modernising nursing careers setting the direction · modernising nursing careers is a springboard...

Modernising nursing careerssetting the direction

Modernising nursing careerssetting the direction

The purpose of this report 3

From the Chief Nursing Officer 4

1. The context of nursing is changing 6

2. Health care is changing 7

3. What will this mean for the way nurses work? 9

4. Nursing and nursing careers today 11

5. Nursing careers for tomorrow 14

6. Towards modern nursing careers: priorities and actions 17

Develop a competent and flexible nursing workforce 18

Update career pathways and career choices 19

Prepare nurses to lead in a changed health care system 20

Modernise the image of nursing and nursing careers 21

Annex 1 Membership of the Modernising Nursing Careers Board 22

Bibliography 23

Modernising nursing careers: setting the direction, 2006 3

No one can doubt that health care services across the UnitedKingdom are going through a period of profound change. Morechange will be needed if we are to continue to provide a healthservice that is free according to need and that keeps the trust andsupport of the public. Wherever they work, nurses will be aware ofhow health care is changing and wondering what it all means fortheir careers.

The four United Kingdom chief nursing officers established themodernising nursing careers initiative in 2005/6. It forms part of anoverarching programme of work covering all the main health careprofessionals. A UK-wide group of nursing leaders formed theModernising Nursing Careers Board, chaired by Christine Beasley,Chief Nursing Officer for England (See Annex 1 for membership).This report is the outcome of their discussions, a series of nationalstakeholder workshops, and the views of nursing colleagues from allparts of the health services across the four countries and includingthe independent sector. The report is for frontline nurses, nurseleaders, education and workforce planners, commissioners andemployers to use locally to develop nursing careers.

The four countries will take forward the actions in this report tomodernise nursing career structures throughout the United Kingdom.

This report sets the direction for modernising nursing careers. Thepriorities focus on the careers of registered nurses, but it is recognisedthat nurses do not work in isolation and nursing teams include morethan registered nurses. Nursing careers also need to take account ofchanges in the careers of other professional groups. Importantly, thisreport recognises that careers take different forms: while some willchoose to climb an upward ladder of increasing responsibility andhigher rewards, many other nurses choose a more lateral careerjourney, moving within and between care groups and settings. Ouractions are for all nurses no matter what the nature of their career.

Nursing careers must respond to the profound changes taking placein the structure of health care delivery and the need for nurses toexercise leadership to bring about change. We hope this report willopen the way for flexible, diverse and rewarding careers for allnurses.

This report is only the beginning. More work will need to be done bymany stakeholders to take forward the priorities and actions set outat the end of this report.

The purpose of this report

Message from Rosemary Kennedy, Chief Nursing Officer, Wales

In common with all other parts of the United Kingdom, the health and social careservices in Wales are overburdened with demand and in need of fundamental changein order to meet the challenges of the 21st Century.

The nursing professions have always very ably demonstrated their willingness and abilityto refresh and reform their practice, develop new opportunities to improve the healthand wellbeing of the communities in which they work, informing and influencingnational and local policy, in full partnership with others. Huge progress has already beenmade, but the required health care reforms we are facing will continue to makedemands on them for the foreseeable future.

Modernising Nursing Careers is a springboard for action, providing a collaborativeenvironment in which to explore challenges in delivering high quality care and to shareexamples of how colleagues across the United Kingdom have addressed and foundsolutions to common problems. The action plan provides strength of unity at a time ofpotential policy divergence.

We must be truly professional in the way we anticipate and respond to the need toradically reconsider who is best placed to deliver care, in what diverse settings and withwhat range of technical support, and work together to ensure that the nursingprofessions remain in a position of strategic importance.

At the same time, we must show a determination to ensure that nurses safeguard theinterests of patients and their families and hold fast to the fundamentals of care that liewithin the nursing domain. Whatever changes lie ahead, this is one principle we mustadhere to.

These are demanding but exciting times and we in Wales look forward to joining withour colleagues across the United Kingdom in rising to the challenges that lie ahead. This work to modernise nursing careers forms an integral part of the wider workforcedevelopment and service modernisation activity, outlined in Designed for Life, which istransforming service delivery, to meet the needs of the people of Wales.

CardiffSeptember 2006

From Christine Beasley, Chair of the Modernising Nursing Careers Board and ChiefNursing Officer, England

“The world of nursing is changing rapidly, patient and user expectations are increasingand health reforms are altering professional roles and how services are delivered. Inthis report, we have looked at what nursing careers need to look like in the future andmake recommendations to ensure a rewarding career for nurses as well as a confident,high quality service for patients and users.

I would like to thank all those people who have contributed to this report and forhelping us take the first step on the journey to modernising nursing careers.”

LondonSeptember 2006


Modernising nursing careers: setting the direction, 20066

1Nursing is changing almost as rapidly as the context in which itis practised. As a dynamic profession, nursing is responsive andis adapting to meet the needs of patients and the public. Acrossthe United Kingdom nurses have taken on new roles, workacross boundaries, and are setting up new services to meetpatients’ needs. Now is the time to take stock, consider whatthese changes mean for nursing careers, and ensure that nursingis fit for the future.

All modern health care systems are facing major global andsocietal changes. A number of factors lie behind governmentpolicies to reform the way the health service works.

l Society in the UK today is more complex, giving rise togreater social, cultural, racial and geographical diversity.

l There are more people in the older age range so long termconditions are more prevalent. As a consequence demand forhealth and social care will continue to rise.

l Major causes of morbidity and mortality such as heartdisease and some cancers can respond well to preventativemeasures, but these frequently require life style changeswhich can be hard to achieve.

l Health is not distributed equally and inequalities continue tobe a major challenge.

l The working population is smaller so fewer people areavailable to enter the profession.

l People’s expectations of health care are changing. They aremore knowledgeable and expect to be treated as partnersand equals, and to have choices and options available tothem.

l Rapid advances in technology mean more effectivetreatments as well as the ability to provide care in differentsettings.

l The cost of new treatments and new information andcommunication technologies means a greater focus on valuefor money.

The context of nursing is changing

The number of people agedover 85 years is projectedto rise by nearly 75% by2025.

Over 15 million people inthe UK currently have along term condition, and asthe number of older peopleis projected to increaseacross the UK by between18% and 23% so thisnumber will increase.

Obesity rates have doubledin the last 10 years andpotentially lead to a rise instrokes, heart attacks andType 2 diabetes. It is esti-mated that 1 in 4 peoplewill be obese by 2010.

Infant mortality rates varyfrom 1.6 per 1000 livebirths in Eastleigh,Hampshire to 9.8 per 1000live births in Birmingham.

Smoking is still the singlegreatest cause of illnessand premature death in theUK, killing at least 86,500people a year and account-ing for a third of all cancersand a seventh of allcardiovascular disease.

Key changes


2Health services in the UK are undergoing unprecedented reformbacked by massive extra investment. This reform programme istransforming the way health care is provided.

The reform programmes across the UK are:

l putting the needs and preferences of patients, users and thepublic, rather than those of professionals, at the forefront ofdecisions about patterns of services

l focusing on integrated care based on individualised pathwaysacross local health economies and social care

l enabling much more choice for individuals

l improving the care of people with long term conditions

l laying greater emphasis on prevention, health promotion andsupporting self-care

l moving more care outside of acute hospitals into thecommunity and people’s homes

l providing incentives for working in new ways.

Health care ischanging

Massive investment in reform

The NHS budget in England has doubled since 1997 and willhave trebled by 2008 when it reaches £93.6 billion.

In Northern Ireland there has been a 35% increase in healthand social care spending over the last three years, with £3.8billion being spent in the current year.

In Scotland the health care budget has increased by 76% since1999 to £8.9 billion.

The health and social services budget in Wales has doubled to£5.1 billion since 1999.

Throughout the UK these reforms are underpinned byconsultations that show what people are looking for from healthservices. They want:

l choice about services

l more care available outside hospital and closer to home

l to take personal responsibility for their own wellbeing and tobe supported in caring for themselves

l better care for those with long term conditions.

While significant improvements have already been made there stillremains much to be done if we are to continue to have a worldclass health care system in a rapidly changing environment.


What patients say about care that is effective and meets theirneeds:

“I am only small, but now I feel tall. Now I can

hold my head up high”

(Now I feel tall, DH 2005)

Some key achievements

Waiting lists are at their lowest since records began.

