Nursing Council

1. Nursing Council 

2. Introduction The HPCA Act 2003 significantly changes the Council’s role in regulation to one of ensuring quality (competence) in practitioners. Ensuring ongoing competence Expanding application of quality assurance provisions to all health practitioners Development of professional standards

3. Purpose of the Act The purpose of the Bill is to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions. Nursing Council is the responsible authority for the practice of nursing (Schedule 2) Definition of “nursing” is important.Definition of “nursing” is important.

4. Functions (s.118) Prescribe the qualifications required for scopes of practice and accredit and monitor educational institutions and programmes. Authorise registration of (nurses) and maintain registers Consider applications for annual practising certificates Review and promote the competence of health practitioners

5. Functions (cont….) Accredit and set programmes to ensure ongoing competence Receive and act on information from health practitioners, employers and the Health and Disability Commissioner about competence of health practitioners. Notify employers, ACC, Ministry of Health and Health and Disability Commissioner that practice may pose risk of harm to the public

6. Functions (cont….) Note the standard setting role is new.Note the standard setting role is new.

7. Functions (cont….) e.g. Medicines Acte.g. Medicines Act

8. Key Changes Consistent regulatory framework for all health practitioners Separate Midwifery Council Scopes of Practice Competency provisions Quality Assurance provisions Multidisciplinary Disciplinary Tribunal

9. Composition of Councils 120 Current 3 nurses 2 midwives 2 educators 4 others (of which 1 may be a nurse and 1 may be a midwife HPCA Act 5 - 14 members, majority of whom are health practitioners 2 laypersons (if 8 or fewer members) 3 laypersons (if 9 or more members) Do not need to be nurses.Do not need to be nurses.

10. Separate Midwifery Council The HPCA Act establishes a separate Midwifery Council to regulate midwives. Comes into force 18 December 2003, establishes scopes of practice, and qualifications necessary, and for that purpose to accredit and monitor educational institutions and degrees, courses of studies, or programmes (118), Takes up the all other regulatory functions on 18 September 2004 Mention dates and discuss dual registration. Numbers: 4653 midwives on the register of whom 551 are midwives only. Mention dates and discuss dual registration. Numbers: 4653 midwives on the register of whom 551 are midwives only.

11. Title protection (S 7) May only use names, words, titles, initials, abbreviations or descriptions implying a health practitioner of a particular kind if a person is registered and is qualified to be registered as a health practitioner of that kind. Compare with s 52Compare with s 52

12. Scopes of Practices 11 Council must describe the contents of the profession in terms of one or more scopes. Scope may be defined however the body sees fit. By reference to: the name or form of words that is commonly understood by persons who work in the health sector an area of science or learning tasks commonly performed illnesses or conditions to be managed, diagnosed or treated. Present scopes document and discuss.Present scopes document and discuss.

13. Scopes of Practices12 Council must describe qualification(s) for every scope of practice, including degree or diploma, successful completion of programme, pass in examination, registration with overseas equivalent authority, and/or experience. Must monitor every NZ institution and may monitor overseas institution which provide degree or diploma designated for scope of practice. Note: may set exam itself or approve other orgs to set exams.Note: may set exam itself or approve other orgs to set exams.

14. Scopes of Practice - conditionss 22 (3) Conditions must be of a kind that Council considers are required to ensure the competent practice of the applicant and may include: practice under supervision or oversight, restrictions on tasks performed, practice only under certain conditions, specified period,attain further qualifications and/or any other conditions Council believes on reasonable grounds necessary for protection of public safety. Discuss how Council intends to use conditionsDiscuss how Council intends to use conditions

15. Scopes of Practice Council may decline an APC if the applicant has failed to comply with a condition included on a scope of practice Nurse can be prosecuted before the Disciplinary Tribunal if they practice outside the scope or breaches conditions.

16. Competence based APCs S 26 and 27(1)(a) Registrar may decline to issue an APC if there are any costs or expenses under disciplinary order which remain unpaid. Council may decline to issue APC if the applicant has, at any time, failed to maintain the required standard of competence, failed to comply with condition, not completed ordered competence programme, not held APC (or practised) for 3 years preceding application

17. Application to Practice form Recency of Practice requirements Professional Development activities Personal Professional Profile Return to Practice programme if out of practice for five (three) years Submitting for sample audit on request (5%) Note. Framework will be out for review very shortly and Council is seeking feedback on every aspect of it.Note. Framework will be out for review very shortly and Council is seeking feedback on every aspect of it.

18. Requirementsfor Ongoing Practice - Nurses Discuss. Discuss.

20. Notifications of Competence Concerns - s34 If health practitioner believes that another health practitioner may pose a risk of harm to the public by practising below the required level of competence, they may notify the Council. Health and Disability Commissioner must notify Council. Employer must notify Council following resignation or dismissal for reasons relating to competence. Note consumers cannot notify competence concernsNote consumers cannot notify competence concerns

21. Competence Reviews After notification the Council must make further enquiries or may review competence. Council may review the competence of nurse at any time. If Council has reasonable grounds for believing that a nurse poses a risk of serious harm to the public by practising below the standard of competence they can suspend, include conditions or change scope. (s39)

22. Competence provisions If fails to meet required standard Council may order Nurse undertake a competence programme Include conditions on scope of practice Nurse to sit examination or competence assessment Nurse to be counselled or assisted

23. Protection of information Section 44 offers protection from disclosure of information from clinical records gained for competence review, programme or recertification. It cannot be disclosed except for report to Council, criminal proceedings or to the person themselves.

24. Health and disability provisionsS 45 Person in charge of organisation, health practitioner, employer or medical officer of health must notify if believe that nurse unable to perform functions because of mental or physical condition Other person may notify Head of education institution must notify if think student will be unable to perform functions because of mental or physical condition. What would we do with such information?What would we do with such information?

25. Interim suspension S 48 Council may suspend APC or change scope of practice or place conditions on practice if it considers nurse may be unable to perform the functions required for practice because of mental and physical condition. Up to 20 working days or extended for further period of 20 working days.

26. Quality Assurance s 53 Act extends quality assurance provisions hitherto only available to medical practitioners, to all health practitioners registered under the Act A quality assurance activity is one that is undertaken to improve the practice or competence of 1 or more health practitioners by assessing health services performed by them and includes whole or part of any assessment or evaluation or study of the incidence or circumstances that may affect the quality of the health services delivered

27. Quality Assurance provisions A sponsor of a quality assurance activity may apply to the Minister who may declare the activity to be protected. This section protects the confidentiality of information that becomes known purely as a result of QA activities and documents which are generated solely for the purposes of the activity, and provides immunity from civil liability to persons engaging in QA. (S 59) Exceptions S 60

28. Disciplinary TribunalS 84 - 99 HPCA Act sets up a multidisciplinary disciplinary tribunal to consider cases of professional misconduct. Members: Chair: experienced barrister and members, 1 layperson and 3 members of the relevant profession. No Council member can be on Tribunal. Tribunal may order interim suspension or conditions on practice if necessary to protect public.

29. Grounds on which nurse may be disciplined S 100 Professional misconduct (malpractice, negligence or bringing discredit) Court conviction which reflects on practice (listed) Practising without an APC Practising outside of scope of practice Failing to observe conditions on practice Breaching order of Tribunal

30. Transitional provisions Comes into force 18 September 2004. Every APC in force rolls over until due under previous conditions. Every application for registration which is pending before 18 September shall continue to be determined under the Nurses Act provisions and, if midwife, then Midwifery Council advised. (S.214)