Day 2 - 2019 CNO Summit

1. Implementation of the new Future Standards
14 March 2019: 1145 to 1230
Presenters:
• Andrea Sutcliffe CBE, Chief Executive, Nursing and Midwifery Council;
• Professor Dame Jill Macleod Clark, Independent Chair of the Future Nurse Oversight
Board
• Professor Margaret Rowe, Executive Dean for the School of Health and Society, University
of Salford & Dr Elaine Inglesby Burke CBE, Chief Nurse, Northern Care Alliance, Salford
• Susan Aitkenhead, Director of Nursing – Professional Development, NHS England – Chair
of session;

2. Welcome and Chair’s Introduction
Aims of today’s session:
1. To provide information on the background and context to the new Future
Nurse Standards.
2. To ensure that colleagues are aware of the changes and what will be
required for system awareness and implementation, particularly from a
practice provider perspective.
3. To provide a forum for colleagues to ask questions and be signposted to
information and support.

3. Andrea Sutcliffe CBE, Chief Executive and Registrar : Nursing and Midwifery
Council
• With over 30 years’ experience in health and social care Andrea Sutcliffe CBE joined as the NMC’s
Chief Executive and Registrar in January 2019.
• She joined the NMC from the Care Quality Commission (CQC) where she was the Chief Inspector
of Adult Social Care since October 2013. While there she led on the regulation and inspection of
adult social care including residential and nursing homes and domiciliary care. Andrea was also
responsible for the registration team, supporting all health and care sectors.
• Prior to that she had roles as the Chief Executive at Social Care Institute for Excellence and also
Chief Executive of the Appointments Commission. She was also an Executive Director at the
National Institute for Health and Clinical Excellence for seven years.
• In July 2016, in recognition of her work in social care, Andrea received an Honorary Award of
Doctor of Science from the University of Leeds. She was awarded a CBE for services to adult social
care in the 2018 New Year’s Honours List

4. Implementation of the
future nurse standards
Andrea Sutcliffe CBE
Chief Executive and Registrar
Nursing and Midwifery Council

5. Time for a new strategy for the NMC
• 2015-2020 coming to an end:
• Fitness to practise
• Education programme
• Overseas registration
• First cycle of revalidation
• Nursing Associates
• New approach to engagement and communication with
people who use services, the public and our
professionals and partners

6. Creating the nurse of the future
• We worked with a range of professionals, people
who use services, and the public to:
• Define the knowledge and skills nurse will
need to meet people and service needs
• Raise the ambition for nursing as a profession
• Make “top of licence practice” the norm
• Emphasise person centred approach and
personalised care at all levels

7. Opportunities and benefits
• More generic skills across all fields – to meet the needs of people across the
lifespan with multiple pathologies cared for in any setting
• New standards bring some post registration knowledge and skills into the pre-
registration phase, to deal with increased complexity
• More knowledge and skills in relation to leadership, management, accountability,
political awareness, service improvement and interprofessional working
• The potential to contribute enormously to the objectives of the long term plan for
nursing, provided they are implemented effectively

8. A new type of standard
• Outcome focused: offers greater flexibility in
terms of how programmes are delivered
• Encourage partnership working between
universities and practice placement providers
• Changes to supervision and assessment
standards will allow more placement capacity,
and more creative and diverse placements

9. Great opportunities – not without challenge
• We need to transform our approach to students
• We need to support current staff to prepare for
the changes
• The biggest risk is trying to “shoehorn” the new
standards into the current arrangements – might
not fail, but benefits will be lost

10. And now …
• The new draft midwifery standards are completed
• Public consultation (12 weeks) 12 February 2019 - 9 May 2019
• Please encourage participation - http://www.nmc.org.uk/future-midwife

