The new nursing framework ‘Leading Change, Adding Value’ announced in May 2016, sets out among its 10 commitments support for nurses to “have the right education, training and development to enhance [their] skills, knowledge and understanding.” Describing “education, learning and training” as vital to high-quality health care, the framework includes plans to create a culture of life-long learning in the NHS, by prioritising training and developing clinical academic careers for nurses and midwives.
Continuing professional development (CPD) was already mandatory for nurses in the UK, who must undertake at least 35 hours of learning, during the 3-year period between revalidation dates for their nurses’ registration with the Nursing and Midwifery Council (NMC). Almost sixty percent of those hours need to be devoted to participatory learning or learning that includes interaction with other professionals, whether in-person or online. The NMC itself does not define any particular type of CPD, leaving it up to nurses to decide which learning activities will be most useful to their development. NHS nurses are supported to reflect on areas in which they would like to develop professionally during their annual appraisal and are required to create a professional development plan that identifies areas of interest and gaps in their skill/knowledge.
Loosely defined by the Royal College of Nursing as a process that helps nurses maintain an updated skills set that ensures the safe and competent care of patients, CPD has been understood to include formal postgraduate study like Masters degrees and PhD level qualifications, as well as informal learning activities like conferences, webinars, reading and mentoring. CPD only includes mandatory workplace training when that training is applicable to a nurse’s area of practice, and therefore excludes fire and general health and safety training.
A new framework for CPD
“Leading Change, Adding Value’ is explicit about the areas of focus for the development of nurses and midwives within the NHS. Among them are learner mentoring, the prevention and control of infections, promotion of better outcomes, experience and use of resources, as well as, awareness of antimicrobial resistance. To this end, nurses will be required to understand and comply with the Health and Social Care Act Code of Practice and follow the NICE guidance NG15.
The new framework takes its structure from Lord Willis’ 2015 review, ‘Raising the bar - Shape of Caring; a review of the future education and training of registered nurses and care assistants.’ In it, Lord Willis highlights the importance of developing the ability of nurses to “research, engage in critical inquiry and implement research findings” into everyday practice. According to Willis, there is significant evidence that this will have an impact on the patient care experience and on clinical effectiveness.
The review further recommends three post-registration learning pathways for nurses - Shared Care, Self Care and Restorative Care - and it is recommended that registered nurses develop the flexibility to “deliver whole-person care” to patients “who are often elderly and have multiple conditions.” The review, which takes a shared multi-agency view, advocates for a new model that takes into consideration the changing role of nurses. It predicts that in the future, nurses will play a larger role in the community, support patients and families to self-care, deliver more holistic care and need the flexibility to balance specialisation and generalism, and enhance research practices.
Professional development planning for nurses
In formalising the CPD requirements for registered nurses, ‘Leading Change, Adding Value’ continued to respond to nurses’ requests for more specific guidelines on the specialist skills and knowledge needed for advancement and to meet public needs. This followed on from the publication of ‘District Nursing and General Practice Nursing Service - Education and Career Framework’, in October 2015, which set out the roles and responsibilities of nurses at each career level and provided a pathway for attainment.
Designed to assist with both workforce planning and educational commissioning, the education and career framework can be used alongside professional development plans for career development planning. Developed around a future context of nursing that is both health and community-based and required to meet “complex emotional and physical conditions,” the framework describes the future nurse as one who will require clinical competence and a sound education.
The NHS Knowledge and Skills Framework, which also underpins the new nursing framework, is another source of guidance on the knowledge and skills required for certain roles and pathways for developing a nursing career.
When creating a professional development plan, it makes sense for nurses to evaluate their current level of skills and knowledge and identify areas of development within their current role that will enhance present competence and be of greater support to their team. This information may make up the short-term goals, with longer-term goals focused on a decided career pathway and the kinds of learning activities that will lead to its accomplishment.