Re: Nursing and Midwifery Council Post-registration Specialist Practice qualifications-District Nursing
Although I appreciate the need for the Nursing and Midwifery Council (NMC) to review the Standards for Specialist Education and Practice, in particular for community practice, to ensure that they reflect contemporary and future practice, the introduction of a single programme that leads to a single qualification fills me with concern.
The new NMC programme will lead to one Specialist Practice Qualification (SPQ), with universal core standards of higher practice for all current community SPQs (i.e. Community Mental Health Nursing, Community Learning Disabilities Nursing, Community Children's Nursing, General Practice Nursing and District Nursing), as well as bespoke standards for the different fields of practice. If this is the case, that is, bespoke standards are a requirement to reflect the additional specialist knowledge and skills needed for that area of practice, how can only one qualification at the end of the programme be acceptable? One size does NOT fit all.
What I cannot support is that, to be a lead nurse in the community in the future, you would not necessarily have to hold a specific qualification, that is, it would be this general SPQ qualification, and it would be up to the employer whether this qualification would be a requirement. This lack of regulation, with no annotation on the register, completely devalues all that we have done over the years to recognise and value what it means to be a district nurse. To leave this decision to the employer in the future will lead to an inequitable system, which, again, clearly demonstrates the lack of understanding about what it means to be a district nurse, who is accountable for care in continuously changing complex community environments.
If we are serious about protecting the patients under our care, we must ensure that the SPQ District Nurse qualification (reflecting the revised standards) is maintained and regulated by the NMC-we fought for the education programme and title District Nurse, which recognised and valued this highly specialist body of knowledge, and the title District Nurse can only be used by somebody who holds the SPQDN qualification. Hence, I assume this title will disappear in the future.
It is through our history that we must appreciate and value what it means to be a district nurse. In the words of Sweet and Ferguson (2000):
‘In a changing environment, we can appeal to history to show whether a continuity of function and definition exists or whether the district nurse of the past is simply that: a thing of the past.’