1. Modernising Nursing Careers Delivering the Vision
Pauline Watts – Project Director (DH)

2. Global challenges for healthcare and society
Ever
higher expectations
Changing NHS and Social Care workplaces
Demand driven by ageing
Health in an information age
Advances
in treatments
Changing nature of disease

3. Workforce – to enable local vision
NHS Constitution
NHS Next Stage
Review
A High Quality
Workforce
The Workforce proposals address these dilemmas through a shared vision (high quality care for all) and national enablers for improvement, underpinned by a rigorous approach to leadership and NHS-wide values – but with a clear recognition that these have to be owned and delivered locally.
David Nicholson, our Chief Executive, calls this ‘freedom within a framework’.
To meet that commitment, we need to care for and maximise the talent of those that are making a difference every day in the NHS - our staff.
Of course, the NHS has always recognised the critical role of its workforce – but the promises made to them through the NSR mean our commitment to them is more significant and tangible than ever before.
The NSR has given us the opportunity to look at workforce issues systematically. As a result, the proposals in High Quality Care for All, A High Quality Workforce and the NHS Constitution represent a coherent, system-wide approach for empowering and strengthening the workforce.
As Will Hutton commented in his recent article in the HSJ, the ambitions for the workforce within the NSR can hardly be faulted. These are significant commitments, which many organisations would be wary about making, not least because they won’t be easy to deliver.
But what is important is that we have identified a clear approach for improvement and will strive to deliver it.
‘… Change – locally-led, patient-centred and clinically driven….’
“…ambitions for the workforce can hardly be faulted…” Will Hutton CEO, The Work Foundation

4. We are on a journey Coming from… Going to…
Modern careers
We are on a journey Coming from… Going to…
Hospital based care
Single point of entry
NHS as employer
Advanced skills not defined
Role dictated by title
Hierarchically managed
Outdated image
Community-centred
Multiple entry points
Alternative employers/models
Standardisation of advanced skills
Needs of patients
Self-directed, multi-professional
Opportunity and diversity

5. Nursing today…
Requires an intricate interplay between fundamental care and high-level technical competence, bio-medical knowledge and decision-making skills and the ability to develop therapeutic relationships based on compassion and holistic and intelligent care.

6. We have set the stage… October 08
Four Country Approach
Role, Image & Recruitment
Degree level registration
Preceptorship Career Pathways
Career Framework
Advanced Practice
Clinical Academic & Educator Careers
Skills Passport
Metrics
Midwifery Careers
Transforming Community Services
Action on Health Visiting
New Horizons
Modernising nursing careers (DH 2006) set out the challenges facing nursing and has prepared the ground work for this by initiating
the NMC review of pre-registration education whose findings have now been published
a consultation on proposals for post registration careers
Commissioning a report on the equalities dimension of careers
Work on advanced practice and leadership with the other countries across the UK
The way forward for England was confirmed in the Framing Document

7. Introduction of new Pre-registration Education Standards for Nursing
Changing health care
Need for Independent practitioners
Higher levels of decision making
Autonomous Practitioners
Leading and developing services from start of career
NMC review
NMC announced principle of new programmes (including degree level) in 2008
New pre-registration standards in Sept. 2010
Programmes from 2011 onwards
Emerging trends
Increasing numbers of pre-registration programmes are at degree level (25% commissions in England - ranges 10% - 40%)
At least 30% of existing registered nurses have a degree or above
Transition timetable
HEI’s to have new programmes implemented by 2013.
Scotland, Wales and NI have or are making the shift (but fewer HEIs/commissions)

8. Pre Registration - Progress and Issues
NMC have agreed the Principles of the new standards
Degree registration
3 years
2 progression points
Generic and field specific competencies
50% clinical practice
Changes to student support arrangements: consultation:
_097475
Practice placements, focus on Community
Teaching Learning and Assessment Framework
Assessment and support needs
State of Readiness assurance tool

9. Preceptorship Framework
‘A period of transition for newly registered nurses during which time they will be supported by a preceptor to develop their confidence as autonomous professionals, refine skills, values and behaviours and continue their journey of life-long learning’
Context:
Policy Drivers
Modernising nursing careers
Next stage review
Associated Policies
Confidence in caring
NHS constitution
Agenda for change
NMC - potential regulatory
requirement by April 2010

