Press Release

New Policy on Advanced Nursing and Midwifery Practice Launched by Minister for Health, Simon Harris – Advanced Practitioner roles proven to deliver significant patient benefits – Plan to increase number of Advance Nurse Practitioners from 420 to 750

Minister for Health Simon Harris TD today (Thursday) launched a new model for developing advanced nursing and midwifery practice with the publication of the policy document ‘The Development of Graduate to Advanced Nursing and Midwifery Practice.’ Minister Harris said the nursing and midwifery profession will be critical in implementing the Sláintecare health reform programme and expanding the contribution of advanced practitioners would make a real impact.

Launching the policy, Minister Harris said “In 2017, the first 124 Candidate Advanced Practitioners commenced their education programme as part of the pilot for this policy. Today, between those registered and on the pathway to registration, we have over 420 nurses and midwives practicing at advanced level. The aim now is to have 2% of the nursing and midwifery workforce working as Advanced Practitioners which would see the number increase to 750 approximately.

“It goes without saying that Nursing and Midwifery will be critical in implementing the Sláintecare health reform programme. All the evidence shows that when advance practitioners are located in sufficient numbers in specific areas they can have a real impact on some of the key challenges in the health service. These include the management of long-term conditions, improving patient access to services and reducing waiting times.

“This has already been demonstrated through the pilot scheme of this policy which showed increased capacity in outpatient clinics and reduced admission rates in Emergency Departments for patients with respiratory problems. More than 11,000 patients were seen by candidate Advanced Practitioners in the second half of last year. These results are very encouraging and entirely in line with Sláintecare. The new model goes a long way towards ensuring that care is delivered to the right person, at the right time and in the right place – as close to home as possible. Importantly, it also puts in place a career pathway for nurses and midwives, which is a key element in retaining staff.”

The Chief Nurse in the Department of Health, Dr Siobhan O’Halloran, who has been responsible for developing the policy, said “Upon graduation, an Advanced Nurse Practitioner can provide a full episode of care for a patient; assessing, carrying out an intervention, prescribing medication and discharging. A rheumatology pilot has demonstrated that patients can be seen faster, start their treatment earlier and be discharged earlier, having a positive impact on both the patient, and on waiting lists.

“In another pilot hospital, an Advanced Nurse Practitioner delivering early respiratory specialist care resulted in hospital admissions decreasing from 100% to 22%, with every patient admitted seeing a respiratory consultant within 24 hours.

“Advanced Nurse Practitioners are also delivering services to older people in the community, resulting in a better patient experience and removing the need to present at an emergency department.

“Until now, advance practice numbers in Ireland have been low by international standards. This policy on the Development of Graduate to Advance Nursing and Midwifery Practice seeks to address this by streamlining the process by which a nurse or midwife can practice at advance level.

“We now propose to support the development of graduate to advanced practice with a minimum 2-year timeframe. This reflects current international practice in this area. It also allows nurses and midwives to use the competencies achieved along the way to registration, with the ultimate objective of developing the nursing and midwifery resource in a way that supports patients and service needs.

“The collaboration between the HSE and Department of Health in bringing this policy to fruition is a clear recognition of the importance of the contribution and impact of nursing and midwifery on the health of the population.”

ENDS

Notes to the Editor

Read the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice here.

International evidence identifies the beneficial impact that Advanced Nurse Practitioners have on the health services due to their specialist knowledge, wide scope of qualifications and the ability to provide a complete episode of care.

This policy addresses the way we utilise our skilled and knowledgeable nursing and midwifery workforce by changing the way we educate and train nurses and midwives from graduate to advanced level. The way we recognise skills and education through a process of credentialing and annotation, the creation of a critical mass of advanced practitioners to impact high areas of need and a process to measure the impact and effectiveness of this model.

In 2016, 0.2% of the nursing and midwifery population were registered at advanced level. When developing the policy, the Chief Nurses Office in the Department of Health tested the model having established a steering committee of key stakeholders to oversee the development of selected demonstrator sites.

Over two years 164 additional ANP posts were developed. These posts are in the areas of Chronic Diseases (Respiratory and Rheumatology), Unscheduled Care (Emergency and Acute Medicine) and Older Persons Care. These posts were based in both acute and community settings. Measuring the impact of Advanced Practice was an essential part of this policy development and therefore a minimum dataset was developed. This is the first national standardised data tool to help measure and demonstrate the impact of the direct and indirect Advanced Practice Nursing and Midwifery interventions.