In Northern Ireland virtually no patient is waitinglonger than 12 months for any treatment.

Throughout the UK 19 out of 20 people at A&E aredealt with within four hours.

Mortality from heart disease across the UK has fallenby 20% and for some cancers by 10%.

9

3The success of the health care reforms depends on thecontribution of nurses: they are responsible for delivering the carethat patients want. Nurses know that if they are to meet patients’needs in a variety of care settings, the values of their professionmust remain.

Wherever nurses work, there are four elements to the nurse’s role.Across the UK these elements link to the core and specificdimensions of the generic NHS Knowledge and Skills Frameworkand so provide a sound structure for future developments.

Nurses will continue to care for people who cannot care forthemselves, support and empower people with long term healthcare problems to care for themselves, and to help people topromote their own health. This will apply to children, youngpeople, adults and older people.

What will thismean for the waynurses work?

Elements for all nurses

Practice

Education, training and development

Quality and service development

Leadership, management and supervision.



Nurses’ roles and responsibilities will continue to change in linewith the health reforms that are improving care for patients. Thenursing workforce will need to:

l organise care around the needs of patients

l ensure patients have a good experience of nursing asreputations of organisations and patient choice will rest on thequality of nursing

l work in a range of settings, crossing hospital and communitycare, and use telemedicine

l have the skills and competencies to care for older people andpeople with long term conditions, who may have bothphysical and mental health needs

l be able to use preventative and health promotioninterventions

l work for diverse employers, and take opportunities for self-employment where appropriate

l have sufficient numbers of nurses with advanced level skills tomeet demand

l work as leaders and members of multidisciplinary teamsinside and outside hospital, and across health and social careteams

l work with new forms of practitioners, for example assistantpractitioners and anaesthesia practitioners

l deliver high productivity and best value for money.

Individual nurses’ stories have been used to illustrate howmodern nursing careers can develop.

Sag trained and worked asan enrolled nurse beforeleaving to work for a bankfor four years. Returning tonursing she worked in careof the elderly then moved tothe community rehabilitationteam. After qualifying as afirst level nurse she movedto the independent sectorfor two years beforereturning to the NHS asward manager. She workedas a nurse consultant thenbecame associate director ofintegrated services and nowmanages 200 staff and abudget of £6.2 million. Herexperience of all parts of thecareer pathway has drivenher ambition to improvepatient care.

Modern nursing career

11

4By taking on new and enhanced roles and responsibilities, nursinghas been instrumental in delivering the improvements in patientcare in recent years. Nurses have already played a vital part inreducing waiting times, making services more accessible andimproving the quality of care.

Since 1997 there has been major investment and change innursing.

l There are 85,305 more nurses in the NHS in England, 4,295more in Scotland and 8,228 more in Wales.

l The number of student nurses in training across the UK hasincreased since 1996.

l Over 18,000 nurses have returned to the NHS in England since1999.

l 50,000 nurses in the UK can prescribe for their patients, withover 7,000 being able to prescribe from the whole BritishNational Formulary.

l New senior clinical roles such as clinical nurse specialists, nurseconsultants, and modern matrons and community matrons inEngland ensure experienced and highly skilled nurses stay closeto patient care.

l The Chief Nursing Officer’s ‘ten key roles’ for nurses in Englandhas given them the legitimacy and authority needed to assumenew responsibilities, like the freedom to admit and dischargepatients.

l Changes in the law enable nurses in primary care to becomepartners in general practices or run nurse-led primary carepractices and the white paper, Our Health, Our Care, Our Say(DH, 2006) signals new options for nurses to beentrepreneurial.

Nursing andnursing careerstoday



l Scotland are developing a set of clinical quality indicators thatwill enable clinical leaders to demonstrate the impact of thenursing team on the delivery of safe and effective care.

l Tools like Essence of Care and Fundamentals of Care have beenintroduced to support nurses caring for patients.

l Over 30,000 nurses in the UK have benefited from leadershipprogrammes since 1997.

l In Scotland a review of the role of the senior charge nurse willassist in the creation of modern charge nurse roles to enablefrontline clinical leaders to maximise their contribution todelivering safe and effective care.