10. Preceptorship Framework
Purpose:
to act as guidance and a resource for the organisations who employ newly registered nurses, including non-NHS sector
by providing a structured approach that facilitates transition from student to fully autonomous professional,
equipping nurses with the skills & confidence
required at the beginning of their career
to facilitate equity of access to preceptorship
and standardised content of preceptorship,
value for money and benefits realisation
Nurses then powerfully placed to deliver high quality care, promote health and wellbeing in healthcare settings and patients’ homes
Aid recruitment and retention and contribute to reducing variability in practice and the improving the image of nursing

11. Preceptorship Framework
Framework document structure:
Background
Definitions - what preceptorship is and is not
The elements of preceptorship
Benefits
Sets out a preceptorship standard
Guidance on implementing preceptorship
Design, content & outputs
Benchmarking current practice
Ensuring equality
Outcome measures: realising the benefits
Sets out how we expect preceptorship to be delivered through pledges.
Copies can be found on the DH Website

12. Preceptorship Framework
Next steps:
Invite feedback through online survey:
Survey closed 14th January 2010
Update following feedback and adapt to include AHPs, Midwives and SCPHNs
Revised framework published Spring 2010

13. Nursing Career Framework

14. Mapping the Nursing Career Framework
Taking forward consultation recommendations on the post-registration framework
Modelled the framework across a number of pathways:
Health Visiting (Children & Families)
Ill & Disabled Child
Learning Disabilities
Cancer Nursing
Collaborative approach with SHAs, HEIs, providers, professional organisations/other key stakeholders
Incorporated concepts of: Practitioner Partner & Leader
Graphic map to support Career Framework model will be published in November
Integration into quality road map (to be published in November)
E-tool to be developed with good practice guide (Spring 2010)
Aligned with rest of the UK & NHS Career framework

15. Our final visual design for the Nursing Careers Framework

16. Next steps
We want to familiarise people with the image and test it’s appeal
PDFs of the posters are available on CNO website for downloading locally
Feedback and comments to be sent to:
We want to use it to update the image of nursing
we will work with NHS Employers, NHS Careers, Universities and others to build it into marketing and recruitment
We want teams, groups, organisations and communities to use it
We will develop it into an interactive tool which can be added to, individually populated and developed for workforce and service planning, curriculum development, career planning

17. Skills Passport
DH England working with Skills for Health (on behalf UK MNC Coalition) to develop the Skills Passport for nursing
The Skills Passport is to be piloted in Nursing first but could be rolled out for the whole Health sector – AHPs particularly interested
‘ Purple Passport’ developing the product
Time frame:
July to Aug. ’09 Co-produce skills passport
Oct to Dec ’09 Pilot & refine
Jan to March ’10 Final Training package & skills passport agreed, Evaluation, Learning event

18. Marketing Nursing as a Career: Enhancing the Image of Nursing
Role, Recruitment & Image…
Develop a role profile of an ‘ideal’ Registered Nurse
Values, skills, attributes, behaviours
Understand what will attract the right people with the right values into the profession
Understand what the patients want
Work in co-production with stakeholders, identifying recruitment / retention best practice e.g. CoDs, NHS Employers
Market Nursing from inside out…
Develop a Marketing campaign for Nursing to coincide with the Commission report
Aim:
Enhanced recruitment of undergraduate nurses
Reduced attrition rates
Increased conversion rates
Enhanced recruitment of qualified nurse to difficult areas e.g. LD, MH & HV
Improved retention rates
Enhanced image of Nursing

19. “Our greatest responsibility is to be good ancestors”
Jonas Salk
American Microbiologist

20. THIS IS AN OPPORTUNITY TO MAKE A REAL DIFFERENCE
CONCLUSION
Modernising Nursing Careers will enable nurses to:
Be increasingly independent & innovative, exercising higher levels of decision making
Assess and apply effective, evidence-based care safely
Lead and develop services, working across service boundaries
Deliver high quality healthcare within a complex health environment
Modernising Nursing Careers enables nurses to contribute towards the changing healthcare environment in a flexible & innovative way
Modernising Nursing Careers allows Nursing to be explicit about its
contribution to healthcare by:
Allowing practitioners and teams to measure the impact, outcomes and experience they have on patients
Allows change to happen locally for improved quality
Gives leaders at the top tables a voice to promote the value, scope and impact of the care of nurses and midwives from the Point of Care to the Board
THIS IS AN OPPORTUNITY TO MAKE A REAL DIFFERENCE

21. QUESTIONS?
We are happy to come and talk to individual health economies / organisations. Please contact: