September 2013

 Issue 6 - September 2013

Alyson Smith and Anne Copeland.  

National Registration and Accreditation Scheme 2013 combined meeting: L-R: Alyson Smith (Executive Officer, Nursing and Midwifery, AHPRA ) and Anne Copeland (outgoing inaugural Chair, National Board).

Presiding Member’s message

An important focus for the National Board this quarter is the upcoming review of the first three years of operation of the National Registration and Accreditation Scheme (National Scheme). Evaluations are a constructive way to encourage growth. Once the review is open, we encourage all our stakeholders to put forward their thoughts on improvements to the National Scheme.

We have seen considerable growth in the maturity of the National Board since our inaugural meeting in September 2009, and we will share with you some of our achievements over the past financial year in the 2012/13 annual report when it is released after September 2013.

As part of our commitment to avoid, where possible, any increase that is more than the consumer price index for the registration fee for nurses and midwives, we announced in July 2013 that we are keeping the fee for 2013/14 the same as last year. Read more on the registration fee in the media release on our website.

We continue our efforts to operate more smoothly in our work on registration, notifications, compliance, accreditation and professional standards for nurses, midwives and students of nursing and midwifery. To this end, we carry on the quest to improve our systems and processes, build on our strengths, make connections with our stakeholders and learn from the environment.

In August 2013, the National Board signed a memorandum of understanding (MoU) with the Midwifery Council of New Zealand, recognising there are potential benefits in close collaboration with international partners. More on the MoU signing is covered in this issue.

We also participated in the National Registration and Accreditation Scheme 2013 combined meeting in Melbourne from 29 - 31 August. The purpose of this meeting is to encourage cross-professional learning through shared ideas, innovations and networking. Through dialogue with partners – such the Australian Health Practitioner Regulation Agency (AHPRA), other National Boards, state and territory board and committee members, Health Workforce Australia, Australian Institute of Health and Welfare, Health Professions Accreditation Councils’ Forum and government – we are positioning ourselves to better understand and respond to the wider regulatory and workforce reform agenda.

We are awaiting the Australian Health Workforce Ministerial Council decision on the appointment of the Health Practitioner member for Queensland and the new National Board Chair. Former Chair Anne Copeland completed her term of office as the inaugural Chair of the National Board on 31 August 2013 and, in the interim, I have been elected by the National Board as the Presiding Member.

On behalf of the National Board, I encourage all nurses, midwives and students to stay abreast of the changes and to engage in our public consultations on new and revised registration standards, codes or guidelines by regularly visiting our website.

Dr Lynette Cusack
Registered Nurse
Presiding Member, Nursing and Midwifery Board of Australia

Dr Lynette Cusack, Presiding Member, National Board.

Dr Lynette Cusack, Presiding Member, National Board.

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Registration

Midwifery

Provision extended to 30 June 2015 for eligible midwives

The National Board has published on its website important information relating to the Eligible midwife registration standard.

This follows the Australian Health Workforce Ministerial Council’s (Ministerial Council) approval of an extension from 30 June 2013 to 30 June 2015 of the provision in the Eligible midwife registration standard for an applicant seeking notation as an eligible midwife.

The provision forms part of a requirement for a midwife seeking to meet the Eligible midwife registration standard. It is for a ‘formal undertaking to complete within a period of time, as determined by the National Board, an accredited and approved program of study determined by the National Board to develop midwives’ knowledge and skills in prescribing, or a program that is substantially equivalent to such an approved program of study’.

For more information, please read the National Board’s Media release on the Eligible midwife registration standard.

As part of the strategic workplan for 2013/2014, the National Board will shortly start the review of both the Eligible midwife registration standard and the Registration standard for endorsement for scheduled medicines for midwives.

The review will involve public consultation to seek feedback on any proposed improvements to these registration standards. We encourage you to participate and provide your feedback once the consultation is public under Current consultations on the National Board website.

Professional indemnity insurance for privately practising midwives providing home birth services

The Ministerial Council has extended a transitional provision under section 284 of the National Law to 30 June 2015 for midwives in private practice providing intrapartum care for women who choose to give birth at home.

This means midwives and eligible midwives in private practice who provide services for women in a home birth setting have received an extension to their exemption from requiring professional indemnity insurance (PII) cover for intrapartum care.

However, the requirement remains that these midwives in private practice have professional indemnity insurance arrangements in place for both the antenatal and postpartum periods of a birth.

Read more in the media release on the National Board website.

Nursing and midwifery

Accreditation – role of the National Board, ANMAC and AHPRA

The Australian Nursing and Midwifery Accreditation Council (ANMAC) is the independent Board-appointed authority to deliver the accreditation functions for the nursing and midwifery professions.

