Professional Nursing Committee 

Our Professional Nursing Committee helps us achieve our purpose as a Royal College, making decisions on professional issues affecting nursing. It is accountable to RCN Council. It has three main functions which are taken from our Royal Charter:

• Promote the science and art of nursing, as well as education and training
• Promote the advancement of nursing as a profession
• Promote the professional standing and interests of our members

Find out more about the role and remit of our Professional Nursing Committee in the terms of reference.

Updates from the Professional Nursing Committee 

Agenda

On 19 March the Professional Nursing Committee met at RCN HQ and online. The following day we were joined by our colleagues on the Trade Union Committee for our second joint meeting of the year to discuss key issues where it is critical for the professional and trade union functions of the RCN to come together.

Meeting first as PNC we received a wide-ranging update from RCN Chief Nurse Professor Nicola Ranger. The committee shared Nicola’s continued and increasing concern at the significant drop in applications to nursing degree programmes, alongside high attrition rates. This led to a discussion on the public understanding of the role of a nurse and perceptions of nursing as a career choice. We recognised that recent rhetoric which has focused on negative incidents involving nurses was damaging to this public perception and is likely to have played a part in young people not seeing nursing as a career of choice. Pay was also agreed to be a critical element in that career choice, as well as increasingly being cited as a factor by those intending to leave the profession. The committee recognised the need to celebrate the value of nursing, whilst recognising the appalling working conditions being endured by nursing staff. We were pleased to hear that this is the subject of live work between the nursing department and the communications and policy teams at the RCN.

The committee reviewed the most recent report on the workstreams arising from Congress 2023, including addressing the increased normalisation of corridor care in all its many manifestations. The placing of patients in inappropriate settings compromises their dignity and safety, and increases nursing workloads, which further impacts on patient safety. Listening events taking place over recent weeks are further refining the RCN position in calling for an end to these unacceptable practices.

Safe staffing remains our most critical workstream. Building on the outcomes from the international Safe Staffing Summit in December we looked ahead to a further summit, which took place the following week.  This summit brought together nurses with operational responsibilities for the nursing workforce to hear from some of the same experts in the field. It was an excellent day which continued the work towards gaining the support of the profession in the development of our position of establishing safety-critical registered nurse-to-patient ratios across health and social care. At the request of PNC (and others) most of the keynote talks from the December meeting are now available in full on this webpage. Former PNC member Professor Alison Leary’s recent William Rathbone lecture was also shown at the summit and received extremely positive feedback. Alison’s lecture is available on the QNI website.

At both PNC and the joint meeting with the TUC, Nicola Ranger presented an update on the RCN Institute of Nursing Excellence, and the progress to date on establishing the five academies which will make up the Institute. These are the academies of nursing practice, nursing leadership, nursing workforce, international nursing, and the activism academy. At PNC this generated further discussion about how we align the committee workplan to the development of matrix working across the college and the Institute. This is an exciting time, and as the meeting progressed, we recognised the way in which much of the work overseen by PNC is woven into plans for the Institute to strengthen the RCN as the Voice of Nursing.

PNC considered a paper from Jonathan Beebee, Professional Lead for Learning Disabilities, which set out the challenges faced by the speciality not only in terms of recruitment and training uptake but also in the perception of the role and relevance in today's world. The Committee considered some very stark data on the reduction of numbers of learning disability nurses, and shared examples of the complexity of the role, and how it has changed over time. We supported plans for a national summit on learning disability nursing, to be convened by the RCN, and look forward to a discussion on the Congress agenda in June, Redefining learning disability nursing.

We were delighted to be joined at PNC by Professor Bridie Kent, the Chair of the Forums Governance Group, and Paul McAleer, the new Chair of the Forum Chairs Committee (and Chair of the Nursing in Justice and Forensic Health Care Forum). They highlighted the huge amount of work the forums have achieved over the last year and the vital contribution they continue to make to the professional voice of the RCN. We were also updated on some of the changes in governance processes which we hope will be agreed by Council, to encourage and support member engagement and involvement. The forums will be promoted at Congress and a third World Café event is planned to achieve as much feedback and discussion as possible.

