of RCN Congress ask RCN Council to lobby agencies to urgently review access to health and social care by groups regarded as being socially excluded, such as travelling communities and homeless people
Work led by the Nursing Practice and Policy Committee
Members at Congress raised concerns that the needs of socially excluded groups are great and called for an integrated health service. The RCN has been actively lobbying to influence key policy developments and initiatives in this area - including the Department of Health’s Transforming community services programme. Discussion points relating to health inequalities have been raised as part of the RCN’s ongoing parliamentary activities, while RCN Wales has responded to the Welsh Assembly Government’s draft traveller strategy consultation - A road less travelled.
The RCN has now drafted a series of letters to be sent to ministers and health departments in the four UK countries, highlighting issues and concerns relating to access to services for vulnerable groups.
The RCN has also raised the issue of access for vulnerable groups in its discussions with the Commission on Nursing and Midwifery.
The RCN continued to support the London Network for Nurses and Midwives’ Children and Young People’s Group in relation to its work with children of travelling families and asylum seekers, as well as homeless young people; the work of the group was short listed in 2009 for a Nursing Times award.
4 ISA — for better or worse?
Matter for discussion submitted by the RCN Swansea Branch
That this meeting of RCN Congress discussed the introduction of the Independent Safeguarding Authority (ISA) register
Work led by the Nursing Practice and Policy Committee
The Safeguarding Vulnerable Groups Act of 2006, which arose from the investigation into the Soham murders, recognised the need for a single agency to vet all individuals who want to work or volunteer with vulnerable adults and children. Congress delegates raised concerns around how the actual vetting process will be managed and around the lack of a right to appeal.
The RCN has taken the lead in a joint TUC coalition of health and education unions to address three priority areas: the cost of registration, duplication of regulation, and ensuring sufficient procedural safeguards which includes a full right of appeal with an independent oral hearing.
Meetings have taken place with the chief executive of ISA, representatives of the Council for Healthcare Regulatory Excellence (CHRE), the Home Office (at a ministerial level) and the Nursing and Midwifery Council (NMC). In November 2009 the RCN presented on behalf of the joint union coalition to the Home Office on the perceived procedural inadequacies of the scheme. As a result of these activities some initial scheme revisions have taken place and further meetings are planned with all bodies. The RCN will also continue discussions with the NMC on its relationship with ISA, and the implications of the duplication of regulatory procedures for the professional regulation of nurses.
The RCN Legal Services Directorate delivered training sessions for activists, staff and members in England and Wales, highlighting the implications of the new scheme prior to its introduction in October 2009, and this training will be maintained as a priority in 2010. The directorate, in conjunction with regional teams, has supported a number of members in relation to cases referred under the new scheme. Case management processes have been devised, together with standard and client care letters for ISA cases.
In August 2009 the RCN’s legal management team and the union coalition jointly instructed a QC and has consulted with barristers to consider procedural safeguards, and whether the new scheme complies with the European Convention on Human Rights and UK law. Guidance has now been developed to support the identification of potential lead cases for a High Court challenge.
A detailed ISA briefing for staff and members has also been developed and made available on the RCN website www.rcn.org.uk. In addition, key information on the scheme has been published in RCN Bulletin.
The RCN has raised its concerns at a number of levels within Parliament, via a series of meetings with MPs; an Early Day Motion; a Westminster Hall debate; meetings with the Secretary of State for Health, Home Office Minister and officials; and a briefing has also been circulated to members of both Houses of Parliament.
5 HR — a positive contribution?
Resolution submitted by the RCN Greater Liverpool and Knowsley Branch
That this meeting of RCN Congress agrees that human resource management in the health care sector has contributed no positive outcomes for either patient care or the workforce in general
Work led by the Membership Representation Committee
This resolution was defeated at Congress
Delegates at Congress 2009 felt that poor communication and failed implementation of policies and procedures was the problem, and not the HR function itself.
