Blog: #FutureCommunityNurse: making the most of this opportunity

When I was first briefed about our post registration standards for community and public health nursing, I was aghast to see how old they were. It’s been more than 15 years since standards for specialist community public health nurses (SCPHN) and specialist practice qualifications (SPQs) were updated. So much has changed since then and the role of nurses in the community has become ever more important – not least in the last 18 months through our experience of the pandemic.

That’s why the development of the new standards is vital and your involvement as a registered professional, partner or member of the public is critical to make sure we make the most of this opportunity. 

Thank you

I’m so grateful to everyone who has contributed already – whether that’s as members of the steering group guiding our work, participating in the working groups developing the proposals, joining in the pre-consultation engagement to refine those proposals, or by responding to the consultation. I’m especially grateful to all the practising community and public health nurses who have given up their time during the challenges of the last 18 months.

All of this wonderful enthusiasm made me wonder why it’s taken us so long, but I think I’ve worked out why. The enthusiasm has generated much debate and controversy, because what we’re doing isn’t easy and there are lots of different views on what we should do and how.

Setting regulatory standards

The reason the NMC sets standards is to fulfil our regulatory role to protect the public and promote confidence in the professions. 

These are post-registration standards, designed to complement the assurance that the Future Nurse and Future Midwife standards for pre-registration education already bring. They build on those ambitious standards that set out what we expect a nurse or a midwife to be able to do when they first join the register. For that reason, the standards shouldn’t repeat what we already expect our registered professionals to do.

As regulatory standards, they form an ambitious, high level framework against which universities will design their curricula. That’s why they don’t go into the detail of the curriculum that education institutions will provide to ensure post-registration professionals are confident and capable of working in their chosen area. 

For SPQs we’ve set one set of standards for the six annotations proposed and in the consultation we ask questions about field-specific standards that would work in this regulatory context. Please tell us if you think we’ve missed out anything specific.

Nursing in the community

There are worries about the future of community nursing with concerns that these important and varied roles are not sufficiently valued and we need a lot more of them. We couldn’t agree more!

Take a look at our latest data report and you’ll see some alarming reductions in the numbers with these qualifications on our register – SCPHN health visitor numbers fell by three percent from March 2017 to March 2021, SPQ district nurses dropped by 4.9 percent, and SPQ community mental health nursing by 16.4 percent – at a time when the need for community nursing has been rising. 

The question for us as the professional regulator is what’s our role in arresting this decline? We don’t commission or fund courses at universities – that role sits with bodies like Health Education England or Health Education and Improvement Wales. We don’t have the power to make post registration qualifications mandatory for different roles, that’s a role for government and employers (and all due credit to Chief Nursing Officer Charlotte McArdle for making the District Nurse SPQ mandatory for district nurses in Northern Ireland). Nor do we decide what is or isn’t a protected title, though we’ve raised with the government the need for that conversation to take place.

What we can do is use our voice to advocate for professionals in the community and people needing those services to ensure some of these wider issues are tackled.

Opportunities

What we can also do is make the most of this opportunity to make a difference in our regulatory standard-setting role.

This is an opportunity for people who’ve never been eligible for an NMC-recognised qualification to gain a specialist practice qualification. If you work in social care, in hospital at home services, in hospices, with homeless people or in prisons, that’s you.

It’s an opportunity for more professionals to develop a greater depth of knowledge and broader skills that really reflect the complexity, responsibility and diversity of modern practice. I truly hope the flexibility of these new standards will encourage commissioners and universities to fund and run more courses. It’s not surprising that numbers are reducing when so few courses are available (for example just one course across the whole of the UK for community learning disability nursing and community mental health nursing).

But most importantly of all, these standards present an opportunity for our loved ones by helping them get safe, kind, effective care, close to home from reliable, qualified professionals.

Your voice

I know people can be sceptical about consultation: “why should I bother when you’ve already made your mind up?” But I can give you an absolute assurance that’s not the case. We’ve already made changes from one proposed SPQ annotation to six as a result of last year’s engagement. We know from the development of the Future Nurse and Future Midwife standards that the final versions were so much better because of the changes we made following consultation. 

We’re already gearing up for the work we’ll need to do. When the consultation is over, an independent agency will provide an analysis of the results. We will convene groups of expert practitioners to carefully consider every single response to every single question in the consultation. Our Council will make the final decision on the next steps.

We’re into the final weeks of our extended consultation which finishes on 2 August.

I know how busy everyone is, but please visit our consultation website pages to find out more, let us know your views and help us get this right.

A massive thank you in advance.

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