In May 2013, the National Board appointed ANMAC as the accreditation authority for nursing and midwifery for a further five years until 30 June 2018. This resulted from a wide-ranging review of ANMAC’s performance as the accrediting authority for nursing and midwifery.

Accreditation functions as defined in the National Law are to:

  • develop accreditation standards and recommend them to the relevant National Board for approval 
  • accredit and monitor education providers and programs of study to ensure that graduates are provided with the knowledge, skills and professional attributes to safely practise the profession in Australia, and 
  • provide advice to National Boards about issues relating to their accreditation functions.

The accreditation function is one of the National Board’s core regulatory and enabling functions. The National Board works in partnership with AHPRA and ANMAC to make sure that an applicant for registration as a nurse and/or midwife is qualified for registration having the knowledge, skills and professional attributes necessary to practise in the respective profession.

ANMAC and the National Board have distinctly separate but complementary functions that are clearly specified under the National Law. For example, the National Law provides that an accreditation authority accredits a program of study and the relevant National Board approves the program of study for the purposes of registration or endorsement.

ANMAC works with the National Board to deliver the specified accreditation functions under a formal agreement with AHPRA.

AHPRA ensures that ANMAC delivers the accreditation function in accordance with the terms of the formal agreement. AHPRA also works in partnership with the National Board to ensure the effective delivery of the accreditation function for nursing and midwifery.

Graduate applications

Students of nursing and midwifery about to graduate will be able to apply online for registration. AHPRA, on behalf of the National Board, will call for online applications later this year from graduates in their final year of a nursing or midwifery approved program of study.

The National Board urges final year nursing and midwifery students to apply for registration four to six weeks before completing their program of study. An email will go out to all on students on the student register, reminding them to apply for registration.

Students can also apply by completing a paper application form.

All applications, online or in hard copy, require applicants to post supporting documents to AHPRA. More information is available under Graduate applications.

Graduates must meet the National Board’s registration requirements and need to be registered as an enrolled nurse, a registered nurse and/or a midwife before practising in the relevant profession. New graduates are eligible to start working as soon as their name is published on the National Board’s national register.

Enrolled nurse to registered nurse applications

Enrolled nurses who are about to complete an approved program of study that will qualify them for registration as a registered nurse can also go online to apply for registration.

Visit the Registration and endorsement section of the National Board’s website for more information.

Registered workforce at a glance

There are 353,189 enrolled nurses, registered nurses and midwives registered with the National Board, according to the June 2013 National Board statistics.

Table - Snapshot of registered workforce: June 2013

Practising

     ACT NSW  NT  QLD  SA  TAS   VIC WA  Not Stated  Grand Total 
Nurse  Enrolled Nurse (EN)  708  13,458  426  11,219  7,826  1,335  19,990  5,019  55  60,096 
Registered Nurse (RN) 4,200 70,826 3,047 47,773  20,788 6,227 62,352 26,940 6,824 248,977 
EN & RN 40 924 44  793 414 29 1,539  378 6 4,167 
Nurse and Midwife  Enrolled Nurse (EN)    4 23   39 
Registered Nurse (RN)  627  9,748  544  6,538  2,328  665  8,426  3,103  227  32,206 
EN & RN            32    44 
Midwife    68  525  49  428  399  15  856  287  67  2,694 
  Sub Total  5,645  95,492  4,110  66,755  31,759  8,271  93,218  35,794  7,179  348,223 

Non-practising

    ACT  NSW  NT  QLD  SA  TAS  VIC  WA  Not Stated  Grand Total 
Nurse  Enrolled Nurse (EN)  15  300  93  63  17  146  56  695 
Registered Nurse (RN)  51  1,303  18  341  188  78  453  241  67  2,740 
EN & RN            16 
Nurse and Midwife  Enrolled Nurse (EN)                 
Registered Nurse (RN)  16  954  10  139  48  23  170  82  17  1,459 
Midwife      20      18  53 
  Sub Total  82  2,585  32  579  305  118  794  384  87  4,966 

The National Board currently recognises four registration types:

  • general registration 
  • limited registration 
  • non-practising registration, and 
  • student registration.

Of these registered health professionals, 4,966 hold non-practising registration. Registrants with this type of registration can continue to retain their nursing or midwifery title without practising their profession during the registration period.

The statistical breakdown within the quarterly registration data shows registrants by state and territory, their age and gender by registration type, and endorsement and notations by state and territory.

