National Care Forum response to the Nursing & Midwifery Council Strategy Consultation (October 2019)

The National Care Forum (NCF) is pleased to respond to the Nursing & Midwifery Council’s (NMC) consultation on the emerging themes for their 2020 – 2025 strategy. This written response builds on the consultation session that Emma Westcott, Assistant Director, Strategy, NMC conducted with the NCF Practice and Quality Forum on 2 October 2019.

NMC draft purpose, vision and strategy themes

Purpose: to shape the practice of nurses, midwives and nursing associates to deliver the care we all want – safe, effective and kind
Vision: a progressive professional regulator playing a leading role in driving better, safer care and a more just, learning culture for everyone

Strategy Themes

 Dynamic approach to how they shape practice
 Building their relationship with the public
 Strengthening the relationship with their professions
 Collaborating with others
 Using and sharing research, data and intelligence

NCF Response

We welcome both the development of MNC’s five-year strategy and the opportunity to contribute our views. We were very pleased to see and hear that the NMC clearly recognise the pressures across the social care system, especially the issues of workforce shortages (including EU and non-EU nationals, changing career pathways and patterns of working and equality, diversity and inclusion challenges) and increasingly complex care needs, as well as the potential benefits and opportunities of medical and technological advances. We also welcome the theme which focuses on a more sophisticated use of all the data available to the NMC as we agree that this will provide invaluable intelligence to help respond to existing challenges and support the future workforce development.

There are however, some key issues relating specifically to adult social care nursing that we would like to see strengthened and more visible in the strategy themes.

This consultation provides a key opportunity to ensure that nursing in adult social care features more prominently within the new NMC strategy and that our nurses are given sufficient focus, support and value by the regulator.

NCF asks: We would like the NMC to strengthen their strategy themes to reflect and support the following key points

 Explicit value and recognition of social care nurses and the immense contribution they make
 Building that respect for and valuing of social care at the beginning of the nursing career with training and placements in social care and better return to practice support
 Future direction of nurses in social care – routine rotational placements between acute and social care settings
 Digital confidence for our future nursing workforce
 Strengthening our social care nurses’ CPD and research evidence based practice
 Nursing associates – better clarity on the role, how it is supported, how it’s funded, how it fits into the future picture
 Images and implied messaging for the strategy

NCF asks in more detail

1. Explicit value and recognition of social care nurses and the immense contribution they make
Given that 12 in every 100 NMC registrants are nurses working in social care, we believe that they merit specific focus within the new strategy. Our nurses continue to experience a lack of parity of esteem with nurses working in the NHS – this is damaging for a whole range of reasons and it needs to be addressed. The NMC’s strategy is an ideal opportunity to explicitly challenge this lack of parity of esteem and to take active measures to prevent it.

Nursing in social care presents many different challenges and opportunities, requires huge levels of responsibility and expertise and it makes an immense contribution to the quality of many vulnerable people’s lives. Nurses working in social care have a huge responsibility often working alone, making key decisions and managing situations that arise at any time. This part of the profession should be able to expect that the NMC is more explicit within the new strategy about the value and recognition the NMC can offer and the support available.

1. Building respect for and valuing of social care at the beginning of the nursing career with student placements in social care and better return to practice support
Linked to point 1, the new strategy should specifically articulate how it will work over the next five years to ensure that training and placements in social care become absolutely integral to the training of all new nurses and nursing associates. In our view, student placements are paramount to developing social care nurses and reducing poor perception of social care nursing. All trainee nurses and nursing associates should have the opportunity to spend some time learning about and experiencing time in social care settings – this should be in the curriculum as the ‘norm’.
Many of our members provide student placements routinely in their services and one member told us in the Practice & Quality Forum consultation discussion that they have recently had a student nurse who had her first placement with them apply for and come to work for them as her first job after qualifying. We are happy to work with the NMC, Health Education England and the wider care sector to support this.
We would also like to see greater support for nurses to return to practice and more flexible ways for the NMC to support nurses to return to practice.

2. Future direction of nurses in social care – routine rotational placements between acute and social care settings and better return to practice support

Our members report that they are looking after people with increasing complex conditions, acuity is increasing and therefore nurses skills and competencies are increasing to adapt to changing needs. This has resulted in them considering their nursing career progression and pathways looking at roles to support team development, skills development and exploring the increased range of functions that nurses in social care will perform (such as verifying deaths, cannulation, care of residents with indwelling tracheostomy tubes) as health and social care integrate more effectively in a professional partnership of a journey of care. For example, one of our members, Belong Villages, are implementing a new Village Nurse Manager role who will oversee professional team and skills development to respond to the increasingly complex social care nursing landscape of increasing and changing complex needs.

Health and social care nursing should be developing as one system, and we would like to see routine rotational placements between acute and social care settings, to start to break down the barriers of acute vs social care nursing and develop a cohesive workforce who are working to improve the health and wellbeing of the person we support and provide care to.

3. Digital confidence for our future nursing workforce

The strategy themes make reference to better use of NMC data and intelligence which would be welcome. They also reference they need to respond to new technologies. It would be helpful to see a greater focus on the importance of supporting the nursing workforce in developing digital confidence to make best use of new and emerging technologies.

Within the NCF, we have an increasing focus on supporting and promoting digitally enabled care and working across the care sector and the software supplier sector to enhance the effectiveness and availability of digital technology in care. Over the next five years, this will be increasingly important, with all sorts of emerging technology to support
the delivery of care – we feel that the NMC can have a key role in supporting the nursing workforce to build and use its digital confidence and that this should be more clearly articulated in the strategy.

4. Strengthening our social care nurses’ CPD and research evidence based practice
We would welcome some reference in new the strategy to CPD provision for social care nurses, which needs to be equitable to any other nurse. All nurses need ongoing development and social care nurses should not be disadvantaged because they choose to work in social care settings. And, aligned to this, it would also be useful to see more support for social care nurses to access research to gain information to develop evidence based practice – for example, access to Athens accounts are unavailable for social care nurses but available to NHS nurses as standard and we would like our nurses to be able to access them too.

5. Nursing associates – better clarity on the role, how it is supported, how it’s funded, how it fits into the future picture
A number of our NCF members have created nursing associate roles and supported staff through the nursing associate training. It would be helpful for the strategy to provide more clarity on the future vision for this role, how it will be developed and supported and how it can be funded and how it fits into the future health and care landscape.

6. Images and implied messaging for the strategy
This is a small but really important point. The visual on the front slide page of the strategy consultation show a midwife and clinical nurses in uniforms in an obvious acute setting. In order to support our points about valuing and recognising social care nursing, please can you include nurses in care settings and particularly those nurses who don’t wear uniforms such as in care settings, mental health settings and Admiral Nurses. This is a simple way to change the imaging and implied messaging that we all present about nursing and will help change the perceptions and preconceived ideas of nurses in social care.

Liz Jones, Policy Director, The National Care Forum 
October 2019