When the Nursing and Midwifery Council (NMC) was established in April 2002, it abolished a separate part of the register for health visitors (HVs). As HVs were involved in practice that involved responsibility for the health of populations (as well as individuals), a new third part was added to the existing parts for nurses and midwives, to recognise the special nature of this public health role. Nurses in other specialist areas contributing to public health were also included on the new part of the register.
The new part of the register, for specialist community public health nurses, came into effect on 1 August 2004, and all existing HVs immediately transferred over. Occupational health nurses, whose OH qualification is on record at the NMC, will also migrate over to the new register, as will school nurses with a recordable qualification, regardless of whether the specialist qualification is at certificate, diploma, degree or higher level. What is important is not the academic level of the qualification but that it is on record.
During the transition period, graduates with specialist practice awards (minimum degree level) from institutions teaching OH specialist practice will be eligible to go on to the new part of the register. However, during this period (the length of which has yet to be announced), institutions will be expected to develop and obtain approval from the NMC the programmes that will incorporate standards of proficiency in public health. Once the transitionary period ends, institutions without approval will not be able to have their graduates placed on the third part of the register.
Although specialist practitioners in OH can currently migrate over to the new part of the register, aspiring OH nurses or their tutors must not assume that they will be able to continue to do this in future without undertaking a specialist programme incorporating public health.
Implications for education
The public health standards have been published by the NMC following a lengthy consultation.1 There are 10 standards of proficiency required for entry to the new part of the register (see box, left), and considering these will apply to HVs, school nurses, and OH nurses, they are remarkable in their relevance to OH practice.
Becky Elliott, chairwoman of the Occupational Health Nurse Educators’ Association (AOHNE), says: “We will be developing our courses collaboratively with practitioners, purchasers and users to ensure that all the standards of proficiency are attained for validation by the NMC, and for the focus to remain with our community, which is the workforce.”
The 17 institutions in England and Scotland that teach OH nursing will work hard to bring their programmes up to the level required for validation by the NMC for the award of specialist community public health nurse. There are clear standards for education, covering everything from the length of programme and contents of curriculum, to balance of theory and practice and assessment.
Changes are likely to include a lengthier programme, improvements in contact between university tutor and practice teacher, more collaborative links with other public health practitioners, and changes in the nature of assessment. While few, if any, of the current programmes have a timed, invigilated examination as part of the assessment, under the NMC requirements there will be at least one such assessment.
Nurses on the third part of the register will have the letters RSCPHN – followed by the relevant annotation OH, HV or SN (school nurse). It is likely that the specialist practitioner recordable qualification will be phased out.
Nurses who currently hold academic qualifications in OH at degree or Masters level, but who do not have a recordable qualification and who are not entitled to call themselves OH nurse practitioner, should in the future be able to apply through a convoluted process of providing a portfolio of evidence to become SCPHN.
With the NMC announcing new consultation on post-registration nursing,2 the only thing that is absolutely certain is that OH nurses are going to experience major changes over the next few years.
Bashyr Aziz, senior lecturer, School of Health, University of Wolverhampton
1. NMC (2004) Standards of proficiency for specialist community public health nurses. London: NMC www.nmc-uk.org
2. NMC (2004) Consultation on a framework for the standard for post-registration nursing. London: NMC
Standards of proficiency for entry to the SCPHN register
Surveillance and assessment of the population’s health and well-being
Collaborative working for health and well-being
Working with, and for, communities to improve health and well-being
Developing health programmes and services and reducing inequalities
Policy and strategy development and implementation to improve health and well-being
Research and development to improve health and well-being
Promoting and protecting the population’s health and well-being
Developing quality and risk management within an evaluative culture
Strategic leadership for health and well-being
Ethically managing self, people and re-sources to improve health and well-being