The current RCN position statement on nursing associates was reviewed and discussed in detail in the light of increased evidence of the substitution of registered nurses by registered nursing associates and continued concerns with regards to inappropriate role expansion. This discussion was taken forward into our meeting with the Trade Union Committee the following day, as it was recognised that this was an area where there were some key questions with regards to employment issues as well as professional concerns. It was agreed that we needed to strengthen our current position, and this is now going through the process of redrafting following insightful input from both committees.

A further issue was raised at PNC in relation to medical associate professionals, and the apparent inclusion of some registered nurses (such as surgical care practitioners) in commentary relating to these roles. During our two days of meetings a further position statement was drafted, discussed, and reviewed and has now been published.

Our joint session with the TUC provided the opportunity for discussion on topics of shared concern, notably our work on safe staffing, and the current consultation on a separate pay spine for nursing. This consultation has generated an impressive level of response from RCN members, and we discussed the draft of the RCN position which recognises that nursing staff working for the NHS are currently not well served by Agenda for Change. Whilst we recognised that a separate pay spine for nursing could bring significant benefits to the profession, there was also some caution with regards to potential risks to terms and conditions and other benefits of AfC. The RCN has now submitted its views to the consultation: A fresh start for nursing pay? RCN responds to government consultation

It is three years since publication of the RCN Nursing Workforce Standards. We are delighted to see how much traction they are gaining, and the many resources which have been developed to support their implementation. It is now time for the Standards to be reviewed and strengthened. In a workshop session with Lena Johnson, Professional Lead for Nursing Workforce, PNC began the review process, and recognised opportunities to align the standards to the work on safety critical registered nurse-to-patient ratios, to address skill mix within the nursing workforce, and the risks of registered nurse substitution, as well as being more specific with regards to the ‘uplift’ which should be applied to nurse staffing establishments. We look forward to continuing this work with Lena and colleagues in the nursing department, with input from our counterparts on the TUC and staff colleagues with regards to the employment components.

Agenda

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Agenda

Our first meeting of 2024 took place in London (and online) on Thursday 1 February. I welcomed our new Committee members, as well as thanking once more those Committee members who stepped down at the end of December. All members of the committee give their time voluntarily on behalf of the members they represent to ensure we are leading the College’s important work to advance and support the profession.

The Committee first discussed our terms of reference, and we will revisit them after some work internally later this quarter. I gave a Chair’s update to the Committee following our last meeting at the end of December and sought their feedback on the joint session we held on Wednesday 31 January with the Trade Union Committee. We work closely together on shared matters of interest, and all agreed that it was really positive for the committee members to meet together and build on this spirit of collaboration. We felt emboldened and hopeful from the session for the work we will progress together in the year ahead.

Our Chief Nurse, Nicola Ranger gave an update to the Committee on the consultation on the nursing pay spine. We believe that Agenda for Change has lost sight of our value - after 20 years, three quarters of our members are on the two lowest pay bands possible for registered professionals. Nurses are too often at the bottom of the pay and grading structure, without a clear route through. We want nursing staff, wherever they work, to be rewarded for their skills and knowledge while staying close to clinical care, and to patients. The Committee will be inputting into the RCN’s response to the government consultation.

The normalising of corridor care is also a key concern for the Committee, and we discussed how this is occurring across health and social care settings, not just in emergency or acute care but also in the community and in mental health. The College’s work, led by PNC, will continue to raise the alarm on this issue and the negative impacts on patients.

We reviewed the Committee’s work plan and risk register for the year and discussed how we will lead and monitor progress on these key areas of work for the College.

One of the most significant workstreams for the College and for PNC is staffing for safe and effective care. We discussed how staffing issues continue to be a key issue for our members and the outcomes from the international Safe Staffing Summit and the work already being undertaken to strive to achieve these. This will involve a range of work including evidenced-based statements on registered nurse:patient ratios across health and social care.

