EDUCATION MATTERS
Working in partnership: the need for candour and transparency Karen Elcock
62
completed, universities just need to update this evidence as and when changes occur, making life easier in the future. This evidence will be scrutinised along with the annual selfmonitoring report that each university submits at the beginning of December and for the majority of the universities this will be all that is required for the academic year. However, some universities (16 this year) will have a 2-day visit, based on an assessment of risk and a rolling selection programme. For both the CQC and the NMC the focus is now on a proportionate risk-based approach to quality assurance; this means that they will be targeting those organisations where risks are either anticipated or known, and for universities the key risk areas will include placement providers. So what are the implications? Evidence of partnership working has always been an important element of NMC reviews, but now far greater candour and transparency will be needed between placement providers and their university(ies). The NMC expects that a university will have: ‘Access to practice placement governance and risk policies and processes (e.g. risk assessment, accident and incident reporting, serious events reviews, major incident and Patient Advice and Liaison Service (PALS) systems.)’ (NMC, 2013, annexe 2) This will mean that placement providers will need to share information regarding CQC visits and their outcomes with their university and also inform them about any other areas of risk identified through their local monitoring processes. Where risks have been identified, the university will be expected to work in partnership with the placement provider to develop action plans that will protect students, patients and carers, and monitor the progress of these action plans. Where the university and placement provider deem it necessary, students may need to be reallocated to other areas and the placement re-audited again before use. Alongside this, the NMC expects the
university to notify it of any risks that are identified as and when they occur, as well as informing them as part of the annual monitoring report. It is still unclear what level of risk is deemed notifiable by the NMC, which could mean that the NMC becomes overwhelmed by notifications as universities exercise caution and report everything. Depending on the degree of risk and how well the university and placement provider have communicated the risk and their response to it, the NMC may judge that the risk is being well-managed and no further action is required on their part. Alternatively, they may require further information or decide that they need to be involved in discussions with the relevant organisations involved; or, where the risk is deemed not to be well-managed, that a major incident review is required. Should the NMC be informed of risks at a placement provider that the university has not alerted them to, then they could instigate an unplanned monitoring review. No one likes to admit that a service they are providing is not meeting the expected level of quality. However, this expectation of the NMC is in line with recommendations in the Francis Report for a new ‘duty of candour’ (Francis, 2014: 104) and provides universities and placement providers with the opportunity to develop stronger partnerships. Working together will enhance the quality of care for patients and the quality of the practice learning environment for students. Both will result in developing a future workforce that will have benefited from high-quality clinical learning experiences, which will inform their BJN future practice. Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry Executive summary. http:// www.midstaffspublicinquiry.com/report (accessed 16 December 2013) Nursing and Midwifery Council (2013) The Quality assurance framework for nursing and midwifery education and local supervising authorities for midwifery. http:// tinyurl.com/qzhzrcu (accessed 16 December 2013)
Karen Elcock Head of Programmes – Pre-registration Nursing and Deputy Head of School, Kingston University and St George’s, University of London
© 2014 MA Healthcare Ltd
H
ealth care, and nursing in particular, has never been under such scrutiny as it is at the moment. In September two key organisations charged with quality monitoring, the Care Quality Commission (CQC) and the Nursing and Midwifery Council (NMC) implemented new approaches to quality assurance. While the CQC is practice-focused, the new NMC quality framework (NMC, 2013) now has a far greater emphasis on placement providers than it has in the past. Unsurprisingly, the events at Mid Staffordshire have had a significant influence in the changes made by both these organisations, both having been on the receiving end of some criticisms in the Francis Report (2013). One of the responses by the NMC is to develop new data-sharing protocols with the CQC, the General Medical Council (GMC) and other healthcare regulators over the next year to enable better identification of risks. Once identified these risks will influence which organisations they decide to review as part of their annual quality assurance visits. The NMC’s new quality assurance framework took onboard feedback from a range of organisations including universities, which highlighted the fact that there was significant repetition in the plethora of quality monitoring process that they are subject to. Universities are quality-monitored annually by the NMC, by NHS commissioners and internal university quality systems, and every 4-6 years by the Quality Assurance Agency. All of these look at many of the same areas, although invariably asking for data to be supplied in a slightly different way. While the NMC will still need to assure themselves of the quality of the educational delivery of programmes in the university, they have recognised that the processes that the universities are already subject to cover much of this. As a consequence, between September and November 2013, universities across the UK were required to upload evidence into a new portal to demonstrate that they are compliant with the NMC standards, a lengthy and timeconsuming activity. However, having been
British Journal of Nursing, 2014, Vol 23, No 1
British Journal of Nursing. Downloaded from magonlinelibrary.com by 193.061.135.112 on November 24, 2015. For personal use only. No other uses without permission. . All rights reserved.
