Nursing and Midwifery Council register: who cares about Part 3?

“The third part of the Nursing and Midwifery Council (NMC) register, designed to ensure that specialist community and public health nurses are safe to practise, is pointless and should be scrapped,” the Royal College of Nursing (RCN) has said, (see first reference, listed below).

Apparently, the RCN believes Part 3 is a “complete nonsense”, while the NMC has no plans to scrap it, and health visitors believe its demise would dumb down public health.

Part 3 is of no direct relevance to the majority of RCN members. Most of the public would not have a clue what Part 3 is. So the largest membership organisation for nurses it does not concern (the RCN) thinks it should go, while the organisation that represents the interests of the public (the NMC), who probably have no idea what it is, think it should stay. Does the public really care?

Of course the largest membership organisation for those it does concern, the trade union Amicus-CPHVA which represents health visitors, thinks it should stay, too – which pretty much guarantees four out of 12 practitioner votes in favour at the NMC. The presence of a multi-part register resulting in a health visitor block vote has long since given them a disproportionate influence at the NMC. This is, of course, about to change with the forthcoming changes to professional regulation.

The advent of Part 3 has had significant consequences for occupational health: shared academic programmes mean nurses can specialise in OH on only a couple of specialty-specific modules some of the most experienced, best-qualified OH nurses have been consigned to the “non-specialist” category and, worst of all, a specialty focused on working-age adults is now consigned to a group most likely to work with children and the elderly.

This last issue has become more important recently as OH has been included with families and children in the Chief Nursing Officer’s (CNO) review. The consultation deadline of 15 February potentially heralds a future where OH nurses are cross-trained in childhood issues. This may have conferred very significant benefits in the early 19th century, but the benefits seem far less tangible in 2008.

I doubt many employers will see the benefits of this approach. I have reservations and have responded accordingly. If OH nurses haven’t responded to the CNO’s consultation, then next year, you will only have yourselves to blame.

I can see two main advantages of Part 3 of the register. First, it has offered the opportunity for OH nurses to have a genuinely good crack at getting a full seat on the NMC, albeit without success. Second, it has done wonders for the business card industry, adding nine extra post-nominals to address blocks if you count the brackets in SCPHN (OH). That in itself is a valuable contribution to patient care and the economy as a whole.

But this is a serious matter. I am yet to be persuaded that patients care about Part 3. If there’s a “complete nonsense” to be found anywhere, then surely it must be that nursing organisations have such emotionally charged things to say about the technicalities of segmentation in the register, and less emotionally charged things to say about ensuring patients get specialist care from specialist nurses who have received appropriate specialist training.


Dr Richard Preece is a consultant occupational physician

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