The Committee agreed that work will take place to set out a position statement to clarify our view on the role of registered nurses and registered nursing associates in maternity care. We discussed the continuing development of the RCN Professional Framework and work that has been delivered to date, including the Definition and Principles of Nursing and registered nurse substitution. We are looking forward to the imminent publication of the new definitions and standards for enhanced and consultant level practice, and the revised definition and standards of advanced level practice, which will be reflected in our contribution to the deliberations of the NMC with regards to possible regulation of advanced practice.

The Committee was updated on the public policy work happening to influence policies that impact on our members. The first item discussed was the Strike (minimum service levels) Act and the impact on our members’ freedom to strike. We also noted the work the organisation will do to influence during the General Election this year, and how we will be kept updated and involved. International recruitment is a key policy focus for the College, and we discussed the Westminster Hall debate on Wednesday 31 January led by Kwasi Kwarteng on international recruitment to health and social care and heard that our briefing was used by MPs to reference the experience of our internationally recruited members.

We had an update on the Institute for Nursing Excellence and the five academies which will make up the Institute. These are the academies of nursing practice, nursing leadership, nursing workforce, international nursing, and the academy for professional activism. It is an exciting time for the College and the Committee will be fully involved in leading this work.

The RCN Professional Lead for Research, Dr Ada Hui presented the new RCN research strategy – this strategy will ensure that RCN’s work, and that of the Institute and Academies, is underpinned by high-quality research to achieve the organisation’s strategic goals for the nursing workforce and will promote nursing leadership in research. The strategy has been developed alongside the Research Forum, and through engagement with a wide range of members. We congratulated Ada for the work, and suggested some final edits before the strategy progresses to publication, with a planned update for members at Congress.

Christine Callendar, RCN Head of Nursing Practice, gave an update on the implementation of the recommendations from our forums and networks review. Progress has been made on the way the forum steering committees can communicate with each other, and other work in progress includes updating our governance structures and training for forum steering committees. This is one of the workstreams where we have been concerned at delayed implementation, and so we were pleased to see the progress being made, whilst recognising that there is more to do to ensure the forums receive the right level of resource and support to sustain the significant contribution they make to the professional work of the college.

The Committee reviewed the mid-year update on Congress 2023 resolutions and confirmed the Committee will contribute to further updates for the Council report to Congress in June. New PNC leads were identified for some of the workstreams.

Our final agenda item for the day was an update on the Governance and Culture Joint Partnership board to take forward recommendations from recent reviews and reports. Most of the deliverables are on track. Members can keep updated here. 

Our new and existing Committee members brought much to the discussions throughout the day and like me, are motivated for the year ahead. PNC members are committed to collaborating with colleagues from the nursing and policy staff teams, our Trade Union Committee counterparts, and with Council, to ensure the work we are doing achieves our aims for the benefit of our members.

At the end of 2023, our General Secretary and Chief Executive Pat Cullen reflected on a ‘historic year for nursing’. This brief report from the Professional Nursing Committee (PNC) reviews progress across our 2023 work programme.

At the start of the year, members in England were back out on the picket lines, with our overarching campaign for fair pay and safe staffing showing more clearly than ever the professional and trade union arms of the RCN working together. PNC meets regularly with our colleagues on the Trade Union Committee (TUC); we work closely together on shared matters of interest. At Congress in Brighton PNC proposed a resolution, seconded by TUC, that ‘This meeting of RCN Congress affirms that the strength of the Royal College of Nursing comes from its dual function as a professional body and a trade union’. We were delighted that this resolution was passed with an overwhelming majority.

Congress in Brighton was also the launch pad for the RCN strategy, A New Dawn for Nursing. Central to this strategy is the development of the RCN Institute of Nursing Excellence. The continuing development of the Institute brings together two of our key workstreams, Education, Learning and Development, and Research, both of which will underpin the work of the five academies within the Institute.

2023 saw the continuing development and dissemination of RCN Learn the single sign-on online portal for RCN and RCNi education and learning resources. One of our priorities for 2023 was the development of the RCN Research Strategy, working closely with the RCN Research Forum. The shared experiences and expertise of RCN staff, members, fellows, forums, and an expert reference group from across the four nations have been invaluable to shaping the vision.

