Several unions and nursing charities expressed deep concerns about plans to reshape nursing careers in response to the DoH consultation, and in response to a second consultation on pre-registration nursing training conducted by the Nursing and Midwifery Council (NMC).
The RCN warned of ‘real concerns' that five pathways proposed by the DoH in an overhaul of nursing careers - children, family and public health; first contact, access and urgent care; supporting long-term care; acute and critical care; and mental health and psychosocial care - do not fit the work of nurses employed in general practice.
‘There is a whole argument here about preserving a pathway for advanced generalist nurses, most likely to be employed in general practice,' the RCN response says.
It says there is a case for ‘an advanced generalist nurse pathway to include skills in mental health first contact and case management'.
Unite/CPHVA warned that plans to re-shape nursing careers could end health visiting as a specialist career in England. In its response to the DoH consultation, Unite/CPHVA says that ‘there is no provision for specialist practitioner qualification in the proposed framework'.
The proposals will cut the ‘quality, depth of skill and knowledge' in the nursing profession, the union adds.
A response from the Queen's Nursing Institute (QNI) says the consultation ‘fails sufficiently to address specialist practice, specialist nurses and the future of advanced practice'. It warns: ‘These are matters of major concerns to community nurses, whose careers are defined by these markers.'
The RCN response echoed these concerns, highlighting ‘a need for a more formalised post-registration career pathway with clearly defined routes to advanced practice level posts'.
Several of the respondents voiced concerns that the five pathways would prove difficult to move between, creating ‘silos' that nurses could become stuck in.
Meanwhile, in response to the NMC consultation on pre-registration careers the RCN and Unite/CPHVA both backed a move to degree-level entry to nursing, despite divided opinion among RCN members, and opposition from Unison.
Unison said that it did not support an all-graduate profession and called for the entry gate to remain ‘as wide open as possible', with clearer definitions of competencies needed in nursing professions.
Unite/CPHVA also backed a proposal that learning in practice in the community should be increased to form half of the total practice requirement for nurses in training within five years.
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