Community nursing: core specialist qualification
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Community nursing: core specialist qualification

Nick Evans Health journalist

The NMC’s new all-encompassing specialist practice qualification is for nurses working in any community setting

The Nursing and Midwifery Council (NMC) has introduced an all-encompassing specialist practice qualification (SPQ) aimed at nurses working in any setting in the community, with the Queen’s Nursing Institute (QNI) planning to build on this by producing a set of standards for nine different fields. Here is what is happening and what it means for nurses, employers and universities.

Nursing Children and Young People. 34, 6, 12-13. doi: 10.7748/ncyp.34.6.12.s6

Published: 03 November 2022

The NMC first developed SPQs for community roles in 1994, covering five fields:

  • » District nursing.

  • » General practice nursing.

  • » Community learning disability nursing.

  • » Community children’s nursing.

  • » Community mental health nursing.

These allowed nurses working at an advanced level to have a recordable qualification listed on the register, demonstrating their ability to deliver advanced practice in these specialist fields.

They were last updated 15 years ago. Since then, new roles have developed in a variety of settings, from the care sector and hospices to prison and other criminal justice settings. This development prompted the NMC to review its approach and now a core specialist community nursing SPQ has been developed, which will be run by approved education institutions and their practice learning partners from 1 September 2022.

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Picture credit: iStock

The new post-registration standards of proficiency for community nursing specialist practice qualifications were agreed by the regulator in July, along with those for specialist community public health nurses, such as health visitors and school nurses. The hope is that the core community nursing qualification will also future-proof the standards by allowing the SPQ to be applied to new roles, as and when they emerge.

The standards set out the knowledge and skills needed to gain post-registration qualifications and operate at a higher level of clinical autonomy. They also cover what is expected from universities and other providers delivering education and training.

The new standards, which have independent prescribing as an optional recordable qualification, are organised under seven headings, or platforms as the NMC calls them.

Working in complex environments

Covering everything from autonomous working and promoting health and well-being to leading and supporting teams, the standards stress that nurses working at an advanced level in the community work with people of all ages in different, often complex, environments.

They also point out that nurses at this level are required to lead and manage teams that could be drawn from a range of different agencies and sectors, while at the same time advocating for and directly supporting the people they care for.

Although the NMC standards do not differentiate or provide detail about what is required to prepare nurses working in specific fields, such as district nursing. The regulator requires education providers to develop curricula that are sufficiently detailed to allow nurses to work in the different fields. This will allow the NMC to reference in what field a nurse has received their qualification – either one of the existing five fields or the generic specialist community health and care field.

To help fill that gap and provide greater clarity, the QNI is developing further field-specific standards to enhance the NMC standards. The aim is to create nine individual sets of standards for advanced practice, seven of which are planned for publication in January 2023, with a further two to follow later that year in July.

The nine fields (to be published in January 2023 unless stated otherwise) are:

  • 1. General practice nursing.

  • 2. District nursing.

  • 3. Community children’s nursing.

  • 4. Community learning disability nursing.

  • 5. Community mental health nursing.

  • 6. Homeless and inclusion health nursing.

  • 7. Adult social care nursing.

  • 8. Hospice nursing (July 2023).

  • 9. Criminal justice nursing (July 2023).

The QNI already has practice and education standards for GP, children’s, learning disability and district nursing. The new standards will refresh these, while also creating five new ones.

In each field, the standards will cover four pillars:

  • 1. Clinical practice.

  • 2. Facilitating learning.

  • 3. Leadership and management.

  • 4. Evidence, research and development.

‘Nursing practice in the community is changing rapidly,’ says QNI chief executive Crystal Oldman.

‘There are new roles emerging and we want to establish greater clarity for advanced level practice in the different settings.

‘We will review and update these standards every five years to reflect that. We think they will be important for universities in helping develop their courses and ensuring they have attractive and appropriate options for post-registration students wishing to progress their careers.’

Dr Oldman added that they will also help employers, by providing access to clear and more distinctive pathways that will help with staff development, recruitment and retention. ‘Nurses themselves can use them to help them plan and prepare their next steps, and as a basis for discussions and appraisals with their employers.’

Standards of proficiency for community SPQs: the seven platforms

  • 1. Being an accountable, autonomous professional and partner in care

    • Required to work autonomously in people’s homes, close to home or in the community with people of all ages

    • Work in interdisciplinary and interagency environments and delegate to diverse teams, including registered professionals, carers, family members, volunteers and others in the third sector

    • Often work in unpredictable, unconventional and complex settings with higher risks

  • 2. Promoting health and well-being and preventing ill health

    • Pivotal to health protection and the promotion of health and well-being

    • Play a central role in co-designing services that support and improve mental, physical and behavioural health and well-being

    • Support people to make their own choices and decisions that can improve their health and care

    • Promote health and reduce health inequalities

  • 3. Assessing people’s abilities and needs and planning care

    • Have the knowledge, skills and attributes to be the lead professional in caring for people who may have complex care needs or life-limiting conditions

    • Ability to see the person before the condition and to undertake an individualised holistic assessment

    • Able to develop therapeutic relationships with people, their families and carers to facilitate shared-decision making

    • Assess and manage risks when making referrals to or receiving referrals from other interagency teams

  • 4. Providing and evaluating evidence-based care

    • Take the lead in providing evidence-based, person-centred and safe interventions

    • Able to initiate and deliver a range of care and treatment that can be supportive, curative, symptom-relieving or palliative

    • Can communicate complex information in a way that seeks to maximise the involvement of people, their families and carers

    • Work in partnership with people, peers and colleagues to assess the impact of care on an ongoing basis, including supporting and managing transition between services

    • Evaluate the care outcomes and whether interventions continue to be effective and in line with the wishes of the person receiving care

  • 5. Leading, supporting and managing teams

    • Responsible for leading services, managing effectively the coordination and delegation of care

    • Able to teach and support the professional development of colleagues and students

    • Able to recognise and address any disagreement or conflict between those planning and delivering care

    • Influencing and negotiation skills to build professional working relationships to achieve seamless care

  • 6. Leading improvements in safety and quality of care

    • Lead the development and implementation of strategies to improve care

    • Able to mitigate and manage the range of risks, complaints and concerns in diverse community settings

    • Able to lead evidence-based quality improvement initiatives

  • 7. Carecoordination and system leadership

    • Understand in detail the functions of the different agencies in the community

    • Understand the political and economic drivers of each agency and the resulting opportunities, constraints and risks, which enables them to build productive working relationships

    • Able to influence and bring about evidence-based change at a local, regional and national level for the benefit of people, families and communities

(Source: NMC 2022)

This is an abridged version of an article at rcni.com/community-nursing-qualification

Find out more

NMC (2022) Standards of Proficiency for Community Nursing Specialist Practice Qualifications. tinyurl.com/NMC-community-nurse-standards

NMC (2022) Standards of Proficiency for Specialist Community Public Health Nurses. tinyurl.com/NMC-public-health

QNI (2020) Standards of Education and Practice. qni.org.uk/nursing-in-the-community/standards

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