The message of positive working environments means better care remains an important lobbying theme for the RCN, and in 2009 the RCN continued to press for improvements in staffing ratios, a reduction in workloads, and for better working environments for nurses, citing a growing body of evidence that links the experience of health care staff at work to positive experiences for patients.
The RCN will continue to lobby that positive working environments affect not just nurses but other health care workers, and supports excellence in services that ultimately improve patient outcomes.
6 There they go!
Resolution submitted by the RCN East Dorset Branch
That this meeting of RCN Congress urges RCN Council to lobby governments to ensure that the retention of nursing staff matches service needs
Work led by the Membership Representation Committee
The debate at Congress 2009 focused on the high attrition rates of nurses leaving the profession, the rising age of nurses, and the importance of productive and valued nursing workforces.
The monitoring, assessment and lobbying on NHS workforce matters are all central activities of the RCN Employment Relations Department (ERD) and the RCN country boards.
Each year the ERD undertakes a labour market review, looking at supply and demand issues for nursing, the number of nurses in pre-registration training, those registered but not in work, those entering the nursing register, and employment from outside the UK. In addition, the RCN undertakes a bi-annual member employment survey which reviews issues such as age profile, satisfaction, and morale and willingness to remain in nursing.
Information from these surveys informs the RCN’s evidence to the NHS Pay Review Body and its wider lobbying activity on workforce matters. In 2009 the RCN was able to provide evidence to the Migration Advisory Committee on the need to expand the categories of nurses entitled to enter and work in the UK.
Each of the UK countries has a nursing workforce planning process, and the RCN is actively engaged in workforce planning discussions in England, Wales, Scotland and Northern Ireland.
7 Agenda for change, changed agenda?
Matter for discussion submitted by the RCN Cumbria Branch
That this meeting of RCN Congress discusses whether Agenda for Change has made a positive contribution to the delivery of patient care
Work led by the Membership Representation Committee
The question of whether Agenda for Change (AfC) makes a positive contribution to the delivery of patient care was discussed at Congress and has been deemed a core issue for the RCN and for the Employment Relations Department in particular. It was agreed there was no requirement to undertake ‘new work’ on this issue.
In June 2009 the Public Accounts Committee debated the National Audit Report on the implementation of AfC - NHS pay modernisation in England 2009 - and criticised the NHS for its failure to establish clear success criteria or productivity measures for the implementation of AfC, making it difficult to assess or support claims that AfC has made a real difference to patient care.
However, the RCN’s 2009 employment survey suggests that the AfC pay and career development package led to improved morale, and there is evidence that where nurses feel valued and supported in the workplace, patients have a better experience of care.
In addition, the Audit Commission report More for less in November 2009 indicated that NHS trusts in England were taking their first steps to “increasing productivity and to meeting the challenges of the future”.
8 Young hearts
Resolution submitted by the RCN United and Homefirst Branch
That this meeting of RCN Congress demands accessible cardiac screening for young people
This resolution was defeated at Congress
The debate highlighted that 12 young people in the UK die each week as a result of sudden cardiac death. Views were heard both for and against the resolution with members urging caution due to the complexities of congenital defects and the consequent impact on NHS budgets; whilst others commented that there shouldn't be a price on any son or daughter.
No further action has been taken following Congress.
9 It’s in the mix
Resolution submitted by the RCN Cumbria Branch
That this meeting of RCN Congress asks RCN Council to lobby to ensure appropriate skill mix is integral to patient safety and the quality agenda
Work led by the Nursing Practice and Policy Committee
Following the overwhelming Congress support for this resolution, the RCN Policy Unit consulted with staff and members on how best to take the work on staffing levels and skill-mix forward.
New RCN guidance on safe staffing levels and appropriate skill-mix will be launched in 2010 and a project plan to support the guidance has already been circulated to country and regional board directors, and to nursing advisors and other key RCN staff.
The guidance will set out evidence that demonstrates the importance of nurse staffing in protecting patient safety and ensuring quality of care, and will review data on ‘typical’ staffing levels and skill mix in a variety of specialities and settings. The document will also highlight the methodologies and tools available for reviewing nurse staffing and skill mix.