Working in partnership: the need for candour and transparency Karen Elcock
62
completed, universities just need to update this evidence as and when changes occur, making life easier in the future. This evidence will be scrutinised along with the annual selfmonitoring report that each university submits at the beginning of December and for the majority of the universities this will be all that is required for the academic year. However, some universities (16 this year) will have a 2-day visit, based on an assessment of risk and a rolling selection programme. For both the CQC and the NMC the focus is now on a proportionate risk-based approach to quality assurance; this means that they will be targeting those organisations where risks are either anticipated or known, and for universities the key risk areas will include placement providers. So what are the implications? Evidence of partnership working has always been an important element of NMC reviews, but now far greater candour and transparency will be needed between placement providers and their university(ies). The NMC expects that a university will have: ‘Access to practice placement governance and risk policies and processes (e.g. risk assessment, accident and incident reporting, serious events reviews, major incident and Patient Advice and Liaison Service (PALS) systems.)’ (NMC, 2013, annexe 2) This will mean that placement providers will need to share information regarding CQC visits and their outcomes with their university and also inform them about any other areas of risk identified through their local monitoring processes. Where risks have been identified, the university will be expected to work in partnership with the placement provider to develop action plans that will protect students, patients and carers, and monitor the progress of these action plans. Where the university and placement provider deem it necessary, students may need to be reallocated to other areas and the placement re-audited again before use. Alongside this, the NMC expects the
university to notify it of any risks that are identified as and when they occur, as well as informing them as part of the annual monitoring report. It is still unclear what level of risk is deemed notifiable by the NMC, which could mean that the NMC becomes overwhelmed by notifications as universities exercise caution and report everything. Depending on the degree of risk and how well the university and placement provider have communicated the risk and their response to it, the NMC may judge that the risk is being well-managed and no further action is required on their part. Alternatively, they may require further information or decide that they need to be involved in discussions with the relevant organisations involved; or, where the risk is deemed not to be well-managed, that a major incident review is required. Should the NMC be informed of risks at a placement provider that the university has not alerted them to, then they could instigate an unplanned monitoring review. No one likes to admit that a service they are providing is not meeting the expected level of quality. However, this expectation of the NMC is in line with recommendations in the Francis Report for a new ‘duty of candour’ (Francis, 2014: 104) and provides universities and placement providers with the opportunity to develop stronger partnerships. Working together will enhance the quality of care for patients and the quality of the practice learning environment for students. Both will result in developing a future workforce that will have benefited from high-quality clinical learning experiences, which will inform their BJN future practice. Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry Executive summary. http:// www.midstaffspublicinquiry.com/report (accessed 16 December 2013) Nursing and Midwifery Council (2013) The Quality assurance framework for nursing and midwifery education and local supervising authorities for midwifery. http:// tinyurl.com/qzhzrcu (accessed 16 December 2013)
Karen Elcock Head of Programmes – Pre-registration Nursing and Deputy Head of School, Kingston University and St George’s, University of London
© 2014 MA Healthcare Ltd
H
ealth care, and nursing in particular, has never been under such scrutiny as it is at the moment. In September two key organisations charged with quality monitoring, the Care Quality Commission (CQC) and the Nursing and Midwifery Council (NMC) implemented new approaches to quality assurance. While the CQC is practice-focused, the new NMC quality framework (NMC, 2013) now has a far greater emphasis on placement providers than it has in the past. Unsurprisingly, the events at Mid Staffordshire have had a significant influence in the changes made by both these organisations, both having been on the receiving end of some criticisms in the Francis Report (2013). One of the responses by the NMC is to develop new data-sharing protocols with the CQC, the General Medical Council (GMC) and other healthcare regulators over the next year to enable better identification of risks. Once identified these risks will influence which organisations they decide to review as part of their annual quality assurance visits. The NMC’s new quality assurance framework took onboard feedback from a range of organisations including universities, which highlighted the fact that there was significant repetition in the plethora of quality monitoring process that they are subject to. Universities are quality-monitored annually by the NMC, by NHS commissioners and internal university quality systems, and every 4-6 years by the Quality Assurance Agency. All of these look at many of the same areas, although invariably asking for data to be supplied in a slightly different way. While the NMC will still need to assure themselves of the quality of the educational delivery of programmes in the university, they have recognised that the processes that the universities are already subject to cover much of this. As a consequence, between September and November 2013, universities across the UK were required to upload evidence into a new portal to demonstrate that they are compliant with the NMC standards, a lengthy and timeconsuming activity. However, having been
British Journal of Nursing, 2014, Vol 23, No 1
British Journal of Nursing. Downloaded from magonlinelibrary.com by 193.061.135.112 on November 24, 2015. For personal use only. No other uses without permission. . All rights reserved.
