References

Nursing and Midwifery Council. Standards and framework for nursing and midwifery education. 2019. http://tinyurl.com/yb6q332w (accessed 11 April 2019)

How the NMC quality standards assure nursing and nursing associate education

25 April 2019
Regulars
02 April 2019
Volume 28 · Issue 8

Abstract

Emeritus Professor Alan Glasper, University of Southampton, discusses the new processes used by the Nursing and Midwifery Council to ensure that all programmes leading to registration are fit for purpose and award

After a long period of consultation, the Nursing and Midwifery Council (NMC) published its new standards framework for nursing and midwifery education in May 2018. The new standards came into force at the end of January 2019 and, over the coming months, all new approvals will be made against these new standards. After 1 September 2020, only programmes approved against these new standards will be able to accept new students and meet the NMC requirements for award and registration. What this means is that students can start a programme leading to nurse registration against either the old standards or the new standards until the end of August 2020. After that, all new students can only join programmes leading to a degree award in approved accredited educational institutions (AEIs) against the new standards. Many nurses who supervise students will be involved in the NMC approvals across the UK over the next 12 months (NMC, 2019).

However, the existing nursing associate programmes remain outwith the current NMC approval process until 26 July 2019, after which training on a NMC-approved nursing associate programme will become mandatory. Hence, until then, individuals can still commence training as a nursing associate in England via a nursing associate programme delivered by a Health Education England-approved nursing associate pilot site, or a nursing associate apprenticeship programme.

However, after July 2019, AEIs will adopt the new NMC standards for nursing associate programmes.

The phasing out of the term ‘mentor’

Under the auspices of the new NMC standards for nursing, the term ‘mentor’ is to be phased out and replaced with ‘practice assessors’, ‘practice supervisors’ and ‘academic assessors’. Unlike the previous cohorts of mentors who followed rigid NMC-approved mentorship programmes, no specific educational courses are being prescribed by the NMC.

Instead, the NMC have produced standards for student supervision and assessment, which are outcome-focused and allow for a degree of local partnership innovation in programme delivery. For the new programmes, including that of nursing associate, student supervision and assessment can be flexible, but at the same time must demonstrably meet the new standards that have been developed by the NMC for student supervision and assessment.

Under these new arrangements for student supervision and assessment, practice assessors will assess and confirm the students' achievements for practice learning, and recommend students for progression in partnership with the academic assessor. Practice supervisors will supervise students on placements, and any registered health or social care professional can undertake this role. It is the role of the academic assessors to collate and confirm the individual student's learning and achievement in the theoretical components of the placement. All approved education institutions, together with practice learning partners, must ensure that nursing students are assigned to practice and academic assessors who are registered nurses with the appropriate equivalent experience for the student's field of practice.

For current mentors and the new practice assessors and practice supervisors who are working in practice across the country and supervising students, there will now be four types of learners: those following either the old or new nursing course leading to a degree and registration as a nurse in all four fields of practice and those following the old or new nursing associate programmes leading to a foundation degree and registration as a nursing associate. Notably, nursing associates can only join on a generic or general field of practice register, although some universities have developed a nursing associate foundation degree curriculum, which focuses on children and young people and their families.

Background

There are around 900 NMC-approved nursing and midwifery education programmes at over 80 approved educational institutions across the UK. To ensure equity of quality across all of these educational institutions, the NMC applies a formal quality assurance (QA) process to ensure that the education programmes for nurses, midwives and nursing associates meet the standards needed to prepare individuals to join the register.

The NMC has appointed the consultancy company Mott MacDonald to operate its QA framework through a dedicated team supported by QA registrant visitors who are, or have been, practising in nursing, midwifery and/or education in the past two years. These visitors are recruited from a range of backgrounds, including university nursing faculties and NHS trusts, and are assigned to undertake a range of QA activities within parts of the NMC register.

Additionally, the new QA framework will help the NMC to increase their commitment to involving service users in the process. They will do this by involving lay visitors, who are members of the public and who will actively participate in the approval of pre-registration nursing, midwifery and nursing associate programmes in conjunction with a QA registrant visitor.

The quality assurance process

Formal approval of AEIs' programmes against the new NMC standards is now conducted through a gateway process consisting of 4 steps, which are detailed below.