Megan started her career asa care assistant in thecommunity and graduallytook on a small caseload offamilies working with thehealth visitor. During thattime, she gained moreknowledge and skills in thefield. She has recently takenup a new role with thecommunity children’s nursesupporting children withasthma and their families.


Lancia is a nurse clinician with a masters degree. She works aspart of a multiprofessional community nursing team and has acaseload of people with acute and chronic problems. Her focusis to improve holistic care while keeping people out of hospital.She is an independent prescriber and refers direct foradmission and consultant opinion. She is becoming involved incommissioning and in how advanced nursing practice cancontribute to modern health care services.


Craig’s career in psychiatricnursing found himspecialising in the care ofolder people. However, aftera few years he was ready fora new challenge butremained committed toimproving care for olderpeople. The solution? Craigworks part-time as assistantmanager in a care home forolder people and part-timein a drug detoxification unitmainly for young people.


13Modernising nursing careers: setting the direction, 2006

Patricia started her nursing career in mental health, followed bygeneral nursing. She then became involved in HIV and AIDSwork, which took her to Oxford, Los Angeles and Johannesburg.She became interested in end of life care and moved intopalliative care, and now has a role which combines lecturing inthe undergraduate programme with leading the palliative careteam in a district general hospital. She continues to have acombined career linking education with hands-on clinical carewhile maintaining her interest in mental health and uses thoseskills in her work with patients with breathlessness, for examplebrief interventions and cognitive behavioural therapy.



Charlie spent four years inthe army, owned a buildingcompany and ran a marketstall before working as anNHS volunteer. Afterworking as a healthcareassistant he joined the localcadet scheme, went touniversity at 50 years of ageand is now staff nurse on astroke unit. He values theeffective mentoringarrangements that areavailable and his aim is tomake the unit a place ofexcellence for stroke care.

Nursing has been supported in this by radical workforce reformsthat have increased capacity, capability and flexibility andintroduced new roles and freedoms. Working conditions haveimproved to help people achieve a better work-life balance andthrough pay modernisation, Agenda for Change has harmonisedconditions of service and provided a more transparent system ofreward and staff development.

A feature of workforce reform has been the move towards acompetency-based work system to drive service and role redesign.Through Agenda for Change we now have a national NHS careersframework that provides the opportunity to break down traditionaloccupational boundaries, enables greater movement andtransferability of skills and provides better career opportunities forall staff. Key to these changes will be effective mentoringarrangements.

5Nurses are vital to achieving the health care reform programme.We need to make sure that nurses have a career structure whichenables them to work in different care settings, to take onchanged roles and responsibilities, develop a varied mix of skills, topursue education and training when they need it, and to developboth generalist and specialist skills as they require them.

To highlight what will be different in the future we have comparedtraditional nursing careers with those we need to see in the future.

Nursing careersfor tomorrow


Anne started her career in nursing practice and became a wardsister. She moved to a corporate management post to managecomplaints in the acute sector before pursuing an interest intelehealth and information technology with NHS Direct. Thisexperience has taken her along a different path into nationalleadership helping to develop new IT systems for nursing.


Laura was a late entrant to nursing working on a temporarycontact with her local trust for several years whilst her childrenwere young. She then pursued a successful career in nurseteaching and research before establishing a small consultancybusiness. Now looking at retirement Laura has scaled down herbusiness and restarted temporary work with NHS Professionals.



An up-to-date picture of nursing careerscharacterised by opportunity and diversity

Care taking place in and outside hospital with theworkforce moving between. Nurses starting theircareer in the community

A career framework that allows nursing to ‘grow itsown’ with multiple entry points for those taking upnursing as a second career or as mature entrants

Plurality of provision offering alternative employersand employment models including NHS FoundationTrusts, self employment and social enterprises

A flexible principle-based curriculum that is builtaround patient pathways, with a strong academicfoundation and interdisciplinary learning

A framework that supports movement betweencareer pathways, practice, management andeducation, and that values and rewards differentcareer types

Better balance of generalists and specialists toprovide integrated networks of urgent, specialistand continuing care

Careers built around patient pathways usingcompetence as the currency for greater movementand flexibility

A career structure with increased number ofassistants working as part of multidisciplinary teams

Standardisation of advanced level skills

Patient pathway-based careers focusing on nursingroles rather than titles

Nursing roles defined according to patient need – to provide intervention that is timely, accurate andswift

