The Development of the Post-Registration Career Framework for Nurses in Wales: Implications for the Advanced Practitione

1. The Development of the Post Registration Career Framework for Nurses in Wales: Implications for the Advanced Practitioner Dr JEAN WHITE Welsh Assembly Government

2. This session will provide…. • Overview of the policy drivers/unique features • Key aspects of the proposed career framework • Issues for advanced practitioners

3. Devolution • Health is a devolved matter; professional regulation is not. • Devolution has led to significant differences in health and social services policies between Home Countries • Key challenge is how to ensure you have a flexible competent nursing workforce, fit for the needs of the service, whose members have recognisable skills and competencies which enable them to easily move around the UK [and beyond].

4. Nursing in Wales • 35,518 registered nurses employed by NHS Wales • 1,356 practice nurses employed by GPs • All Wales Fitness for Practice Initiative to support 2002 curriculum change. Key elements shared across Wales • All degree level initial preparation nurses 2004 & midwives 2003 • Since 2000 - standards for nurse, midwife, AHP and paramedic consultant posts – masters mandatory • Free to Lead: Free to Care initiative (empowering ward sisters/charge nurses)

6. The ambition “Nurses are vital to achieving the health care reform programme. We need to make sure that nurses have a career structure which enables them to work in different care settings, to take on changed roles and responsibilities, develop a varied mix of skills, to pursue education and training when they need it, and to develop both generalist and specialist skills as they require them.” Modernising Nursing Careers: Setting the Direction (2006)

7. Closing date 27.2.09

8. Starting point • 1. Wales’ standards for non medical consultants • 2. Scotland’s Advanced Practice Toolkit • Common themes in both: • - Clinical/Professional Practice •         - Leadership and Management •       - Facilitated Learning and Development •      - Research • Nursing roles at career levels 8 and 9 ‘Leadership and Management’ will be extended to include ‘strategic service development’ • Board level management roles will also include ‘corporate skills/responsibilities’.

9. Principles • Skills for Health - Career Framework Levels would be used • Recognition that although career frameworks are presented as ladders of progression, many nurses stay within a level, often doing different roles. Framework therefore supports lateral and well as vertical progression

10. Post Registration Career Framework for Nurses in Wales - consultation • Consolidation phase – increased rotation/taster experiences – some to be linked to patient pathways – include education, research, in-patient and community/primary care. Preceptorship – linked to NMC work.

11. Post Registration Career Framework for Nurses in Wales - consultation • Nurses to have development in each of the key dimensions commensurate with the role they are in • Career advice at key points • Specific management and leadership preparation for ward managers/sisters/charge nurses

12. Post Registration Career Framework for Nurses in Wales - consultation • Recognition of specialist and generalist practice up to advanced level. Education and training to prepare practitioners for roles – emphasis on knowledge and skills preparation that can be transferred. • Clinical Nurse Specialists to have a degree in a relevant subject and be able to demonstrate competencies in field. • Advanced level practitioners – develop existing clinical nursing staff so that they meet the description and role competencies of advanced practice, this includes supporting staff to reach graduate status and subsequently complete education at master’s level.

13. Expert Practice Specialist Practice Generalist Practice Novice Practice

14. Post Registration Career Framework for Nurses in Wales - consultation • Flexible approach to clinical academic careers – greater movement between education and service. • Investment in research capacity building • Already in place: • - Research Capacity Building Collaboration Wales • Clinical Research Collaboration Cymru – research networks, community of scholars • Research policy board and external advisory board

15. Overview of the career framework Level • Careers in consultant, senior and strategic level roles, senior clinical academic and academic/research posts. • Continued education in 4 ‘pillars’ plus (where appropriate) • Strategic service development • Corporate skills/responsibilities 9+ Post graduate to doctorate level study 8 Careers in advanced generalist/ specialist roles, ward manager posts, management, education and research posts. Continued education in the 4 ‘pillars’ 7 Advanced Practice • Careers in: generalist/ specialist clinical posts, academic and teaching posts. • Continued education in 4 ‘pillars’: • Clinical/Professional Practice • Leadership and Management • Facilitated Learning & Development • Research Graduate and post graduate level study 6 5 Consolidation of practice Career Advice Registration Pre-registration degree level preparation WIDE ENTRY GATE

16. The Challenge • The nurses we have now will be in our workforce for the next 20-30 years. • Academic attainment – will take time to realise aspiration of an all graduate profession • Misleading use of titles, especially specialist/ advanced practitioner • Financial pressures – will it inevitably lead to less nurses and more support staff? Or will we see more advanced practitioners with expanded remits? • Will people still want to be nurses in the future?

17. Questions?