The nursing and midwifery registrants comprise:

  • 248,977 registered nurses 
  • 60,096 enrolled nurses 
  • 4,167 registered as both a registered nurse and enrolled nurse 
  • 2,694 midwives, and 
  • 32,289 people registered as both a midwife and either a registered nurse and/or an enrolled nurse.

Providing data that accurately reflects the number of registered nurses and midwives is one of the important benefits of the National Scheme. It has enormous value for nursing and midwifery workforce planning and helps improve access to health services.

Before the advent of the National Scheme, this data could not easily be collated and reported.

Find more on registration data for nurses and midwives in the About section of the National Board’s website.

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Consultations

Registration standard for scheduled medicines endorsement: public consultation

The National Board is inviting all interested parties to give feedback on a public consultation paper on the proposed Registration standard for endorsement of registered nurses and/or midwives to supply and administer scheduled medicines under protocol.

The proposed registration standard expands the existing Registration standard for endorsement for scheduled medicines registered nurses (rural and isolated practice) to:

  • include midwives, and 
  • apply in areas of practice other than rural and isolated practice.

This public consultation closes on 4 November 2013 and is published under Current consultations on the National Board website.

Re-entry to practice: public consultation

The National Board will soon consult publicly on re-entry to practice requirements for individuals who previously held registration as a nurse and/or a midwife in Australia, including those who:

  • are seeking general registration following a lapse in practice of five or more years 
  • have held non-practising registration for five or more years, and are seeking general registration, or 
  • have a sole qualification in mental health nursing or paediatric nursing or disability nursing and no longer hold registration or have held non practising registration for five or more years.

The current Board-approved Recency of practice registration standard annually applies to nurses and midwives when they apply to renew registration. Previously registered nurses and/or midwives in Australia who have not practised in the respective profession for a period of five or more years are required to undergo an individual assessment of their application.

This assessment is based upon the previously registered nurse’s and/or midwife’s:

  • qualifications (includes both undergraduate and postgraduate nursing and/or midwifery studies) 
  • professional practice history, and 
  • length of time away from practising in the profession/s.

The outcome of this assessment determines the re-entry pathway that the nurse and/or the midwife is required to complete.

The National Board consultation will include a proposed revised Re-entry to practice policy, principles for assessing applicants for re-entry to practice and guidelines for supervised practice.

The public consultation will be published under Current consultations on the National Board website.

Review of registration standards

Registration standards, codes and guidelines developed for the onset of the National Scheme by the first ten health professions regulated under the National Scheme are due for review at least every three years.

The National Board is in the process of reviewing common registration standards and profession-specific registration standards for nursing and midwifery.

Common registration standards include:

  • Criminal history registration standard, and 
  • English language skills registration standard.

The National Board’s English language skills registration standard is not due for review until September 2014. However, the National Board is participating in the all National Boards’ review of common, or largely common, registration standards which include the English language skills registration standard and the Criminal history registration standard.

Profession-specific registration standards include:

  • Recency of practice for the nursing profession and the midwifery profession 
  • Continuing professional development for enrolled nurses, registered nurses and nurse practitioners 
  • Continuing professional development for midwives 
  • Professional indemnity insurance arrangements (applicable to all enrolled nurses, registered nurses, nurse practitioners, midwives and eligible midwives except those with non-practising registration).

The reviewed registration standards will go to preliminary consultation for the opportunity to road-test the proposed content. This will help identify any operational impacts, issues or concerns before release for an extended public consultation to inform the review.

Once feedback from the preliminary consultation is analysed, a public consultation paper will be available under Current consultations on the National Board website so you can give your feedback.

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Supplementary news

National Board to fund nursing and midwifery health program in Victoria

The National Board will fund the Nursing and Midwifery Health Program Victoria (NMHPV) for two more years from 1 July 2014 to 30 June 2016.

At its August 2013 meeting, the National Board decided to extend the funding to the NMHPV while it examines best practice in the role of national and international regulators in relation to referral, treatment and rehabilitation programs for regulated health practitioners with a health impairment.

The National Board will work with AHPRA and the other health profession National Boards in the National Scheme to undertake this exploratory study. The process will involve the development of a comprehensive business case followed by a tender process that AHPRA will manage on behalf of the National Board.

The National Board will progressively publish more information on this exploratory study.

See the media release on this funding to the NMHPV.

Midwifery Council of New Zealand signs MoU with National Board

On 30 August 2013, the National Board signed a memorandum of understanding (MoU) with the Midwifery Council of New Zealand, recognising there are potential benefits in close collaboration. This is in the spirit of the Trans-Tasman Mutual Recognition Arrangement, a non-treaty arrangement between the Commonwealth, state and territory governments of Australia and the Government of New Zealand under the Trans-Tasman Mutual Recognition Act 1997.

