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

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

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

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care Single point of entry NHS as employer Advanced skills not defined Role dictated by title Hierarchically managed Outdated image Community-centred Multiple entry points Alternative employers/models Standardisation of advanced skills Needs of patients Self-directed,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

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.

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

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)

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: www.dh.gov.uk/en/managingyourorganisation/Humanresourcesandtraining/DH _097475 Practice placements, focus on Community Teaching Learning and Assessment Framework Assessment and support needs State of Readiness assurance tool

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

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

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

Preceptorship Framework Next steps: Invite feedback through online survey: http://survey.westmidlands.nhs.uk/index.php?sid=33282&newtest=y Survey closed 14th January 2010 Update following feedback and adapt to include AHPs, Midwives and SCPHNs Revised framework published Spring 2010

Nursing Career Framework

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

Our final visual design for the Nursing Careers Framework

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: Chris.caldwell@dh.gsi.gov.uk 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

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

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

“Our greatest responsibility is to be good ancestors” Jonas Salk American Microbiologist 1914-1995

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

QUESTIONS? We are happy to come and talk to individual health economies / organisations. Please contact: Pauline.watts@dh.gsi.gov.uk