As part of this process the RCN is investigating what ‘unsafe staffing’ looks like, and is consulting with workforce experts, staff and members, to identify the signs and symptoms of inadequate staffing. A tool for reviewing the adequacy of staffing and skill mix is planned for development in mid 2010.
Supplementary to this activity, the RCN continued to lobby for safe staffing levels. The issue is a key policy item in the RCN General Election manifesto and has been highlighted in the RCN responses to the Prime Minister’s Commission, and in numerous consultation responses relating to quality and standards of care.
10 RCN reps — what next?
Matter for discussion submitted by the RCN Derby Branch
That this meeting of RCN Congress considers the future of the RCN representative
Work led by the Membership Representation Committee
Discussion at Congress 2009 highlighted that in order to do the role well, representatives need support, and that work should be done to further highlight the benefit of the role to both employees and employers.
Work to develop and extend the representative role - including a new learning and development pathway, a mentorship system, and the creation of practice and relationship standards - has been undertaken by the RCN, and RCN Council has also agreed to a pilot project to develop equality representatives, who will build on the work undertaken by diversity champions in recent years.
Facilities time — the time and facilities a representative can access in the workplace to undertake their role — remains a key issue for representatives. Parties on the NHS Staff Council have been reviewing how best to promote local partnership working in the NHS and maximise staff involvement. The recent ACAS Code (December 2009) provides helpful guidance on ‘backfill’ - how employers can cover the absence of staff representatives from the workplace - and this, together with other guidance has been placed on the RCN website, published in Activate (the newsletter for RCN activists), and circulated to all regional and country offices.
A joint position statement, developed by the UK national committees (stewards, health and safety, and learning representatives) on facilities agreements will be published and launched at Congress 2010.
11 HPV vaccine for all
Resolution submitted by the RCN United and Homefirst Branch
That this meeting of RCN Congress supports the right of young people to obtain equal access to the HPV vaccine
Work led by the Nursing Development Committee
At Congress 2009 delegates voted to support the rights of young people to obtain equal access to the human papilloma virus (HPV) vaccine by a majority vote of 98.99 per cent.
Letters have been sent to ministers and health departments in each of the four UK countries, highlighting the key issues that were raised during the debate at Congress, namely, the need for equitable access to the HPV (human papilloma virus) vaccine, the importance of providing alternative access to the HPV vaccine through GPs and health centres in addition to any national ‘opt in’ schools immunisation programme to capture those young people not in education, and the value of educating parents on the preventative health benefits of the HPV vaccine.
To ensure nursing professionals are better informed on HPV and the HPV vaccines, throughout the year articles and news items have appeared in Nursing Standard and other specialist nursing journals.
The RCN has also participated in a GSK (GlaxoSmithKline) campaign to increase awareness among the general public and health care professionals on HPV.
On 3 September 2009 Health Secretary Alan Johnson announced the introduction of a HPV immunisation programme to routinely vaccinate girls aged 12-13, alongside a two-year catch up campaign for girls up to 18 years of age. The Scottish Government is funding a similar immunisation programme. The announcement signalled a key shift in focus, from a sickness service to a wellbeing service, for the NHS.
12 Foundation for a healthy future?
Matter for discussion submitted by the RCN Suffolk Branch
That this meeting of RCN Congress considers whether foundation status is a healthy option for the NHS (applies to England only as foundation trusts do not apply in Scotland, Wales and Northern Ireland)
The proposer of this matter for discussion questioned whether a service judged on its business, HR and strategic plans could effectively deliver the quality and levels of patient care required. Members agreed that nurses must be assertive and take the lead in standing up for patients. It was also argued that foundation trusts are an opportunity to engage and contribute to the development of priorities and targets.
No further action has been taken following Congress.