Nursing teams more self-directed and professionallyaccountable

Nurses leading, co-ordinating and commissioningcare, as well as giving care, to bring about changemeasured by health gain and health outcomes

Care based on evidence and critical thinking andassisted by new technology

Coming from Going towards

Nursing careers

Outdated image of nursing careers dominated by media stereotypes

A nursing workforce focused on hospital based care

A single point of entry to nursing

Working for the NHS as a single employer

An education system with a one size fits allapproach, struggling to balance academic andpractical learning and reflective of health care todaynot tomorrow

Linear careers characterised by increasingspecialisation or promotion out of practice with penalties for those stepping off or changing pathway

Increasing specialisation and sub-specialisation

Careers defined by discipline or setting

Career structure with few opportunities forassistants

No standardisation of advanced level skills

Organisation-based careers with a proliferation of titles

Role dictated by title

Nursing teams hierarchically managed

Nurses involved mainly in giving care

Care dictated by custom and practice


These shifts in the direction of travel for modern nursing careerswill promote greater movement and diversity than ever before.People will be able to move between clinical, management andacademic careers and into different organisations and sectors. Anurse in care or service delivery might move between the healthservice (NHS), independent and third sector 1, or increasingly intosocial services, housing and schools. As more services are deliveredin or closer to home, there will be many opportunities for nurses inacute settings to follow patients and work wholly or partiallyoutside hospital. Some nurses will start working in the communityand will spend all or most of their careers there developingeffective models of care.

Careers in education and research might take place in or betweenservice and the university; leadership might take people intodirectorships or chief executive posts; into government,professional or employee organisations as well as regulation. Alltypes of career can lead to social enterprise through self-employment, franchised services or small business operations.

Modernised nursing careers should encourage movement andprogression but also provide rich opportunities for those who wantto stay where they are and to work as locally as possible. Theyshould also support more personalised career paths that meet theneed and aspirations of individuals at different stages in life.

There are already examples of nurses who have developed careersthat reflect the modern career structure that we want to see for allnurses.

1 Includes local community and voluntary groups, registered charities, foundations, and social enterprises and co-operatives.

6Four key priority areas have been identified that need to beaddressed. To create modern nursing careers that are fit for purposewe need to:

l Develop a competent and flexible nursing workforce

l Update career pathways and career choices

l Prepare nurses to lead in a changed health care system

l Modernise the image of nursing and nursing careers.

The Department of Health in England and the devolvedadministrations 2 of Northern Ireland, Scotland and Wales will nowengage stakeholders on these priorities making links to existinginitiatives wherever possible.

Where appropriate actions will be taken forward across the fourcountries. In some instances the action will be country specific.Discussion is underway across the four countries to set out the detailsof implementation for each action.

Towards modernnursing careers:priorities and action

2 These will be refered to as ‘the Health Departments’ in the priorities and action.



Action

The Health Departments will work with others to explore whether changes are neededto the content and level of the pre-registration programme. Initially we will scope thechanges that have already been made to support new patterns of care, and flexiblecareers.

The Health Departments will work with stakeholders to map nursing roles andcompetencies to the national NHS careers framework with proposals for acompetency passport scheme.

The Health Departments will work with stakeholders to review the career pathwaysand educational preparation required for specialist and advanced roles.

These are major pieces of work so more detailed information on process andtimescales will be published in 2006/7.

Priority: Develop a competent and flexible nursingworkforce

Rationale: Nurses should be prepared for different patterns of care, inparticular, caring for older people, working with the whole family,meeting mental health needs, supporting self care, rehabilitation,integration across the health and social care system and workingoutside hospitals. They need to be competent to deliver high standardsof nursing care as well as new and advanced clinical interventions.They need to be able to provide high quality services and value formoney. Pre- and post-registration learning needs should therefore beplanned and funded to take account of patient needs and the changesidentified in this report.

Nurses will take responsibility for care co-ordination, standards of careand leading the nursing workforce as part of multidisciplinary teams.

There will be a need to manage changes in supply and demand and toplan for advanced level and specialist roles, balancing local provisionand access with plurality, diversity and choice. Investment in ‘growing’senior and advanced nurses from within the existing workforce will beimportant.

