A milestone for specialist community and public health nursing

Published on 19 May 2022

Next week, we’re asking Council to approve new standards of proficiency for future specialist community public health nurses (SCPHN), community nursing specialist practice qualifications (SPQs) and associated programme standards. Professor Geraldine Walters (Executive Director, Professional Practice) looks at our journey to develop the standards and the benefit they’ll have for people who use services and their wider communities.

We published this blog on 19 May 2022. These standards have since been agreed by our Council and published on 07 July 2022. Find out more about the new standards

Next Thursday (26 May) will mark a significant milestone for us. Council will consider the final draft of our proposed new post registration standards for specialist community public health nurses (SCPHNs) and community nursing specialist practice qualifications (SPQs). This completes our education programme which we began in 2016 to modernise all our standards of proficiency.

Our new standards will help people and communities

These standards are particularly focused on the additional knowledge and skills that nurses need to provide specialist care and support for people in their own homes and communities, and on the influence that specialist nursing can have on the health of populations.

They’ll set a consistent level of knowledge and skills, and assure a quality of educational preparation that will enable community nurses to independently meet more of the needs of the people they serve. Those people will then be assured of the knowledge and skill of the person looking after them, because professionals will have a qualification which can be seen on our register.

The standards also include the knowledge and skills needed to prepare these professionals to develop their careers further, to become the leaders, educators and researchers of the future.

We’re so grateful to our partners and stakeholders who have given their time and expertise to co-produce these standards with us. We believe they truly reflect the additional expertise and depth of knowledge required to deliver modern, effective specialist community, and public health nursing.

The journey

It’s been a challenging journey to get to this point. I’m really proud of the work everyone has done to get us here. These standards were long overdue for renewal as some were developed over 20 years ago. Back then, there were different expectations of community nursing, and how it should be regulated.  

Addressing these standards ignited an opportunity to debate these issues for the first time in many years. Unsurprisingly, this exposed strongly held and diverse views.

It was important for us to focus on the purpose of the standards, and what they could and couldn’t achieve. Most of all, they had to benefit people who use services and their wider communities.

The vital role of specialist community, and public health nurses

We knew about the level of knowledge and skill required to be a specialist community nurse or specialist community public health nurse. The care provided in hospitals is well understood; the care provided in the community, in all its guises, less so. But it’s in these settings where nurses are often working alone, with people in vulnerable circumstances, and dealing with additional risk and uncertainty.

This has always been the case but over the years community nursing has evolved even further. Across the four countries of the UK, there are aspirations for ever more complex care and treatment to be provided in the community, in both health and social care. Professionals need to be more clinically autonomous, and require ever higher levels of knowledge and skill.

Standards fit for the future: SCPHN

SCPHNs are frontline professionals who make a difference to the health outcomes of people, communities and populations. They are in the front line of public health, are culturally competent, autonomous practitioners who are committed to improving people’s health and wellbeing, and seek to address health inequalities.

The draft SCPHN standards represent our future ambitions for health visitors, occupational health nurses and school nurses. They’ll ensure these professionals have the best possible knowledge and skills to make a difference to the people and populations they serve.

We also hope that if our legislation is modernised we’ll be able to make regulation of these qualifications more meaningful in future. We could then enforce the principle that nurses and midwives should not use titles that suggest they hold one of our qualifications if it’s not recorded on our register and they haven’t demonstrated through revalidation that their practice is current and up to date.

This will be positive for SCPHN practitioners themselves, and the people and communities they care for and support. We’ll continue to recognise, register and record these qualifications.

Standards fit for the future: SPQ

Our review of the SPQ standards took a slightly different path. At the start there was some debate about whether we should continue to regulate these qualifications in future. It was decided that we should, to provide consistent standards and assure the quality of education, which in turn would further protect the public.

We needed to address whether the way these standards were regulated in the past was fit for the future. The previous qualifications addressed a small number of specific community nursing roles. There are now many more roles and it would not be proportionate to develop separate qualifications for all possible community roles, nor can we predict what roles might exist in the future.

We also had to ensure that all community professionals who might require additional levels of knowledge and skill had access to a regulated qualification. We have done this by introducing an additional SPQ for community nursing in health and social care with no field of practice specified. This might be appropriate for those working in hospital at home teams, in intermediate care, in care homes, in hospices or in health and justice settings.

So, we have modernised and streamlined all of our standards to reflect the requirements of all SCPHN and community nursing SPQ roles. We have also renewed our education programme standards, which set the standards for universities wishing to run courses leading to each individual qualification. These standards will ensure that programmes are taught in the context of a professional’s field of practice.

Working together

It was vital to work together to get the standards right. Much work took place as we developed them, with thousands of people letting us know their views via our webinars and roundtables.

It was important to consult widely to give everyone the chance to have their say. We had more than 2,000 responses, from professionals, the public and our partner organisations. We were so pleased that the vast majority responded positively. And since we published our independent report on the consultation findings, we’ve been lucky enough to work with experts from across the UK to refine the standards based on what we heard.

While there are important differences between specialist community nursing roles, the evidence from our consultation showed that the knowledge and skills required for regulation across the five current specialist community SPQs apply to all. The differences relate to how they are applied for different client groups and settings.

We know when Council looks at these standards next week, they can be confident that we’ve co-produced them with a large and diverse group of professionals and the public.

A bridge to advanced practice

In raising the ambition for the level of clinical autonomy, leadership, research and education within the standards, and subjecting them to regulation, the similarities with the skills of advanced practice are clear to see.

We’ve committed to explore the regulation of advanced practice, which will expand our framework for post-registration education and training across the profession(s).

These standards will provide those community nurses who wish to undertake advanced practice qualifications in future a head start along this path. We expect to begin our work to explore the full scope of advanced practice regulation later this year.

A huge thank you

It’s taken a lot of work to reach this point from so many people right across the sector. I’m so grateful to everyone we’ve worked with to get to this point. We could not have done this without you. I’m really looking forward to seeing how specialist community and public health nursing develop and flourish in the years to come, and to the NMC playing our part in supporting their vital work.

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