Staffing for Safe and Effective Care remains one of our most significant workstreams, as well a critical issue for our members. PNC provides oversight to the UK programme board for this work, and supported the move to be much clearer about what safe staffing means in practice and establish a strong position on the need for a ‘safety critical red line’ below which staffing levels should never fall. This has led to a focus on the need for a minimum ratio of patients cared for by a registered nurse. This position was presented and debated at the end of the year in the RCN international Safe Staffing Summit. This event, which I had the privilege to Chair, brought together national and international experts to present the evidence behind the ‘international case for ratios’. In 2024 we will be looking to harness four country, cross sector and political support for this position. Members can find out more here.

We continue to provide oversight to the development of the RCN Professional Framework for Nursing. Three workstreams have continued to progress this critical work: Professional Practice; Levels of Practice; and Career Frameworks.

2023 saw the completion of the professional practice workstream, with the publication of the revised Definition and Principles of Nursing. This definition was well received, and underpins the development of the whole framework.

2024 will see the culmination of the workstream on levels of practice, with publication of the new definitions and standards for enhanced and consultant level nursing practice, and the revised definition and standards of advanced level practice. This will be reflected in the RCN contribution to the deliberations of the NMC on possible regulation of advanced practice. 2024 will also see the start of a new workstream, collaborating with the Nursing Support Worker Committee, to define and set standards for supportive and assistive nursing roles.

During 2023 we became increasingly concerned at the evidence from across all countries and settings pointing to increased substitution of the registered nurse. This is despite the evidence that demonstrates the impact of this practice on patient outcomes. We recognised the need to reiterate our position statement on preserving safety and preventing harm - Valuing the role of the registered nurse (2021) and a suite of resources was developed to support this position focused on registered nurse substitution.

Following on from discussions at Congress in 2023 we supported the development of a further position statement with regards to the role, and scope of practice of the Registered Nursing Associate (in England) affirming that the post is intended to support the role of the registered nurse, and, for some, to provide a bridge to nurse training, and should never be used as a substitute. RCN position statement on the role and scope of practice of the Nursing Associate | Royal College of Nursing.

PNC remains committed to the recommendations of the Forums and Networks Review. We have worked closely with the Director of Nursing, and her Deputy, for whom this work has been a priority in 2023. Progress has been made on the way the forum steering committees can communicate with each other, and other work in progress includes updating our governance structures and training for forum steering committees. The Chair of the Forum Governance Group, and the Forum Chairs Committee remain central to this workstream and meet with PNC on a twice-yearly basis to provide updates from the forums. At the end of the year, we were delighted to receive the collated Forums Annual Report, which demonstrated the amazing work done by our professional forums over the year.

At the end of 2023 we regretfully said goodbye to five members of PNC who completed their terms of office: Siobhan Donald (Northern Ireland), Sue Haines (East Midlands), Sally Young (North West), Paul Trevatt (London) and Suzanne Davies (student member). I am very grateful for the significant contribution each one of them made to the work of the Committee, and the College. They were all valuable members of the PNC whose knowledge and expertise will be much missed. We welcome Donna Gallagher (Northern Ireland), Aquiline Chivinge (East Midlands), Dunni Akinbulumo (North West), Sonia Henry (London) and Alisha Brown, (student member) who joined the committee in January 2024.

Agenda

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Agenda

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Our September meeting took place in London (and on-line) on Wednesday 6 September. I would like to place on record once again my thanks to our committee members. They are all busy, working nursing staff who give up their time voluntarily on behalf of the members they represent. Their contribution to the college can often go unseen, but the impact is incalculable – huge thanks to them all.

As a committee we recognised significant opportunities over the coming months to raise the professional profile of the RCN through our work programme, notably through the work on Staffing for Safe and Effective Care (SSEC), the development of the RCN Institute of Excellence, and the RCN Professional Framework. All were addressed during the meeting, and individual members provide a lead for specific workstreams on behalf of the committee.