13 Leading change for nurse leaders
Resolution submitted by the RCN Cumbria Branch
That this meeting of RCN Congress asks RCN Council to develop a strategy that supports directors of nursing with executive responsibility in commissioning
Work led by the Nursing Practice and Policy Committee
Following discussion at Congress 2009 where delegates voted overwhelmingly in favour of this resolution, the RCN has lobbied extensively to ensure the appointment of executive nurses to the new primary care trust (PCT) commissioning boards in England, and their equivalents in Northern Ireland, Wales and Scotland.
A survey of regional PCT boards in England enabled the RCN to establish which PCT commissioning organisations have nurse leadership engagement, and to actively lobby those with executive nurse representation on their board.
In 2009 the RCN hosted a commissioning event, inviting nurse leaders from PCTs to review future structures and the delivery of world class commissioning. A further event in January 2010 included a speaker from the Department of Health (DH) (England), and it is anticipated that event attendees will shortly establish a PCT nurse executive network which will be facilitated by the RCN. Work has also been undertaken to establish the core competencies for nurse executives to influence commissioning.
In November 2009 Inspire was launched, a new RCN programme of resources to inform and support executive nurses which includes an online networking community to support the sharing of best practice, and an e-newsletter for nurse leaders. The Inspire programme is now a key forum for effective online and face-to-face collaborative working between RCN regional directors and strategic health authority (SHA) directors of nursing and their networks.
The RCN Management and Leadership forum has seen a significant increase in lead nurse membership and engagement since Congress 2009, will be undertaking further work in 2010 to develop additional online communities and learning networks that meet the needs of aspiring nurse leaders.
In Scotland, preliminary discussions have taken place to review senior nurse leadership structures and the changes in community services provision and RCN Scotland is now planning additional work to research leadership structures and succession planning.
Further activities are planned for 2010, including a programme of master classes to support nurse leaders, a political leadership programme, and the development of Learning and Development Institute leadership resources.
14 Green light for red light?
Resolution submitted by the RCN Cambridgeshire Branch
That this meeting of RCN Congress makes appropriate recommendations to the UK government to enable local councils to license brothels
Work led by the Nursing Practice and Policy Committee
At Congress 2009 it was agreed that the RCN should make recommendations to the UK government to allow up to four sex workers to work together legally before requiring a license and that the primary consideration behind this recommendation was the safety and protection of workers.
Prior to Congress 2009 the RCN had been engaged in lobbying parliamentarians on the new Policing and Crime Bill, which contained legislation that further criminalised sex workers.
The Congress resolution and ensuing debate enabled the RCN to review its parliamentary briefing on the Bill. Throughout its lobbying process the RCN worked alongside the English Collective of Prostitutes, and held a number of meetings with members of both the House of Commons and the House of Lords.
Following a meeting, Baroness Miller of Clithorne Domer agreed to change the wording of a previously tabled amendment to encompass the RCN’s recommendation to allow up to four sex workers to work together from the same property in the name of safety. While the amendment was withdrawn, this was on the basis that the Minister understood the point and would respond at a later stage of the legislation.
Unfortunately, on the specific point around the criminalisation of prostitutes, the final Act does not encompass the RCN view that the decriminalisation of prostitution would enable both easier access to health care services and a route out of prostitution.
15 APs — who needs them?
Resolution submitted by the RCN Essex Branch
That this meeting of RCN Congress asks RCN Council to evaluate where, when and why we need assistant practitioners
Work led by the Nursing Practice and Policy Committee
One discussion point raised at Congress 2009 centred on the need for the RCN to support the continuing professional development of health care assistants.
In November 2009 Skills for Health published its Core standards for assistant practitioners; the standards document is available for download from the RCN website www.rcn.org.uk.
In January 2010 the RCN’s Future Nurse, Future Workforce Group agreed to undertake research into the UK NHS workforce, with a key focus on assistant practitioners (APs).
This research will enable the RCN to establish exactly what roles APs perform, where they work, and the benefits or otherwise of these roles. The findings of the research will be utilised to develop a clear direction for the future of APs.
