The COVID-19 pandemic raised the profile of complex care delivered at home by district nursing teams which kept people out of hospital (Green et al, 2020). District nursing remains core to healthcare delivery across the UK, which continues to focus on keeping people out of hospital by offering care closer to home. It is within this context that the Nursing and Midwifery Council's (NMC's) Standards for Post-Registration provide an opportunity for forward thinking and innovative programmes of education. These will ensure the district nurses of the future can meet the varied and complex needs of the individuals and local communities they will serve.
The Part 3 NMC Standards for Post-Registration Programmes (2023a) and the Standards of Proficiency for Community Nursing Specialist Practice Qualifications (SPQ) (NMC, 2023b) were initially published in 2022, following extensive stakeholder consultation. The Part 3 NMC Standards are supported by Part 1: Standards Framework for Nursing and Midwifery Education (2023c) and Part 2: Standards for Student Supervision and Assessment (NMC, 2023d). Parts 1 and 2 were both updated in 2023 following the UK's departure from the EU. The district nurse (DN) SPQ programmes have been developed to reflect the changes in healthcare delivery since the previous standards were published. The opportunity these standards provide for rethinking preparation of the DN SPQ of the future should be grasped.
Part 1(2023c) underpins all programmes leading to an NMC qualification. The standards are underpinned by partnership working between key stakeholders; approved education institutions, practice learning partners, people who use services, carers, students and others. This reflects the strong ethos of partnership working across health and care delivery, including district nursing. Student empowerment is one of five components of the standards framework (NMC, 2023c). It emphasises the importance of a variety of learning opportunities supporting students to become life-long learners who are caring, reflective and resilient. At a time when newly qualified nurses who work in the community may not remain in the workforce (While, 2023), recognising prior learning mapped to the programme outcomes can be an important aspect of programme development and delivery (NMC, 2023c). This may include, for example, potential post-registration students that may already have completed independent prescribing.
The Part 3 Standards for Post-Registration Programmes (2023a) and Standards of Proficiency for Community Nursing Specialist Practice Qualifications (NMC, 2023b) build on the Future Nurse Standards (NMC, 2018), reflecting the complexity of healthcare in the community across the lifespan of patients. DN is one of five named fields of community nursing SPQs with the opportunity for other fields, such as health and social care to be specified. The knowledge, skills and proficiencies required for evidence-based health and care, for example, understanding genomics and epigenetics and the implications for personalised healthcare, must be included within DN SPQ programmes (NMC, 2023d). All community SPQ programmes must be a minimum of 45 programmed weeks (NMC, 2023a) to support the increasing complexity of healthcare. The development, delivery and evaluation of DN SPQ programmes in partnership with key stakeholders should ensure that programmes meet the needs of local communities to deliver person-centred care. For example, considering diversity and inclusion, and access to services in remote and rural locations. The requirement to use simulation and technology across the curriculum provides an opportunity to consider innovative approaches to support supervision, learning and assessment (NMC, 2023a). For example, simulation of learning to support students to gain insight into safeguarding processes for end-of-life care offers a supportive method of student learning.
Partnership and interprofessional working have long been core to district nursing. Formalising opportunities supported by in-practice learning with a range of people, further strengthens the ability of the programmes to include a variety of learning opportunities and interprofessional education (NMC, 2023d). Students working towards the DN SPQ must have a practice supervisor, practice assessor and academic assessor. Practice supervisors can be any registered health or social care professional with experience that enables effective evidence-based learning for community nursing SPQ students (NMC, 2023a). For example, the opportunity to spend time with a community pharmacist to focus on medication reviews.
The NMC has delivered webinars and workshops for approved education institutions and practice learning partners to support the implementation of the post-registration standards. These have included an opportunity to hear from people who use services and students who have been involved in programme development. In addition, supporting information including frequently asked questions are available. More information, including the webinars and workshops, can be found at: https://www.nmc.org.uk/standards/standards-for-post-registration/standards-of-proficiency-for--community-nursing-specialist-practice-qualifications/.