RCN Chief Nurse Professor Nicola Ranger updated the committee on her recent trip to Montreal as part of the RCN’s delegation to ICN Congress. We will be hearing more from Nicola in our next meeting as to some of the key learning from this event. We were delighted to hear of the warm reception given to the RCN delegation, which included Deputy President Tracy Budding, and the positive impact of rejoining the global nursing community at the ICN.

As the lead committee overseeing the college’s safe staffing work, we discussed the strides other countries have made in ensuring safe nurse staffing levels, and how the RCN can use its influence to achieve similar results in the UK. We discussed the plans for this work for the remainder of the year, and in the lead up to Congress 2024, with reference to the development of the college’s policy position on ratios - maximum patients to registered nurse safety standards. Staffing levels are our members’ top priority, and the committee continues to have a laser focus on doing everything it can to drive this work forward. So much of the committee’s work plan – and the work of the wider college – is directly related to staffing issues. We look forward to an international summit on safe staffing to be hosted by the RCN towards the end of the year.

Nicola Ranger updated us on plans and progress of the new RCN Institute - its structure, ambitions, and scope. Many of our priority work areas – including safe staffing, education, learning and development, research, the professional framework, and nursing policy – will migrate to the Institute, and we continue our engagement in its development and alignment with our work programme. 

As part of our priority work on the RCN Professional Framework for Nursing, we were delighted that the definition and principles of nursing, a critical element which will underpin the framework, were ready for publication.

One of the key aims of the Professional Framework is to set out the RCN position on the levels of nursing practice. Following discussion in our August ‘Deep Dive’ session, we formally ratified the RCN definitions of enhanced, advanced, and consultant level nursing practice. We expect these definitions to be published ahead of the RCN Advanced Nurse Practitioner conference in October. They will inform the RCN contribution to the work being undertaken by the NMC on Advanced Practice. The work of the Professional Framework will include work on defining the nursing support workforce and provide clarity on supportive and assistive roles in that workforce.

We looked in detail at the supporting evidence which has been gathered to inform a revised position statement concerning the risks of substituting registered nurses with other health workers. The RCN’s original position statement was published in 2021: Valuing the role of the registered nurse The Committee considered whether publishing an updated position statement on substitution was required as we are developing the position on the ratio of patients to the registered nurse, and had recently agreed a position on the specific concerns related to the scope of practice of the Nursing Associate in England. It was agreed that the 2021 statement covered the key concerns on substitution, but that it needed to be made more easily available to members and stakeholders, and that it should be reissued with the inclusion of a selection of case studies, to help illustrate the risks of substitution of the registered nurse.

The committee went on to review the agreed position statement on the scope of practice of the Nursing Associate. This had come back to the committee in the light of developments in the other three countries of the UK, most notably in Wales since the position statement was signed off. 

Nicola Ranger outlined recent developments in Scotland, Wales, and Northern Ireland in relation to the potential further development of Band 4 roles and the possible introduction of the Nursing Associate role in these countries. The Committee agreed that there was no need to amend the position statement as the points made in relation to the potential for the development of the role outside England addressed the need for the evaluation of the role as implemented in England, and the need to develop an England wide employer code. 

The Committee concluded that the position statement was clear that Nursing Associates should not be asked to carry out any duty outside their scope of practice, as defined by the NMC, and should therefore not be used as substitutes for registered nurses. The NA role should be in addition to the registered nursing workforce, not a replacement, and this was clear in the statement. It was agreed to publish the position statement agreed and signed off by both PNC and Council as soon as possible.

Finally, under any other business, the committee welcomed plans for the RCN’s first ever Nursing Support Workers Day Conference taking place on 23 November at RCN HQ.

Meeting agenda

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14 March

Meeting agenda

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Meeting agenda

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Overview

For many reasons, 2022 will be remembered as an incredibly significant year for the RCN. We held our first ever UK-wide industrial action ballot, completed far-reaching reviews into our governance and culture and raised unprecedented political and public awareness of both our college and the challenges faced by our profession.

In October, we acknowledged the publication of Bruce Carr KC’s independent review into the culture of our college, and we accepted its recommendations in full. We’re fully committed to working alongside RCN Council, the Trade Union Committee and the RCN Executive Team to achieve change.