16 NHS Ltd - worth the price?
Matter for discussion submitted by the RCN Greater Liverpool and Knowsley Branch
That this meeting of RCN Congress discusses the impact of a finance-driven, business-orientated NHS on patient care
Delegates discussed the impact on patient care of a finance-driven, business-orientated NHS. The difference between being 'finance-driven' and 'business-orientated" was highlighted. The overwhelming message from members was to emphasise the importance of focusing on patient care rather than finances.
No further action has been taken following Congress.
17 Waste not, want not
Matter for discussion submitted by the RCN Southampton and District Branch
That this meeting of RCN Congress discusses the real impact of waste management and waste segregation policies on patient care
Work led by the Membership Representation Committee
Delegates at Congress 2009 discussed the importance of waste management and the projects they are involved in. RCN activists and members continue to take up the RCN guidance on waste management, Safe management of health care waste (2007), which includes measures on how to reduce waste and ensure waste enters the appropriate waste stream.
Subsequent to Congress 2009, the RCN has sought clarity from the Health and Safety Executive on the carriage of clinical waste in nurses’ private vehicles and published this information on the RCN website (October 2009). In November 2009, over 600 members working in the community responded to an RCN questionnaire on the management of community health care waste. The results indicated that the majority of respondents carry some form of clinical waste in their personal vehicle - primarily sharps waste contained in a sharps box, or waste deemed infectious such as used dressings.
The RCN is currently involved in consultations relating to the proposed revision of the community nursing chapter of the Department of Health (DH) Health Technical memorandum 07-01: Safe management of health care waste (HTM 07-01) and is working to ensure the revised edition will address member concerns relating to the definition of infectious waste and the logistical difficulties in implementing safe disposal and transport. The RCN is also preparing a positioning statement and member guidance on the carriage of waste in the community.
In December 2009 RCN President Maura Buchanan met with the Campaign for Greener Healthcare to initiate closer working links on ‘greening’ clinical services. The RCN will continue its collaborative work with the Campaign for Greener Healthcare and Healthcare Without Harm organisations, to ensure the nursing voice is heard.
Prior to the Copenhagen climate change summit, the RCN participated in the Climate Change Coalition’s UK Wave event, hosting an event on the impact of carbon emissions on health in December 2009.
A discussion document on the RCN’s proposed environmental strategy has been presented to the UK Safety Representatives Committee (October 2009), and work on the strategy - which will influence the greening of health care and ultimately reduce the carbon footprint of health care - is continuing.
18 Union matters
Resolution submitted by the RCN UK Stewards Committee
That this meeting of RCN Congress calls on RCN Council to lobby for the implementation of equitable and accessible trade union facilities agreements
Work led by the Membership Representation Committee
Delegates voted overwhelmingly in favour of this resolution describing how RCN representatives work tirelessly for their colleagues. The RCN has argued that developing facilities arrangements should be included in the work plan for the NHS Staff Council for 2009/10. At the NHS Staff Council executive meeting on 17 September 2009 it was agreed that NHS Employers - the representative body of trusts in England on workforce issues - would publish Section 25 (time off and facilities for trade union representatives) as a standalone document on its website, and notify employers via its Workforce bulletin - a weekly update on HR and workforce issues in the NHS.
As a result, the following statement was published in Workforce bulletin, 8 October 2009:
‘The parties on the NHS Staff Council have been discussing how best to promote local partnership working. In developing local arrangements, employers should be aware of good practice relating to time off and facilities that is set out in section 25 of the NHS Terms and Conditions of Service Handbook. This includes principles designed to maximise staff involvement. Section 25 of the handbook is published on our pay and contracts web page www.nhsemployers.org/PayAndContracts/AgendaforChange/Pages/TimeOffandFacilitiesforTradeUnionRepresentatives. This has also been put on the Social Partnership Forum website www.socialpartnershipforum.org/News/Pages/Promotingexistinggoodpractice.’
Following extensive consultations, in which the RCN participated, in January 2010 the Advisory, Conciliation and Arbitration Service (ACAS) launched its revised code of practice on time off for trade union duties and activities. The revised code reflects the changing nature of the British workplace and what this means for time off arrangements for trade union representatives, and the RCN believes the new code will support RCN representatives in their trade union activities across the NHS, other parts of the public sector, and the independent sector. The revised code is available for download from the ACAS website www.acas.org.uk.