We also need to address the current inflexibilities and barriers innursing that get in the way of integrated care for patients, restrict theability to redeploy resources to shortage areas and limit careeropportunities for staff. These currently exist between the branches,different parts of the register, education, research and service, and thepublic and independent sector.

Nurses also need a sense of identity and confidence in their specificcontribution to multidisciplinary teams. Pre- and post-registrationeducation will need to increase the flexibility and responsiveness of thenursing workforce to health service changes.


Priority: Update career pathways and career choices

Rationale: Nursing careers in the future will be shaped by the needsof patients and clients. They will encompass the wide range of newand advanced roles, clarify the contribution of specialist andgeneralist roles and show how they fit with the wider workforce.Nursing careers in the community are a priority area fordevelopment.

Nurses should all feel confident to work with a wider range ofproviders and new organisational models. Careers will need to takeaccount of the global nature of the nursing workforce. Renewedeffort will be needed to ensure a critical mass of high qualityeducators supporting academic and practical learning.

Action

The Health Departments will work with key stakeholdersto review the career pathways and educationalpreparation required for nursing in the community,focusing on public health, long term conditions and acutecare 3. This will include supporting acute nurses to followservices from hospital to community 4, and in Scotlandreviewing nursing in the community.

The Health Departments will initiate a review of educatorroles and career paths spanning service and education.More detailed information on the scope and timing toemerge 2006/7. It will draw on the UK Clinical ResearchCollaborative work on clinical academic careers andrecommendations from the Strategic Learning andResearch Advisory Group (StLaR).

Tools to support career choices, such as career navigationaids, will be produced 5.

The UK chief nursing officers will work with the new andexisting independent sector providers on supportingmodern careers for nurses.

3 This includes first contact care.4 This work will be taken forward in England in partnership with NHS Employers.5 This will be taken forward in England with NHS Careers.


Priority: Prepare nurses to lead in a changed health caresystem

Rationale: Nurse leaders of the future will need to deliver ever-improving quality and productivity and have business andentrepreneurial skills. Nurses need to have greater confidence toengage in strategic decision-making and business issues and toachieve the maximum gain from nursing skills and better healthoutcomes for the public. If frontline leaders, including modernmatrons and nurse consultants, have these skills it will buildleadership capacity and provide this group of nurses with alternativecareer options.

Nurses will play a central role in patient choice and developing aquality driven service. This is an area where nursing is already activebut where we need to be pro-active to ensure there is leadershipdevelopment in this area. Nurturing ability, fast tracking and careerdevelopment opportunities for key leaders at board level will beimportant.

Nurses will also continue to lead ever-changing skill mixed teams.They will need to know how to maximise the contribution ofindividuals and the team so that they are patient focused and qualityorientated.

Developing leaders in education and research will need to overcomethe current divisions between service based and academic careers,with their separate career paths and employment arrangements.

Action

The Health Departments will work with key stakeholdersto provide information for the profession on the nursingresponsibilities of leading and co-ordinating care.

The Health Departments will work with stakeholders tonurture ability and develop fast track schemes for futurenurse leaders.

Work on these actions will commence in 2006/7.


Action

The Health Departments will work with stakeholders toagree and communicate key messages about nursingand nursing careers 6, including information for thepublic on ‘what nurses can do these days’. To beavailable by early 2007.

Priority: Modernise the image of nursing and nursingcareers

Rationale: We need to attract the best and most suitable peopleinto nursing, promote a more accurate view of what nursinginvolves and reflect the different motivations and career choices oftoday. Nurses should be encouraged to consider a wider range ofemployment options for their career in health. Everyone in theprofession needs to promote a public image that reflects theconstant values of nursing with its caring role, along withopportunities for the complex and varied roles of nursing today.

