Read one account of what it's like to use our new approvals process.
We've been delivering pre-registration nursing and midwifery programmes at Eden University in Bristol* for 15 years.
We're currently delivering our nursing and midwifery programmes in line with our pre-2018 standards and now we're going through the process of gaining approval for our programmes under the new NMC standards.
In 2017, we also began delivering a pre-registration nursing associate programme as a Health Education England (HEE) test site.
*This is a fictional scenario.
Learning about the NMC’s new approach to quality assurance
The QA Framework sets out the NMC’s strategy for quality assurance and gives a helpful overview of the four-stage approval process, which they refer to as the Gateways. The QA framework explains how each of the set of standards we needed to comply with, would be assessed.
We work closely with our practice learning partners so we found it really useful to share the framework with them too.
What’s good about the Gateway approach?
It’s less cumbersome.
The same Standards framework which are assessed in Gateway 1 and the Standards for student supervision and assessment (Gateway 2) apply to all the programmes - nursing, midwifery and nursing associate - that we are going to run, which means we only need to submit evidence once.
It also takes the worry out of wondering if we’re going wrong since you can’t run any programme under the new standards, until you have successfully passed through each of the four Gateways and received written confirmation of approval from the NMC.
We learned the NMC works with a company called Mott MacDonald, who manage the entire approvals process, organise the visits and are a helpful point of contact for guidance.
The value of the QA handbook
We also read the QA handbook, and found out:
- what we would have to submit at each step or Gateway
- how to use the mapping tool
- what the quality assurance visitor will do
- what the NMC will do.
The QA handbook outlines the timelines for each of the stages.
Agreeing our approach and timing
We met with colleagues across the departments who manage the nursing, midwifery and nursing associate programmes, as well as our practice learning partners, service users and carers, to plan when we would want to seek approval for our programmes under the new standards.
We wanted this programme to start in September 2019, which meant we needed to submit all our documentation for Gateway 1 by 31 December 2018.
Colleagues running our midwifery programme can’t yet transition onto the new programme standards for midwifery as these are currently being developed by the NMC for launch in January 2020. However, we decided that we wanted to transfer our current midwifery programme onto the new standards of supervision and assessment early.
Nursing associate programme
We decided that as we were due to recruit students to our programme in September 2019, we were keen to be approved as soon as possible. We are aware that after 26 July 2019, students can only join a NMC approved pre-registration nursing associate programme.
We contacted Mott MacDonald to discuss our approval process and the timeline for approval visits. We agreed a provisional visit date of March 2019 for our pre-registration nursing programme. Mott MacDonald confirmed that we would only need to submit Gateway 1 once across all three of our programmes.
What having AEI status means in practice
As an approved education institution (AEI) the process is easier for us.
However a new university nearby, is not an AEI, and they also wanted to run a nursing associate programme.
They had to submit an initial proposal to the NMC's Quality Assurance Team. Their proposal included high level principles that confirmed their intentions for programme delivery and gave evidence of what they had in place.
Once this was reviewed by the NMC they were referred to Mott MacDonald, and then able to proceed to the Gateway process. Because this will be the first time they've been approved by the NMC to run any programmes, all their programmes will be under new programme monitoring, which means the NMC will continue to monitor them, ask for regular updates and then follow up with visits.
In contrast, because we are an existing AEI , we'll be under enhanced scrutiny for our nursing associate programme.
Going through the gateways
Gateway 1: Standards framework for nursing and midwifery education
We started the Gateway process for our nursing and nursing associate programmes at the same time, as we knew we’d be seeking approval for both simultaneously. Although we won't be seeking approval for our midwifery programme until 2020, we still had to put it through Gateway 1 at this point.
We used the mapping tool in the QA hub to upload evidence to show that we meet all of the NMC’s standards.
Using the mapping tool
In the mapping tool, QA criteria along with examples of the type of evidence we need to provide to show how we meet those criteria, are shown against each standard.
We submitted our Standards Framework (Gateway 1) material in early November 2018. This involved providing evidence of important policies and procedures, many of which are in place across Eden University as a whole, and also apply across all of our practice learning partners.
A QA visitor reviewed Gateway 1 and after two weeks they came back to us with some questions and asked for additional evidence in relation to one of the standards.
We responded quickly, and they confirmed we’d provided all of the information needed to proceed to Gateway 2.
Gateway 2: Standards for student supervision and assessment (SSA)
We couldn't emphasise enough how helpful the supporting information for SSA (SISSA) is.
Now that the NMC isn’t prescriptive about the methods we use to show we’ve met their standards, there is room to innovate and be creative, but that's a bit of a blank canvas so we found it really helpful to refer to the tips and advice which is contained in SISSA.
Along with our practice learning partners we decided to take an organisation-wide approach to student supervision and assessment.
This meant our submission covered our nursing, midwifery and nursing associate programmes, and it also meant we’d be transferring students across who were previously under the old Standards to support learning and assessment in practice (SLAiP).
For example, we asked the NMC whether we still needed to deliver a mentorship programme.
The NMC said it was up to us to decide locally what supervision and assessment model to apply and how supervisors and assessors would be prepared for their role.
What this has meant, in effect, is that along with our practice learning partners, we've used this as an opportunity to rethink the way student support works at Eden, as well how we use shared practice assessment across our practice placement sites. We also included details of our new approach in our submission.
Great result - the QA Visitor was happy with how we’ve implemented the standards.
Once our programmes are formally approved, our next nursing and nursing associate cohorts will start under the new standards. We'll also be transferring our current midwifery students onto the new standards for student supervision and assessment.
To transfer our current midwifery students to SSSA, we notified Mott MacDonald of what we wanted to do and provided evidence of our transfer arrangements and taken account of our current student expectations as part of the submission for Gateway 2 of the approval process. The next step will be done as a major modification to allow for due regard.
Gateway 3: Programme standards
This was the stage of the process where we provided detailed evidence about how we intend to run the nursing and nursing associate courses.
- information about the curriculum
- practice assessment documentation
- details of staff contributing to each programme.
- a document to map how we will meet the standards for each programme.
We'll transfer existing NA students onto the new programme following approval mapping their current programme proficiencies to the new proficiencies. We've decided that our existing nursing students will continue on the current curriculum until they finish.
Gateway 4: The visits
The final stage of the approval process is the visit to make sure that all of the evidence that we submitted in Gateways 1, 2 and 3 is accurate, and, to confirm that we have strong and effective partnerships in place. Our visit will take place in March 2019.
The QA visitors contacted us to discuss an agenda and structure for the visit.
The QA visitors will meet a selection of students from across all our programmes, and senior managers from our practice learning partners, as well as service users and carers involved in the programmes.
After the visit a report will be sent to the NMC for a final decision to be made about whether we've been approved.
New programme monitoring close up
Because the nursing associate programme is a new pre-registration programme, it will be under new programme monitoring.
We'll need to submit additional reporting to the NMC every six months. In addition to this we'll have a follow-up call each time with a member of the NMC’s QA Team to give them updates on how the programme is progressing.