The RCN UK Stewards Committee is currently considering how best to publicise the Agenda for Change arrangements and the revised ACAS code to RCN representatives.
19 A word for dyslexia
Resolution submitted by the RCN West Midlands Regional Board
That this meeting of RCN Congress calls on RCN Council to lobby employers to recognise and provide for the needs of nurses with dyslexia and similar conditions
Work led by the Nursing Practice and Policy Committee
Recognising that the needs of staff – and those who manage them – with dyslexia, dyscalculia and dyspraxia is of paramount concern to members and in the debate at Congress this resolution received strong support. The RCN Nursing Department has commissioned an in-depth report highlighting evidence of good practice in nursing and similar public-focused occupations. The report, together with an accompanying online toolkit to support managers and staff, is being presented at Congress 2010.
Following the launch of the toolkit, the RCN will continue to monitor and disseminate examples of good practice to members.
20 Putting its house in order
Matter for discussion submitted by the RCN UK Stewards Committee
That this meeting of RCN Congress discusses whether the NMC has restored the faith of nurses in its fitness to practice
Work led by the Nursing Practice and Policy Committee
At Congress 2009 the discussion focused on the changes in the Nursing and Midwifery Council (NMC) over the last year and a number of delegates felt there was still some way to go. RCN has been working closely with the Nursing and Midwifery Council (NMC), providing support and advice in addressing the issues that the Commission for Healthcare Regulatory Excellence (CHRE) raised in its 2008 report Special report to the Minister of State for Health Services on the Nursing and Midwifery Council (11 June 2008), in relation to the running of the NMC.
The RCN attends stakeholder meetings with the NMC, and senior RCN staff are in frequent contact with NMC directors. The RCN Legal Services Directorate also attends fitness to practice meetings with the NMC to review the management processes relating to fitness to practice cases. The length of time to resolve such cases continues to be a concern, and whilst there has been some progress this has not been as fast as we would like.
The RCN is lobbying hard on both advanced practice and health care support worker (HCSW) regulation. We believe that through revalidation there is the opportunity to recognise those nurses working at an advanced level of practice and that there is now an overwhelming case, in terms of patient safety and public protection, to support the regulation of HCSWs. The RCN welcomed the announcement made by the NMC in January 2010 that it will commission research to consider the regulation of HCSWs.
The RCN has long supported the move to an all-graduate profession and has been supportive of the announcement to achieve this by 2013. In 2010 we will respond to the NMC consultation on the standards for pre registration education.
The case of RCN member Margaret Haywood who was initially struck off for whistleblowing and exposing her concerns over poor standards of care was clearly a significant issue. The original NMC decision to strike her off was, in the view of the RCN, disproportionate, and in the wake of the Healthcare Commission’s report into Mid Staffordshire NHS Trust created the impression among many nurses that if they were to speak out about poor clinical care or standards they too would be struck off.
The RCN has satisfactorily resolved this individual case and is working with the NMC to develop further guidance for registrants on whistleblowing. The RCN wants to ensure consistency in the decision making of fitness to practice panels in relation to the implications this has for registration to maintain the safety of health care providers.
The RCN has contributed comments to the CHRE’s annual performance review of the NMC for 2009/10.
21 Diversity equality, opportunity
Resolution submitted by the RCN Islington Branch
That this meeting of RCN Congress urges RCN Council to ensure that its own diversity reflects the diversity of RCN members
This resolution was defeated at Congress
Work led by the Diversity Committee
There were a high number of delegates who wanted to speak on this matter at Congress 2009 and there was some debate on the meaning of the wording of the resolution. The resolution was not passed.
Since Congress 2009 RCN Council reaffirmed its commitment to diversity and equality issues by establishing a sub-committee to focus on how the RCN delivers its corporate diversity and equality strategy.
