There is currently a ‘once-in-a-decade’ – possibly a ‘once-in-a-generation’ – opportunity for the advanced practice of general practice nurses to be systematically regulated by our professional regulatory body – the Nursing and Midwifery Council (NMC).
While the NMC are not (yet) mandated to regulate advanced nurse practitioners, the draft standards for the recordable Specialist Practitioner Qualification (SPQ) reflect elements of advanced practice in primary care – for example, by the inclusion of standards of proficiency which include advanced clinical assessments and independent prescribing.
Importantly, following the intervention of the Chief Nursing Officers (CNOs) of the four countries of the UK in November 2020, the NMC re-introduced the SPQ annotations which include ‘General Practice Nursing’ as a field of practice. This provides an excellent opportunity for general practice nurses working at an advanced level of practice to be recognised alongside their colleagues leading and managing clinical care in District Nursing and Community Children's Nursing, for example.
Arguably, there could not be a more important moment in the 21st century for general practice nurses to secure their education and training at this level and to have the qualification recorded against their name on the NMC register. Should the NMC later regulate advanced practice – hopefully utilising the four pillars of advanced practice – those who have undertaken the new GPNSPQ programme will seamlessly have their SPQ qualification mapped and their named entered on this new part of the NMC register.
The QNI, along with nine other expert nursing organisations, has expressed deep disappointment that, despite annotations being introduced to the draft programme standards and the draft standards of proficiency for SPQ, after the conclusion of the engagement phase and at the request of the CNOs, no time was then taken to consider specific standards to distinguish between one field of practice and another. So, the standards for the annotated field of Community Children's Nursing are identical to those for General Practice Nursing.
The stated expectation of the NMC is that the universities delivering the SPQ programmes will be able to create ‘routes’ through programmes which meet the standards of proficiency as they apply to each of the fields of practice – and which satisfy the NMC Visitor who will be approving each SPQ programme. The question then is – against what standards will the NMC Visitor judge the programmes to be appropriate to the five fields of practice, should all five be presented for NMC approval?
Without specific standards for each of the fields of practice there will be unwarranted variation in the outcomes of programmes across the UK and the potential for patient safety to be compromised. What you ‘know and are able to do’ by the conclusion of the GPNSPQ programme will logically be dependent on the views of each individual university and local employers.
The Queen's Nursing Institute (QNI) has seen this unwarranted variation in the programmes that support nurses new to General Practice Nursing – often called GPN Foundation programmes, which vary hugely in length, content and learning outcomes. Now, there are QNI standards on which programmes are based which aim to reduce variation and support patient safety (QNI, 2020).
So, I encourage you to please read the NMC draft standards and complete the consultation questionnaire. All the information you need to know about the QNI position is here, and we have drafted templated letters to support your feedback to the NMC (QNI, 2021).
The QNI is not being protectionist – we are deeply concerned about patient safety and the need for consistency in the NMC standards of education for general practice nursing. To have anything other than specific standards of proficiency for GPNSPQ will take general practice nurse education back a decade, not forwards, where it should be – at the cutting edge of independent, innovative nurse-led services in the community.