We were delighted at the end of the year to welcome Professor Nicola Ranger as our Executive Director of Nursing and look forward to working closely with her. Huge thanks to Helen Whyley, Director for Wales, who has provided Executive Leadership to the Nursing Department, the Staffing for Safe and Effective Care Programme and the Professional Nursing Committee.

Much of the second half of 2022 was dominated by our industrial action ballot and subsequent strike action. This campaign has seen both the professional and trade union aspects of the RCN working in tandem – it has demonstrated the incontrovertible link between fair pay and safe staffing. As a senior nurse and picket supervisor so succinctly put it: “patient care is unsafe, because we don’t have enough staff, because we’re not paid enough."

Despite the organisational focus on industrial action, progress against KPIs on all areas of the committee’s workplan has been made.

Education, learning and development

RCN Learn

KPIs

• Launch and evaluate Phase 1a of RCN Learn
• Secure resource for Phase 2

Progress

Phase 1 of the RCN Education, Learning and Development Strategy saw the launch of RCN Learn, a single sign-on online portal for RCN and RCNi education and learning resources to be accessed from one accessible place for members, registered users, and subscribers to RCNi plus. Work on Phase 2 started at the beginning of 2023.

Research strategy

KPIs

• Secure resource and establish an engagement programme for the RCN Institute of Nursing Excellence
• Launch the RCN Research Strategy (2023)

Progress

Council agreed and approved the funding for the Institute of Nursing Excellence which will bring both the ELD and Research strategies together. Market research to explore funding opportunities and international comparators has been completed.

A series of virtual events has been planned with the RCN Research Society and other members to discuss and agree our vision for the RCN Research Strategy.

Staffing for safe and effective care

Nursing Workforce Standards

KPIs

• The RCN Nursing Workforce Standards are endorsed, and adopted nationally, regionally and locally.
• Setting-specific Nursing Workforce Standards resources are developed.

Progress

A process for the adoption and endorsement of the Standards is under development through the Staffing for Safe and Effective Care Programme.

Criminal Justice and Speciality Nursing-specific content has been developed and is now live. Other setting and country-specific content within the professional guidance section of the Nursing Workforce Standards will be reviewed and enhanced.

Professional Framework

KPIs

• Agree an RCN definition of nursing to underpin the programme.
• Revise the principles of nursing practice; co-create and publish an overarching UK professional framework for nursing.

Progress

Definition of nursing: An engagement and consultation process has been completed, and long and short definitions have been agreed by the committee. Once the sign-off process has been completed, these will be adopted as the college’s standard definitions of nursing.

Professional framework: Three workstreams have been established to progress aspects of this work: Professional Practice; Levels of Practice; and Career Frameworks. A draft revision of the Principles of Nursing Practice – which are based on the definition of nursing, have been informed by expert feedback and have been mapped to the NMC Code. This has been presented to the committee, and the work is continuing. Work on Levels of Practice and Career Frameworks has commenced.

Forums and networks

KPIs

• Recommendations within the forums and networks review are implemented.

Progress

While some operational improvements have been made, other recommendations detailed in the report present challenges and will take longer to implement. We will work closely with the Director of Nursing who has identified this work as a priority for 2023. The Chair of the Forum Governance Group, and the Forum Chairs Committee will remain central to this workstream.

Policy

KPIs

• To promote RCN policy positions and see them adopted by stakeholders
• To develop evidence-based rationale to establish and / or support our influencing position
• To gain increased political support (contacts, mentions, attitude and disposition shift) within political parties across the UK

Progress

Using the approach agreed with PNC in 2022, a review and analysis of the UK Government legislative programme is underway. This will result in recommendations for our lobbying approach being presented to RCN committees and Council.

Mapping work on a nursing leadership (international to bedside) position and resource is ongoing, and is aligned to the corresponding Congress workstream.

Policy analysis and solutions for nursing workforce supply, recruitment and retention in England was completed and published October 2022.

An evidence-based policy analysis and proposed solutions for retention will be published and promoted in February 2023.