The Nursing and Midwifery Council (NMC) approved new Standards for Specialist Community Public Health Nursing (SCPHN) on 26 May 2022 and they are now published. The iHV welcomes these standards that set out expectations for future health visitors and build on the evidence base for preventative public health for babies, children and their families. The NMC engaged with many practitioners and organisations in the development of the standards, and we are pleased that inputs from the iHV and our members have been taken on board.
Here, we consider some of the key features, offering answers to common questions:
Why are the new NMC standards important?
They establish standards on an up-to-date evidence base to meet the future public health challenges and opportunities to impact health outcomes across the life-course.
They establish the distinctive knowledge and skills of health visitors that exceed those of the ‘Future Nurse’ Standards of proficiency for registered nurses (NMC, 2018) so that the public can be confident of who health visitors are and what to expect of them.
What are the key differences from the previous NMC (2004) standards for SCPHN?
Proficiencies for Practice
The previous standards did not have field specific proficiencies. They lacked meaning for families who value knowing their health visitor and want to be confident that all health visitors have the skills and knowledge to support family health in real world circumstances.
The proficiencies set out in the new standards are structured differently from the previous proficiencies. The four ‘domains’ are now replaced by six ‘spheres of influence’ that reflect the significant leadership role of SCPHNs in their autonomous practice. Two of the spheres are shared with other SCPHNs (school nurses and occupational health nurses) while the other four spheres formulate proficiencies for each of the respective fields of HV, SN and OHN.
Student Supervision and Assessment
Standards for student supervision and assessment are now separate from the proficiencies. This signals the discontinuation of the NMC approved and recorded Practice Teacher qualification. ‘Standards for post-registration programmes’ are also published separately from the Standards of Proficiency providing some strengthening of the application of the standards for student supervision and assessment to SCPHN programmes. This reflects some of the concerns that the standards for student supervision and assessment were not sufficiently robust for the needs of SCPHN students that the iHV expressed in our response to the NMC’s formal consultation in summer 2021. The iHV has further supported the Queens Nursing Institute in the development of additional standards for community practice teaching to support a more consistent and effective approach to teaching and assessment of SCPHN and community specialist practice students.
Programmes of Learning
Overall, the standards aim to support local partners in education to adopt flexible and innovative approaches and programme standards are accordingly somewhat less prescriptive than previously. For example, Approved Education Institutes (AEIs) must:
- ensure that the curriculum provides a balance of theory and practice learning opportunities. There is no specified minimum number of practice days, though the ratio of theory to practice must be justified. This means that AEIs and partners could, if they desire, design programmes with different theory/practice ratios for different categories of SCPHN programme entrant, so long as each ratio of learning is adequately justified.
- ensure programmes are of a suitable length (but no less than 45 weeks for full time programmes) to support student achievement. Previously SCPHN programmes were required to be 52 weeks long with 45 programmed weeks.
- design and validate all programmes at postgraduate level.
- make it clear how each route of the SCPHN programme is sufficiently differentiated with staff resources to match.
How will they be implemented and how can I be involved?
The new Standards for Specialist Community Public Health Nursing (SCPHN) will come into effect on 1 September 2022. Approved Education Institutions (AEIs, typically universities) will need to develop and validate their curricula with practice partners to meet the new Standards to be ready for delivery no later than 1 September 2024.
Practice Partners, Practice Supervisors and Assessors
Practice partners (employers) will need to work with AEIs on the new curriculum and particularly on the provision of suitable learning opportunities in practice. The field specific proficiencies are considerably more detailed than previously and so Practice Supervisors and Assessors will need to scope learning opportunities and assessment strategies.
Many Health Visitors have reported in iHV surveys that they are challenged to exercise their autonomy and leadership in the context of service pressures. This will require capacity and capability building for Practice Assessors and Supervisors locally to realise the ambition of the new standards.
After 31 August 2024, all new students must be registered on the new programme. Existing students are able to continue with the programme they started at point of registration.
Students starting SCPHN programmes approved against the new 2022 standards can expect their learning in practice and academic contexts to be guided by the focused set of proficiencies. The range, depth and ambition of the proficiencies could seem rather daunting. This will require all partners to profile learning needs, plan learning opportunities and devise proportionate assessment strategies, emphasizing again the crucial practice teaching skills, knowledge and leadership of Practice Assessors and Supervisors.