11. PROFESSOR DAME JILL MACLEOD CLARK DBE,PHD,BSC, RGN,FRCN,FQNI
• Dame Jill qualified as a registered nurse at University College Hospital, London and worked in a
range of acute clinical settings and as a practice nurse before pursuing a clinical academic career.
She is now Emeritus Professor at the University of Southampton where she was previously Dean
of the Faculty of Health Sciences.
• Over the years, Jill has held a number of academic leadership posts and has fulfilled key
professional policy and advisory roles. These include Chair of the UK Council of Deans for Health,
Chair of the NIHR clinical academic awards panel and being a member of consecutive REF panels
for Nursing and Allied Health Professions. Most recently she acted as Lead Advisor to the NMC
for the development of their new Future Nurse education standards.
• Jill is currently Chair of the Future Nurse Oversight Board, charged with overseeing the
implementation of the Future Nurse standards and is a Trustee of the Florence Nightingale
Foundation. She is married with two sons and five grandchildren and is a keen sailor.

12. THE FUTURE
NURSE
STANDARDS
GRASPING THE NETTLE
Meeting Future Needs for
Expert Nursing Care and
Professional Leadership:
Opportunity and Challenge
Professor Dame Jill Macleod Clark
Chair, Future Nurse Oversight Board
Emeritus Professor, University of Southampton

13. Future Nurse: An Ambitious Response to Changing Needs
• ageing population
• increased complexity of care needs
• technology juggernaut
• influence of Dr Me/Google
• challenging long term conditions
• self care requirements
• inequitable access to services
• epidemic of lifestyle related morbidity
= inevitable increase in demand for expert nursing care and leadership

14. Future Nurse: Raising Benchmarks and Shifting Focus
Future Registered Nurses must therefore be equipped to:
• demonstrate high level knowledge and skills and decision making
• act as role models for expert, evidence based nursing care
• provide accountable clinical nursing leadership
• advocate high quality, safe and compassionate care
• respond to mental, physical and cognitive care needs
• work across places of care and health/social care boundaries
• demonstrate political awareness and acumen

15. Future Nurse: Ambition creates Opportunity
Why FN Standards are in the Public and Professional Interest:
• define the essence of future registered nursing practice
• offer transparency, focus and absence of ambiguity
• reflect expectations of proficiency at point of registration
• provide solid foundations for advanced/higher levels of practice
• acknowledge the requirement for post-registration development
• encourage new approaches to practice learning and skills acquisition

16. Future Nurse: Ambition Generates Challenge
The Future Nurse Oversight Board: Ensuring high level engagement in
priority setting and monitoring during implementation
Key national implementation challenges identified to date:
• Achieving profession wide understanding, engagement and sign-up
• Radically transforming the portfolio of practice learning opportunities,
supporting new placements and preparing new supervisors
• Supporting and upskilling existing nursing workforce to meet FN
requirements
• Changing public and other professions’ expectations of future registered
nurses roles and responsibilities

17. Future Nurse: An Opportunity to Recalibrate Expectations
and Gain Professional Buy-In
Generate professional pride and confidence in the INDISPENSABLE role
of the RN – the system would collapse without their roles as:
• pivot and hub of safe and effective nursing care
• leader and supporter of formal and informal nursing team members
• advocate for safe, high quality care
• autonomous practitioner – clinical assessment, intervention and Rx
• supervisor and assessor of students and nursing associates
• key to responding to predicted changes in care delivery demands -
LTP and the need for affordable and sustainable health care services

18. Challenges of Recalibration and Professional Buy In
FN standards designed to prepare students for the rigours of being a
modern registered nurse – therefore have implications for every
existing practising nurse across all care settings who will need to:
• understand the new standards and recalibrate own practice
accordingly
• demonstrate the new proficiencies in all aspects relevant to own area
of practice
• supervise and support future students and unregistered staff
• be personally prepared for the rigours of modern RN practice

19. Future Nurse - An Opportunity to Exercise Leverage
The New Standards provide an unarguable case for additional
resources and infrastructure to:
• develop and upskill existing RN’s at all levels
• identify and prepare a new portfolio of practice learning placements
and prepare all supervisors across a wide range of settings
• transition current student nurses
• develop robust post-graduate advanced practice benchmarks
• Introduce cohesive, benchmarked clinical career pathways
• exploit an attractive hook for recruiting students into a career defined
by leadership at every level