6 This work will be taken forward in England with NHS Careers.


Annex 1 Membership of the Modernising NursingCareers Board

Professor Christine Beasley, Chief Nursing Officer, Department of Health, England (Chair)

Gail Adams, Head of Nursing, UNISON

Obi Amadi, Lead Professional Officer, Amicus (CPHVA)

Sir Jonathan Asbridge, President, Nursing and Midwifery Council (until July 2006)

Dr Neil Brimblecombe, Director of Mental Health Nursing, Department of Health

Professor Tony Butterworth CBE, Professional Advisor on Nursing and Professions, NHS Employers

Guy Cross, Account Manager Workforce Directorate, Department of Health

Kathy Fodey, Nursing Officer, Department of Health, Social Services and Public Safety, Northern Ireland

Nic Greenfield, Acting Director of Workforce, Department of Health

Karen Lockhart, Nursing Officer Education and Regulation, Scottish Executive Health Department

Paul Loveland, Head of Education Training and Development, Department of Health

Professor Dame Jill Macleod Clark, Deputy Dean of the Faculty of Medicine, Health and Life Sciences, Head of School of Nursing and Midwifery, University of Southampton, and Chair, Council of Deans and Heads of UK University Faculties for Nursing and Health Professionals

Ros Moore, Professional Officer Acute Care Nursing and Research, Department of Health

Maureen Morgan, Professional Officer Policy and Practice, Department of Health

Jane Naish, Policy Advisor, Royal College of Nursing

Chris Pearson, Director of Development, Skills for Health

Catherine Powell, Nurse Advisor, Department for Education and Skills

Deborah Sturdy, Nursing Advisor Older People, Department of Health

Noel Scanlon, Director of Nursing, East and North Hertfordshire NHS Trust, and Nurse Directors Association

Janice Sigsworth, Deputy Chief Nursing Officer, Department of Health

Louise Silverton, Deputy General Secretary, Royal College of Midwives

Robert Tunmore, Nursing Officer Communications, Department of Health

Professor Graham Wilcox, Professor of Clinical Geratology, University of Oxford

Sula Wilshire, Director of Quality and Professional Development, Oxford City Primary Care Trust

Jean White, Nursing Officer, Welsh Assembly Government


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Scottish Executive Health Department (still tobe published). Delivering Care, DeliveringHealth (Working Title).

Scottish Executive Health Department (still tobe published). Review of Nursing in theCommunity (Working Title).

Policy documents relating to WalesNational Assembly for Wales (1999) Realisingthe Potential: A strategic framework fornursing, midwifery and health visiting inWales into the 21st Century. Cardiff: NAfW.

National Assembly for Wales (2000) Realisingthe Potential Briefing Paper 1: Creating thePotential - A plan for education. Cardiff:NAfW.

National Assembly for Wales (2001) Realisingthe Potential Briefing Paper 2: Aspiration,Action, Achievement – A framework forrealising the potential of mental healthnursing in Wales. Cardiff: NAfW.

National Assembly for Wales (2002) Realisingthe Potential Briefing Paper 3: Inclusion,Partnership and Innovation – A frameworkfor realising the potential of learningdisability nursing in Wales. Cardiff: NAfW.

National Assembly for Wales (2002) Realisingthe Potential Briefing Paper 4: Delivering theFuture: A framework for realising thepotential of midwives in Wales. Cardiff:NAfW.

National Assembly for Wales (2002) Realisingthe Potential Briefing Paper 5: Principles toPractice: A framework for realising thepotential of child and adolescent mentalhealth nursing in Wales. Cardiff: NAfW.

National Assembly for Wales (2004) Realisingthe Potential Briefing Paper 6: Achieving thePotential through Research andDevelopment: A framework for realising thepotential through research and developmentin Wales. Cardiff: NAfW.

National Assembly for Wales (2004) Realisingthe Potential Briefing Paper 7: Nurturing theFuture: A framework for realising thepotential of children’s nurses in Wales.Cardiff: NAfW.

National Assembly for Wales (2001)Improving Health in Wales: A Plan for theNHS and its partners. Cardiff: NAfW.

National Assembly for Wales (2002)Informing Healthcare Cardiff: NAfW.

National Assembly for Wales (2003) Wales: Abetter country. Cardiff: NAfW.

National Assembly for Wales (2005)Designed for Life. Cardiff: NAfW.

© Crown copyrightProduced for the National Assembly of WalesChlorine free paper

The text of this document may bereproduced without formal permission orcharge for personal or in-house use.

First published September 2006

Further copies of this document are availablefrom:Stephen Barry, Business Unit ManagerOffice of the Chief Nursing Officer Welsh Assembly GovernmentCathay’s ParkCardiff CF10 3NQTelephone: 029 20823328Email: [email protected]

This publication is available at:www.wales.gov.uk

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