Developing graduate, specialist and advanced nursing and midwifery practice

The Minister for Health has approved the Draft Policy on Graduate, Specialist and Advanced Nursing and Midwifery Practice. A National Steering Group has been appointed to oversee the establishment of demonstrator sites in 2017.

The draft policy proposes a framework to:

  • Create a critical mass (700 by 2021) of Registered Advanced Nurse Practitioners /Registered Advanced Midwife Practitioner‘s (RANP/RAMP‘s) through a developmental pathway for graduate and specialist nurses and midwives;
  • Change the way we educate and train nurses and midwives from graduate level;
  • Change how we utilise and deploy the nursing and midwifery resource;
  • Measure impact and effectiveness of the new framework.

The purpose of the draft policy is to contribute to providing a solution to a number of critical challenges facing the health service. This will require the development of a critical mass of advanced nurse/midwife practitioners in areas of most service need to address current issues in service delivery. The key driver for the draft policy is the creation of a more responsive, integrated and people-centred health and social care service, as outlined in Strategic Priority 3 of the Department of Health Statement of Strategy (2016-2019). Linked to this priority, is the development of ANPs to support the implementation of the integrated care programmes by the HSE. The key areas for ANP development have been aligned to the five Integrated Care Programmes as follows:

  • patient flow,
  • chronic disease management,
  • older person care,
  • children’s care,
  • midwifery and women’s health.

The output of each ANP service must demonstrate an impact on one or more of the following objectives as stated in the Programme for Government Commitments and the DOH SoS (2016-2019):

  • to reduce waiting lists;
  • facilitate early discharge;
  • improve access to services and;
  • increase hospital avoidance.

It is intended that there will be a pilot to demonstrate if this nursing/midwifery service can address these challenges. The objectives of the demonstrator projects are to:

  • contribute to service needs and reduce waiting lists, keep patients at home or as close to home as possible and create pathways of integrated care;
  • create a critical mass of RANP/RAMP’s through a developmental pathway for graduate and specialist nurses and midwives;
  • test the capability of the framework to deliver better outcomes e.g. patient outcomes, service integration, staff experience and value for money.

The underpinning principles of the new education model and the significant increase in the number of Advanced Nurse Practitioners are to support the introduction of in integrated model of care by the provision of care within the home, improving hospital avoidance, increasing early discharge, improving access to service and improving patient flow through the health services.