The MoU formalises a close relationship between the entities in the following areas of collaboration:

  • developing standards for regulating midwives 
  • exchanging professional knowledge to develop these standards 
  • recognising midwives mutually 
  • enabling flexible movement of midwives between Australia and New Zealand, and 
  • facilitating the exchange of registrants’ information within the scope of the respective entities’ legislative powers.

The National Board looks forward to the future and more opportunities to engage in collaborative initiatives and projects with the Midwifery Council of New Zealand. This will help improve the regulation of midwives.

Guidelines on PII arrangements for enrolled nurses, registered nurses and nurse practitioners

The National Board has developed new guidelines on professional indemnity insurance (PII) arrangements for enrolled nurses, registered nurses and nurse practitioners.

Enrolled nurses, registered nurses and nurse practitioners are expected to apply these guidelines in conjunction with the requirements of the Professional indemnity insurance arrangements registration standard.

Under section 129 of the National Law, enrolled nurses, registered nurses and nurse practitioners (endorsed under section 94 of the National Law) must not practise the nursing profession unless they are covered in the conduct of their practice by appropriate professional indemnity insurance (PII) arrangements.

The guidelines are available under Codes and guidelines>Guidelines for registration standards on the National Board website.

Nurse practitioner standards of practice

The National Board will soon publish on its website revised Nurse practitioner standards of practice, formerly known as the National competency standards for the nurse practitioner.

The former Australian Nursing and Midwifery Council first published the National competency standards for the nurse practitioner in 2006. These standards came under National Board ownership on 1 July 2010 at the onset of the National Scheme.

Southern Cross University and the University of Sydney were the two collaborating partners in the Board-funded project that finished in June 2013. They performed an extensive review of the standards for relevance and currency against the contemporary role and scope of practice of nurse practitioners.

The project took into account relevant local and international literature, and the current scope of practice and role of nurse practitioners across Australia.

Project research included a survey of nurse practitioners, interviews with nurse practitioners and consumers and observations of nurse practitioners in practice. Feedback was also integrated from wide-ranging public consultation with National Board stakeholders to inform revisions to the standards.

The standards of practice are the minimum applicable across diverse practice settings and patients or clients for both beginner and experienced nurse practitioners.

The National Board recommends reading the newly revised standards of practice in conjunction with other relevant documentation available under Codes and guidelines on the National Board website, including:

National Board presence at Australian College of Nursing expos

The National Board participated this year in the Australian College of Nursing (ACN) Nursing and Health Expos 2013 (ACN expos) held in Western Australia, Queensland, Victoria and New South Wales.

Established in 1999, the ACN expos are the only event in Australia specifically dedicated to enhancing the profile of nursing as a profession.

By showcasing a wide range of health service providers, education providers, recruitment agencies, specialty nursing groups, health products and services, ACN expos help promote recruitment and retention within the nursing workforce.

The National Board hosted exhibitions at each event, in order to:

  • promote the role and functions of the National Board 
  • engage with nurses and students of nursing on topical issues surrounding the profession, and to inform policy development, and 
  • reinforce Board-approved standards and guidelines.

The following are visitor statistics for the 2013 ACN expos, as sourced from the Australian College of Nursing.

Table 1: Visitor numbers

State  2012 attendance  2013 attendance*  Percentage (2013) 
Western Australia  1,600  1,059  16% 
Queensland  1,800  807  12.2% 
Victoria  5,500  4,221  63.6% 
New South Wales  900  550  8.2% 
Total  9,800  6,637  100% 

*89% of the visitors were women.

Table 2: Visitor ages

Age range  WA  VIC  QLD  NSW  Total 
12-17  7.1%  2.8%  2.5%  13.0%  6.9% 
18-25  33.2%  50.6%  27.8%  23.1%  28.3% 
26-35  20.4%  19.0%  26.6%  28.7%  25.6% 
36-45  17.9%  16.6%  21.5%  13.9%  14.8% 
46-55  18.4% 8.5% 13.9% 13.9% 14.8%
55+  3.1%  2.4%  7.6%  7.4%  5.5% 

The National Board is also participating at the ACN National Nursing Forum from 20-22 October 2013 in Canberra. Visit the ACN website to register and for more details.

Focus on policy, projects and initiatives

The National Board releases a Communiqué each month on its website to inform everyone of the decisions made at the monthly meeting of the National Board. You can also read media releases on important matters on the National Board website.

Between July and September 2013, the National Board released the following communications on its website.

September 2013

August 2013

July 2013

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Page reviewed 18/09/2017