20. Exercising Leverage: THE Leadership Challenge
Confidently arguing the case for urgently securing a stable and motivated
existing RN workforce and a robust pipeline of new graduates means:
• stepping up at a time of overstretched resource and staff shortages
• motivating, supporting and retaining existing registered nurses
• demonstrating professional solidarity and cohesion
• exploiting the arguments around protecting the public’s need for highly
skilled RN’s as leaders of the nursing team and that they are the key to
sustainable health care delivery in the future
• turning anxiety and stress into excitement and enthusiasm

21. Using evidence based messages to strengthen leverage and influence
policy:
• effective nursing care and improved health outcomes depends on RN role
• without RN stewardship, nursing care deteriorates
• retention and motivation of existing RNS depends on personal
development opportunities and recognition
• post-registration funding and support for nurses has been systematically,
dramatically and unfairly eroded – not the case in medicine
• the LTP cannot be delivered with growing and retaining the RN workforce
to ‘maximise the nursing contribution’
• FN standards are here to stay and must be responded to
Grasping the Nettle: Its Now or Never

22. GRASPING THE NETTLE: GROWING POLITICAL MUSCLE
BELIEVE IN THE MESSAGES – YOU ARE PROTECTING THE PUBLIC’S NEEDS FOR AND RIGHTS TO SAFE,
EFFECTIVE, COMPASSIONATE AND HIGH QUALITY NURSING CARE
• create a strong storyline around resource and infrastructure requirements which all senior nurse leaders
sign up to and use to leverage local and national workforce and education funding
• develop a strong alliance with a range of partners eg qni, codh, rcn, nuffield etc
• stick together in order to punch above weight when lobbying DHSC, ministers, lords and ladies, local
workforce boards, trust boards etc etc
• gain the support of the public and MP’s to strengthen the case locally and nationally, using media where
appropriate
• channel negative energy and possible despair into fight and determination to win the case
THE FAILURE OF PREVIOUS GOVERNMENTS TO INVEST IN THE CONTINUING DEVELOPMENT AND
RETENTION OF REGISTERED NURSES IS COMING BACK TO BITE!

23. Margaret Rowe, Executive Dean for the School of
Health & Society, University of Salford
An adult, children and young person’s nurse, professor of
workforce design, and Council of Deans’ representative -
Margaret is highly regarded on the regional, national and
international stage and was the Higher Education national
representative on the NMC Revalidation Strategic Steering
Group.
Margaret is a board member of the Salford Health &
Wellbeing Board, HEE Collaborative Board, a Governor of the
Greater Manchester Mental Health NHS Foundation Trust,
and has worked with Health Education England, national and
regional bodies and the Greater Manchester Combined
Authority.
Margaret brings a wealth of international experience,
including the successful development of new programmes
and partnerships development in a number of countries
including Malaysia, Thailand, China, Egypt and India.
Margaret actively contributes to national and regional
debates and forums on workforce issues, policies, and future
ways of working in Health and Social Care.
Dr Elaine Inglesby Burke CBE Chief Nurse
Northern Care Alliance, Salford
Elaine joined the Salford Royal NHS Foundation Trust as
Executive Director of Nursing in April 2004. Elaine has held
Executive Nurse Director positions since 1996 in both
specialist and large Acute Trust’s. She qualified as a
Registered nurse in 1980 at Warrington District General
Hospital and specialised in critical care and general
medicine.
She has held various clinical positions at ward level and
nurse specialist. Educated to postgraduate degree level
Elaine maintains her professional/clinical development by
regular clinical shifts and executive safety shifts with
frontline staff.
She is a Florence Nightingale Leadership Scholar and took
the opportunity to undertake a women’s leadership
programme for global executives at Harvard University as
well as the Executive Quality Academy at the Institute of
Healthcare Improvement, Boston. She has a strong track
record in professional nursing and operational management.
Salford Royal has now come together with Pennine Acute
Trust and formed the Northern Care Alliance NHS Group.

