Tag: Health Education England

Specialist practice in the community

For many years I led a Nursing and Midwifery Council (NMC)-approved post-qualification degree course for mental health nurses working in, or wanting to work in, the community. I wrote about the curriculum we developed in Cardiff, and was involved in two surveys of course leaders of programmes of this type which went on to be published here and here. Our Cardiff course, like others of its type, was recognised by the NMC (and by the NMC’s predecessor, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting) as preparing qualified nurses for ‘specialist practice’. Linked to a set of UK-wide standards, specialist practice was designated as practice beyond that expected at initial registration.

Most programmes of this type have long since disappeared, ours in Cardiff included, but the regulatory standards against which they were validated remain. The specialist practice qualification (SPQ) was first introduced in the 1990s, with the standards for SPQ in community nursing (including community mental health nursing) not being updated since the early 2000s. In 2019 the NMC commissioned an independent review into SPQ, with the final report from this exercise making clear how poorly understood these long-outdated standards had become and how much a root-and-branch review was needed.

A debate can be had on the extent to which standards for practice beyond those linked to professional registration should be prescribed by a regulatory body such as the NMC. For the professions of nursing and midwifery, however, no UK-wide bodies able to definitively set standards of this type exist other than the NMC; this is partly because we have no equivalents to the royal colleges, which exist to set and maintain standards for doctors preparing for post-registration practice in the various fields of medicine.

The NMC’s ongoing programme of work developing its standards has so far included the publication of an education framework, the Future Nurse standards of proficiency for registered nurses and new standards for student supervision and assessment. Now, following receipt of its independent evaluation of SPQ the NMC is embarking on a post-registration review. In August, through my membership of the All Wales Senior Nurse Advisory Group for Mental Health I took part in an NMC webinar and discussion on specialist practice in the community, convened as part of this wider post-registration programme of work. With work already happening in parts of the UK to more closely specify ‘advanced’ practice, such as through Health Education England’s Advanced Practice Mental Health Curriculum and Capabilities Framework, the NMC is stepping into an already-crowded space. It is in this context that consistency and joined-up policy and standards will surely be needed: which is something members of Mental Health Nurse Academics UK (me included) will continue to say as this programme of activity continues to progress.

Joining mental health nursing

Mental health nursing is important and fulfilling work, and offers a fine and rewarding career. More people also need to be doing it. By way of background, last month Mental Health Nurse Academics UK (MHNAUK) submitted a response to Health Education England (HEE)’s Facing the Facts, Shaping the Future draft health and care workforce strategy for England to 2027. Contained in this HEE draft are figures on trends in the numbers of nurses, by field of practice, employed in NHS England over the period 2012 to 2017.

Growth/reduction in NHS employed nurses and midwives by field, 2012 to 2017 (extracted from Facing the Facts, Shaping the Future)

Obvious at a glance from this figure is the decline in both mental health and learning disability nursing numbers over time. Elsewhere HEE also describes a 14% mental health nursing vacancy rate.

Now, the Nursing Times reports a reduction for the second year in a row (£) in the numbers of applications for nursing degrees received via the Universities and Colleges Admissions Service (UCAS). Declining applications need to be viewed in the context of the removal of bursaries for students of nursing enrolling at English universities. In MHNAUK we have said, more than once, that we fear the loss of bursary support poses a particular threat to our field of practice. The same applies to learning disability nursing, where at least one degree programme closed last year (£).

Evidence like this is why initiatives like #MHnursingFuture (see also here, for the Twitter account) are important. Initiated by Dave Munday from Unite the Union, this is all about celebrating the work of mental health nurses and encouraging others to join us. As an occupational group we haven’t always been good at describing what we do, and why what we do is valuable (£). This needs to change, now more than ever.

With all this in mind this may be a good time to remind people of this useful page, hosted on the MHNAUK website, on joining the profession. As this says:

Forget all the stereotypes about straitjackets and Victorian asylums; modern mental health nursing focuses on helping and supporting people from all walks of life with a variety of ‘common’ mental health disorders (such as anxiety and depression) as well as more serious disorders such as drug and alcohol problems, suicidal feelings, psychosis, bipolar disorder and dementia. They also play a key role in promoting mental health and well-being among the public and preventing mental health problems occurring in the first place.

This helpful MHNAUK resource also includes suggestions for further reading, included in which are texts describing in detail many of the skills that mental health nurses routinely use and the context in which they go about their work. And, for any reader contemplating applying to any of the 60+ mental health nursing degree courses offered throughout the UK, do give some thought to our undergraduate nursing programmes here in the School of Healthcare Sciences at Cardiff University.