A group which includes RCN Council members, RCN members and the RCN Chief Executive & General Secretary Peter Carter is also examining how best the RCN can respond to the original objectives of the resolution which asked for the RCN to consult on how to improve diversity of its Council membership.
In March this year the RCN held its Race Equality: Getting it Right conference. The purpose of the event was to engage RCN members in facilitated conversations about what works well and what changes can be made in order to make race equality a reality for all RCN members.
Further details about the Diversity Committee can be obtained from Jane Clarke, Director of Governance Support on jane.clarke@rcn.org.uk
22 Millennium goals or own goals?
Resolution submitted by the RCN Lewisham and North Southwark Branch
That this meeting of RCN Congress asks RCN Council to work at home and internationally to account for progress on achieving the UN Millennium Development Goals
Work led by the Nursing Practice and Policy Committee
The consensus from delegates at Congress 2009 was that more work needs to be done to meet the targets of the eight millennium goals agreed by the United Nations. The RCN has been involved in a number of activities to highlight the need for further action on the Millennium Development Goals.
The RCN continued to lobby for the establishment of a UN Women’s Agency to address gender equity - one of the key Millennium Development Goals (MDG) - and in September 2009 the UN General Assembly agreed in principle to create the Agency. The RCN joined the European arm of the international Gender Equality Architecture Reform (GEAR) campaign to press EU foreign ministers and European Commissioners for a fully funded agency with senior leadership and wrote directly to Douglas Alexander, Secretary of State for International Development.
In September 2009 Peter Carter, RCN General Secretary & Chief Executive, joined a meeting hosted by Sarah Brown at 10 Downing Street to support the maternal mortality campaign she is championing as global patron of the White Ribbon Alliance. The RCN Midwifery Forum’s international lead, Gill Barber, was one of the co-presenters of a petition to the Prime Minister as part of the campaign. RCN members were also encouraged to write to Douglas Alexander about prioritising maternal mortality prior to the G20 meeting in September.
In December the RCN contributed to the European consultation on the future role of the EU in global health; the EU and its member countries collectively account for 60 per cent of global aid assistance. The RCN response called on the EU and member states to meet their aid commitments, to give particular effort to achieving MDG 5 on maternal health, to promote policies to improve access to services, and to invest further in educating, recruiting and retaining health workers. The EU will develop its strategy in 2010.
In the build up to the UK general election and the UN summit on the Millennium Development Goals in September 2010, the RCN is working with Action for Global Health - a network of international development organisations - to commit the incoming government to deliver on the UK’s funding commitments, improve aid coordination, work to ensure universal access to primary care, and invest in stronger health systems, including strengthening the health workforce needed to deliver services.
23 Nurse or police officer?
Resolution submitted by the RCN Croydon Branch
That this meeting urges RCN Council to examine the ethical, professional and safety issues related to sharing knife crime data with the police and issue a policy position
Work led by the Nursing Practice and Policy Committee
Debate at Congress 2009 highlighted the need for guidance on how to deal with confidentiality issues related to reporting knife crime data to enable the police to identify knife crime ‘hot spots’.
Following Congress 2009, the RCN Emergency Care Association (ECA), RCN Policy Unit and RCN Nurse Advisor reviewed the wording of existing RCN knife crime guidance, and consulted with the College of Emergency Medicine in response to the General Medical Council’s (GMC) revised guidance.
In September 2009 the RCN issued a policy briefing Dealing with knife injuries: the nursing role. The briefing offers guidance on best practice derived from Reporting knife wounds (GMC, 2008) and Nursing and Midwifery Council (NMC) guidance on confidentiality.
RCN revised guidance has been presented at two knife crime workshops facilitated by RCN North West Region and to the RCN ECA Annual Conference. In addition police agencies in the North West were consulted while RCN ECA Link members were consulted regarding the suitability of the revised wording via a forum website.
The RCN Policy Unit is seeking a further consultation on this matter with the NMC and is collating responses from the workshops and RCN ECA ready for distribution via a forum e-newsletter in February 2010, prior to the production of a final version of the guidance.