24. Dr Elaine Inglesby Burke CBE
Chief Nurse, Northern Care Alliance, Salford
Professor Margaret Rowe
Dean of Health & Society, University of Salford

25. Including Chief Nurses, Directors of Nursing across
Greater Manchester from Health and Social Work
• Acute
• Primary
• CCG
• Private
• Local Authority
• Voluntary Sector
Development of a Strategic Advisory Board for the
Future Nurse Curriculum

26. Our Co-Production Journey
• We have developed a Future Nurse
Curriculum Co-Production Strategy
• We have held weekly Curriculum
Development Group meetings where co-
production began with the identified need
for a strategy
• People have come to us, and we have gone
out to people, e.g. Service User and Carer
Committee, meeting clinical staff, LDN&SW
Consultation Event
• We have held drop-in events for wider
academic staff to listen to people’s ideas
O U R
FNC Steering Group
Dean of School, Greater
Manchester Directors of Nursing
Weekly Meetings
Curriculum Development Group
Service users and carers, current students, practice
representatives and academic staff
Workstreams
• IPE
• Practice Learning
• Internationalisation
• Personalised Care
• Simulation
• Safeguarding
• Curriculum Design Teams

27. GM Model for supervision and assessment in practice agreed -
30th NOVEMBER 2018
Communications for the model and transition arrangements developed and shared
across organisations - 31st DECEMBER 2018
Training requirements and a phased approach to delivery agreed through GM PEG
(phase 1 NMC registrants; Phase 2 other registered professionals) must include pre
and post Reg programmes - 31st JANUARY 2019
Staff within all clinical placement areas have been assessed/ trained as meeting the practice
supervisor outcomes and appropriate number of staff upskilled to undertake practice assessor
roles
- 30th SEPTEMBER 2019
The Development of Design Teams to collaborate
on preparation of preparing practice

28. Experience of learning from, within and about key professional and non-
professional’s roles and responsibilities within health and society
Explore how policy
and socio-political
drivers impact on
different
frameworks of
interprofessional
teamwork and their
application for
effective integrated
service delivery
IPE Curriculum Outcomes
Distinguish how
one’s own and
others’
communication
styles, values and
belief systems
impact on people,
teams and
interagency-
working
Distinguish how one’s own and others’ communication styles,
values and belief systems impact on people, teams and
interagency-working

29. How have the new standards given us innovative approaches
• Routes – increasing non-traditional routes into the programme such as
apprenticeships and for Trainee Nursing Associates (TNA)
• Practice learning environments – increasing student empowerment by co-
designing VSCE experiential learning opportunities
• Simulation – increasing opportunities to achieve parity of esteem between
physical and mental care, increased focus on public health, and developing
greater depth of knowledge and proficiency where field specific emphasis is
required

30. • Topol Review 2019 - consideration of embedding NHS Health and Care Digital Capabilities
Framework level 1 at least into the curriculum
• Programme Design - Salutogenic approaches to health and well-being
Generic focus across the lifespan for year 1 and integration of all fields of practice learning
Year 2 and 3 being field specific focus with interprofessional learning threaded through.
• Module Design - Novel, creative approaches that encompass the standards, include all fields of
practice.
IPE threaded throughout the programme and assessed in each year for all fields of practice.
Simulation formally embedded in programme design although some challenges related to field of practice activity.
• Social Prescribing - Recent award from HEE to pilot 2 innovative placements within the third sector.
Opportunities for nursing students to work with those from Human Geography – discovering ways to support
communities combat food poverty.
How have the new standards given us innovative approaches

31. GM Practice Education Group (GMPEG) - a mix of education and practice, developing the definitions and
education standards for the new roles, with the emphasis on GM collaboration and co-creation
Chair of GMPEG for 19/20 within the school of Health & Society, University of Salford
GM group circulated to practice partners a readiness framework
Director of Practice Placements in post
We will be holding a series of workshops to prepare practice staff for the new roles using MSLaiP monies
over the summer
Practice Education Facilitators (PEFs) have contributed to Gateway 2 & 3 providing evidence
Preparing practice for nursing students

32. Questions