Joint statement on expanding the nursing and midwifery workforce in the Covid-19 pandemic

You may already have seen our previous joint statements and further update in relation to expanding the nursing and midwifery workforce to respond to the Covid-19 pandemic. These statements describe:

• How we would facilitate nurses and midwives who left the register within the last three years to join the Covid-19 temporary register.
• How we would maximise the contribution of student nurses and midwives who are in the last six months of their pre-registration education.
• Options for the contribution and continuing education of midwifery and nursing students in all fields during the emergency, who are not in the final six months of their programme.

The Nursing and Midwifery Council (NMC) has been given permission from the UK Government to establish the Covid-19 temporary register. The temporary register became live on 27 March and currently includes nurses and midwives who left the register in the last three years. We are humbled and exceptionally grateful to these people who have volunteered to return to health and social care during this time.

As set out in our previous statement, student nurses in their final six months of training could potentially be invited to join the temporary register. A decision on whether to open the register to them will be taken by the NMC in the coming weeks. Before then, students have the option of undertaking their final six months in clinical placement as a means of allowing them to continue their educational programme while also contributing to clinical services during the pandemic.

What we are doing now

As the pandemic continues and intensifies, it is clear that we will need more people to support the health and social care workforce who are working under unprecedented pressure. We have therefore identified two additional groups of people who the NMC will invite to join the Covid-19 temporary register. These people will not all be invited immediately but sequentially as set out below. This is to ensure we build up the temporary register in a safe and measured way.

The four groups of Covid-19 temporary registrants will now be as follows:

1. Nurses and midwives who left the register within the last three years (already invited to join the temporary register).
2. Overseas applicants, including both nurses and midwives, who have completed all parts of their NMC registration process except the final clinical examination (OSCE).
3. Nurses and midwives who have left the register within the last four and five years. This may include those who have left the register up to five years ago who have started but not completed Return to Practice programmes.
4. Nursing students on NMC approved pre-registration programmes who are expected to qualify inthe next 6 months. (This group was identified in the first statement but the decision to open up the register to them has not yet been agreed by the signatories of this statement.)

So we can deliver these outcomes as quickly as possible, each of us has agreed to the actions below:

The Nursing and Midwifery Council agrees to:

• Write to those overseas qualified nurses and midwives who are currently waiting to take their OSCE examination, and those nurses and midwives who left the register within the last four or five years letting them know how they can join the Covid-19 temporary register.
• Create appropriate conditions of practice to ensure appropriate safeguards are in place for the different groups invited to join the temporary register. (See annexe one for details.) 
• Establish a fair and transparent policy and process for the removal of registrants from the temporary register in response to concerns in line with their emergency powers.
• Share information on numbers of additions to and removals from the temporary register with signatories to this document.
• Support temporary registrants to join the permanent register once the temporary register is dissolved by ensuring that they understand the process, and work with employers to support overseas applicants from the temporary register continue with their registration application

The Chief Nursing Officers for England, Scotland, Northern Ireland and Wales agree to:

• Develop and maintain appropriate deployment guidance for employers, professionals and nursing and midwifery students that are bespoke for each of the four countries of the UK, working with stakeholders, including the terms and conditions and remuneration for those on the Covid-19 temporary register. This deployment guidance will make particular reference to and assurances for overseas applicants recognising that many of them will already be employed in an alternative role in a health or social care setting.
• Ensure that all nurses and midwives on the temporary register and nursing and midwifery student in clinical practice are given access to personal protective equipment and other resources to ensure their personal safety, the levels of which to be consistent with that being provided to those on the full NMC register and with national guidance.
• Maintain a point of contact (telephone helpline, website) for all health and social care employers in all four nations across the UK that can provide appropriate information.

Council of Deans of Health agrees to:

• Work with Approved Education Institutions (AEIs) to let those people already on Return to Practic programmes who left the register within the last four or five years know how they can join the temporary register. They will also outline how those people could then join the full register when the temporary register is closed.
• Continue to work with AEIs to help nursing and midwifery students consider their options with appropriate information, advice and support.
• Royal Colleges and Trade Unions representing nurses, midwives and students agrees to:
• Provide expertise with and on behalf of their memberships to inform the development and implementation of guidance, ensuring individual choice is paramount within the context of emergency measures.
• Provide representation of members as well as provide expert advice on maintaining Health & Safety and wellbeing of staff.
• Provide feedback and representation on behalf of those joining the temporary register.
• Negotiate employment terms and conditions within emergency measures.

UK Government is:

• Working with other stakeholders, government bodies and devolved administrations to clarify policies concerning pay, pensions, indemnity, student loans and ongoing training for nursing and midwifery students.
• Ensuring that no nurse or midwife who is subject to immigration control will have a negative outcome through the immigration system due to joining the Covid-19 temporary register.

In conclusion
We would like to take this opportunity to reiterate our thanks to all of you for your continuing dedication and commitment during this time which is difficult and worrying for us all.

In a rapidly changing situation, we do not yet have all the answers but please be assured we are committed to continuing our work together and sharing further updates with you as soon as we are able to.

Ruth May, Chief Nursing Officer, England
Professor Fiona McQueen, Chief Nursing Officer, Scotland
Professor Charlotte McArdle, Chief Nursing Officer, Northern Ireland
Professor Jean White CBE, Chief Nursing Officer, Wales
Professor Jacqueline Dunkley-Bent OBE, Chief Midwifery Officer, England
Dr Dale Spence, Midwifery Officer, Northern Ireland
Professor Ann Holmes, Chief Midwifery Officer and Associate Chief Nursing Officer, Scotland
Karen Jewell, Midwifery Officer for Maternity and Early Years, Wales
Professor Brian Webster-Henderson, Chair, Council of Deans of Health
Andrea Sutcliffe CBE, Chief Executive and Registrar, NMC
Gill Walton, CEO, RCM
Dame Donna Kinnair, CEO, RCN
Colenzo Jarrett-Thorpe, National Officer, Health, Unite
Sara Gorton, Head of Health, UNISON

Download signed joint statement on expanding the nursing and midwifery workforce in the Covid-19 pandemic

Annexe one: conditions of practice for the temporary register

For overseas applicants and those who left the register four or five years ago

• You must work as registered nurse or midwife in an employed capacity for a health or social care employer.
• You should always work under the direction of an NMC registered nurse, midwife or other registered healthcare professional who is not on a temporary register.

For students

• You must ensure that you are supervised any time you are working. Your supervision must consist of:
• Working at all times with, but not always directly observed by, a NMC registered nurse, midwife or other registered healthcare professional, who is not on a temporary register.
• You must not carry out any activity in which you have not been assessed as competent and appropriately signed off during your training unless you are supervised by an NMC registered nurses, midwives and other registered healthcare professionals who are not on a temporary register (unless a lifesaving intervention is required to avoid sudden and unexpected death).

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