Policy on Graduate, Specialist and Advanced Nursing and Midwifery Programme
The Minister for Health approved the Draft Policy on Graduate, Specialist and Advanced Nursing Practice following national consultation, in March 2017. A National Steering Group was established to oversee the establishment of demonstrator sites for the development of a critical mass of Advanced Nurse Practitioners (ANPs). This draft policy has been tested and implemented across the health system since 2017.
The draft policy was developed following a review of national and international evidence including contributions from professionals in the acute and community health services, academic institutions, policy and senior management.
1. What is the ANP Policy?
This draft policy proposes a framework for graduate, specialist and advanced nursing and midwifery practice that can develop a critical mass of nurses and midwives to address emerging and future service needs including driving integration between services.
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.
In summary, the framework proposes a streamlined, accessible, flexible and enabling pathway that recognises prior learning from graduate level through to advanced practice.
2. Why is the Policy on Graduate, Specialist and Advanced Nursing and Midwifery needed?
A growing body of evidence shows that Advanced Nurse/Midwife Practitioners make a substantial and positive contribution to the management of long-term conditions and that they can improve patient access to services and reduce waiting times, while delivering high quality healthcare.
As senior decision makers, the Advanced Nurse/Midwife Practitioners undertake a comprehensive advanced physical and/or mental health assessment of patients with complex multiple healthcare needs including those in crisis. They can interpret the results of multiple different assessments and investigations to make a diagnosis, and plan and deliver care. As team leaders they can confidently and competently make ethical, evidence based decisions and interventions and use appropriate therapies when faced with complexity and assess and manage the risk associated with these decisions.
In the context of the overall challenges facing the health services it was timely to pilot the development of a critical mass of advanced nurse practitioners, to see if they can contribute to tackling some of the service challenges and address emerging and future service needs including driving integration between services.
3. What are the aims of the Policy on Graduate, Specialist and Advanced Nursing and Midwifery?
The purpose of the draft policy is to contribute to providing a solution to several critical challenges facing the health service including
- Access and choice for patients
- Avoiding unnecessary hospital attendance
- Support early discharge
- Impact on waiting lists
The vision for the development of Advanced Practise Nursing/Midwifery is to support the implementation of the integrated care programmes by the HSE and support the WHO principles.
4. How will the Policy on Graduate, Specialist and Advanced Nursing and Midwifery achieve its aims?
The framework recommended changes to the education pathway, the regulatory pathway and the contribution that the nurse/midwife can make in practice to service provision. The intended outcome of these revisions is to permit the nurse or midwife to develop their capability to work to the maximum of their registration. The policy made recommendations to measure the impact and effectiveness of the new framework towards adoption if successful in achieving the goals of the policy.
5. Current progress of the Policy on Graduate, Specialist and Advanced Nursing and Midwifery
In September 2017 124 Advanced Nurse Practitioner candidates commenced in demonstrator sites throughout the country. Education Programmes were put in place by 4 HEIs and changes to the regulation were made in June 2018.
A further 30 candidates will commence in demonstrator sites in September 2018.
A data collection tool has been devised and commenced with candidates submitting their activity and interventions. An independent evaluation has also been commissioned by the HSE, the activity and interventions captured by the ANP candidates in the demonstrator sites will inform this.
A final report will be prepared for the Minister in December 2019.
Click here to see the Consultation Paper of the Policy on Graduate, Specialist and Advanced Nursing and Midwifery Practice.