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NMC community nursing plans risk patient safety, warns QNI

NMC community nursing plans risk patient safety, warns QNI

The NMC’s community nursing plans put patients at risk because they will lead to ‘unwarranted variation in course quality and content’ for specialist roles, the QNI has said today.

This warning is the latest in the QNI’s campaign against the planned introduction of a single set of standards for specialist practitioner qualification (SPQ) programmes. The renewed debate comes as the NMC prepares to close the public consultation on the proposals on 2 August.

In its response to the consultation, the community nursing charity argued the generic standards will also lead to ‘increased risks of suboptimal or poor care’. They pose ‘genuine and serious risks’ to staff retention at a time of serious staff shortages, ‘none more serious than in the community’, it added.  

Currently, the NMC has separate SPQ standards for district nursing, general practice nursing, community learning disabilities nursing, community children’s nursing and community mental health nursing. But the draft proposals would introduce one set of standards for all community programmes.

But the QNI said these ‘catch all’ community standards risk ‘eroding and undermining the qualities that make each community nursing field of practice unique’. It worried the NMC was incorrectly assuming ‘all five existing SPQ fields of practice are all very similar’ and do not go beyond ‘the competencies for initial registration as a nurse’.

The charity concluded the absence of field-specific standards of proficiency would lead to ‘greater variation in education, with resulting variation in practice’. Community specialist practitioners ‘will not be adequately prepared as leaders of high-risk, field-specific nurse-led services’ as a result, it added.

It also branded last year’s pre-consultation engagement process ‘incomplete’ because it did not include ‘open discussion and thorough exploration with key stakeholders’. This meant SPQ annotations on the NMC register will be ‘meaningless’, it said.    

In addition, the QNI repeated its ‘serious reservations’ about the ‘decision to proceed to public consultation while the Covid-19 pandemic continues to have such a serious impact on the capacity of community nursing teams and the nursing profession generally’.

The NMC initially said the generic set of community standards would include ‘bespoke elements where needed’ – but concluded none were needed during the pre-consultation process. It will continue to ‘test this view’, it said in consultation documents.

In March this year, the QNI joined nine other organisations and groups, including the RCN, in raising concerns that the NMC has not identified any bespoke – or specialist – standards for each of the five community nursing fields.

Also in March, QNI chief executive Dr Crystal Oldman suggested to Nursing in Practice that the NMC may have made decisions on post-registrations standards proposals prior to the pre-consultation engagement process, meaning it did not properly take into account expert feedback.

Last month, community children’s nurses raised fears that the plans could put patients’ lives at risk and lead to slipping standards in the profession.

The NMC started the process of evaluating the community post-registration standards in 2018, when it commissioned an independent evaluation to help inform its approach. It set up a steering group to in Autumn 2019 and undertook pre-consultation engagement in the summer and autumn of 2020.

As part of the same review, it has proposed introducing bespoke standards of proficiency for each field of practice covered by the Specialist Community Public Health Nursing standards (SCPHN), including school nursing and health visiting. These plans have been widely welcomed.

 Nursing in Practice has approached the NMC for comment.

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