Gateway 1

Gateway 1 applies to the standards framework for nursing and midwifery education, and consists of five sections around which AEIs and their partners, such as NHS trusts, have to produce documentation that demonstrably shows:

  • A learning culture. The NMC will only approve programmes where the learning culture is ethical, open and honest, and is conducive to safe and effective learning. Further, this learning must respect the principles of equality and diversity, and innovation, inter-professional learning and team working should be embedded in the learning culture
  • Educational governance and quality. NMC visitors expect to see evidence that education providers are complying with all legal and regulatory requirements
  • Student empowerment. The NMC needs to see evidence that all students are empowered and provided with the learning opportunities they need to achieve the desired proficiencies and programme outcomes
  • Qualified educators and assessors. Importantly, the NMC must be assured that those who support, supervise and assess students are suitably qualified, prepared and skilled, and receive the necessary support for their role
  • Curricula and assessment. The NMC has developed and published standards for curricula and assessment that enable students to achieve the outcomes required to practise safely and effectively in their chosen area. Submitted documentation must show adherence to these standards.

    • Gateway 2

    This gateway relates to the standards for student supervision and assessment. AEI partnerships must produce documentation to show how they have developed innovative approaches for the provision of education. There are four aspects of this gateway that must be fully described within the course approval documentation. These are:

  • The student journey. The partnership must structure the documentation to follow the student journey through the programme
  • Effective practice. The NMC has produced standards that describe what needs to be in place to deliver safe and effective learning experiences for nursing and midwifery students in practice. Gateway documentation needs to precisely describe how the partnerships have embedded these standards in the overall course design. Compliance with all these standards is mandatory before any educational institution can be authorised to offer and run NMC-approved programmes. Partnerships need to describe how students are provided with safe, effective and inclusive learning experiences. There is a range of criteria that partnerships need to address within the approval documentation, including detail of the appointments of nominated persons for each practice setting, to actively support students and address student concerns
  • Supervision of students. How students are supervised in practice is of paramount importance. Many would argue that the professionals who supervise students are pivotal to the whole development of nursing education. The NMC has a range of criteria that is expected of practice supervision, including that there is sufficient coordination and continuity of support and supervision of students to ensure safe and effective learning experiences. The introduction of academic assessors, practice supervisors and practice assessors will replace traditional mentors
  • Assessment of students and confirmation of proficiency. AEIs, together with practice learning partners, must ensure that practice supervisors serve as role models for safe and effective practice in line with their code of conduct. Practice supervisors should support and supervise students, and should receive ongoing support themselves.

    • Gateway 3

    This gateway is designed to convince the NMC that the AEI partnership has fully embodied the programme standards and that they provide detailed evidence about how they intend to run and operate the programmes. This includes giving the Mott MacDonald team detailed information about the prospective curriculum, the configurations of the intended modules and the practice assessment documentation.

    The final part of gateway 3 requires the AEI partnership to give details of the staff who will contribute to the programmes, to ensure that there are sufficient human resources available to optimally run the programmes.

    Gateway 4

    Gateway 4 is the concluding aspect of the approval process, and consists of the approval visit. This visit takes place when the Mott MacDonald reviewers are happy with the documentary evidence submitted. Nursing course approvals are prospective, in that what the AEI partnership is promising is a future probability. To ensure that what is promised is delivered, reviewing visitors from Mott MacDonald conduct periodic retrospective reviews of programmes.

    The agenda for the approval visit is made jointly by the senior members of the AEI partnership and the programme reviewers. During the approval day, the team from Mott MacDonald will usually meet with a selection of students, registrants and senior academics, in addition to managers from the practice learning institutions. Subsequent to the approval meeting and on the basis that any outstanding conditions have been met, the NMC, on receipt of the approval report, will confirm in writing that the course has been approved and is fit for purpose and award.

    KEY POINTS

  • The new NMC standards came into force in January 2019 and, over the coming months, all new courses will be approved against these new standards
  • Nursing associate programmes remain outwith the current NMC approval process until 26 July 2019, after which training on a NMC-approved nursing associate programme will become mandatory
  • Mentors will be phased out and replaced with practice assessors, practice supervisors and academic assessors
  • The formal approval of accredited educational institutions' programmes is now conducted through a four-step gateway process