Shape of Caring Review
Raising the Bar: Shape of Caring – A Review of the Future Education and Training of Registered Nurses and Care Assistants
Health & Social Care
Independent review commissioned by Health Education England and the NMC examining the future education and training of registered nurses and care assistants in England. Made 34 recommendations across eight themes.
34recommendations
34Not Yet Responded
Government Response
HEE accepted the recommendations and committed to implementation; the Care Certificate was developed as a direct outcome.
Recommendations
Recommendation 1
HEE should commission research to identify the forms of patient and public involvement that best support learning, and to ensure that patients and the public are utilised as a valuable resource.
Recommendation 10
Following implementation of recommendation nine, a standardised portfolio skills passport should be developed for nurses.
Recommendation 11
HEE should maximise existing collaboration opportunities and use funding levers to support HEIs that are willing to become centres of excellence. Care assistants should be offered APEL that could account for up to 50 per cent of the undergraduate nursing degree.
Recommendation 12
HEE, in collaboration with employers and HEIs, should support the development of more innovative work-based learning routes. Those learning routes should be standardised to allow care assistants to move easily into the nursing profession without having to give up their employment, as they study and train for their nursing degree and registered nurse status.
Recommendation 13
NMC should gather evidence, explore and consult on the proposed 2+1+1 year model, alongside other alternatives, to examine whether the existing 'four fields' model is fit for the future.
Recommendation 14
NMC should explore and consult on the introduction of additional fields of practice such as community nursing.
Recommendation 15
HEE should expect its LETBs to explore a model of guaranteed employment for nursing graduates that includes robust preceptorship.
Recommendation 16
Universities, RCN, HEE and NMC should work together to bring forward into pre-registration education and preceptorship the advanced skills that will support the delivery of future patient care.
Recommendation 17
NMC should review its current mentorship model and standards, informed by the outcome of the RCN review and final evaluation of the Collaborative Learning in Practice model, and amend the standards relating to the requirement for one-to-one mentor support.
Recommendation 18
Without duplicating existing data collections the NMC, in conjunction with HEE, should develop an annual undergraduate student nursing survey, with the results used to inform local and national improvement in both care practice and education delivery.
Recommendation 19
NMC should explore the development of a national assessment framework.
Recommendation 2
NMC and HEE must incorporate the findings of recommendation one into future standard and quality assurance processes.
Recommendation 20
Universities, employers, regulators, professional bodies and commissioners should work together to build on the existing preceptorship standards in order to explore the development and implementation of a year-long preceptorship programme for newly qualified registered nurses, which will meet requirements for revalidation.
Recommendation 21
HEE should undertake an evidence review to identify the educational attainment of the current qualified workforce, to provide a baseline in order to develop appropriate and effective learning standards and raise the bar across the workforce.
Recommendation 22
HEE should set the standards and selectively commission from other organisations with the ability to accredit and deliver ongoing learning, including authorisation to permit LETBs to recognise and commission HEIs as centres of excellence.
Recommendation 23
HEE should develop and consult on the integrated 'pillars' model of self-care, shared managed care and restorative care, and commission appropriate organisations to develop a career framework (in conjunction with the other three nations).
Recommendation 24
HEE should consult and explore the membership and fellowship model. Then allow (as part of the career framework model) appropriate expert organisations, in partnership with HEIs where appropriate, to develop clinical membership and fellowship standards, where members would be following an awarded postgraduate pathway/programme. The member would be responsible for renewing their registration with NMC through revalidation. Any member who is peer reviewed can be appointed a fellow. These fellows will also be responsible for developing education and training programmes.
Recommendation 25
HEE should ensure that funding arrangements for ongoing learning (and ongoing learning and career pathway qualification in speciality learning) for registered nurses should be made more transparent across the system.
Recommendation 26
HEE should forge greater links with the Academic Health Science Networks (AHSNs) to ensure that the workforce is able to adopt and use the latest research to inform and provide better patient care.
Recommendation 27
HEE should accredit Academic Health Science Networks (AHSNs) and Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) to work with LETBs.
Recommendation 28
There should be greater development of postgraduate doctoral centres in LETB areas to drive up clinical research in practice and increase the number of academics in practice.
Recommendation 29
HEE should establish an expert group to examine the potential and implications of developing and implementing Magnet principles to improve the education of the workforce and patient outcomes.
Recommendation 3
HEE should evaluate the impact of the Care Certificate on care outcomes and patient experience.
Recommendation 30
HEE should review current commissioning and funding mechanisms to explore whether a more multi-professional skill mix/population-based approach should be taken forward for education and training.
Recommendation 31
HEE should ensure that the funding for ongoing learning (and ongoing learning and career pathway qualifications in speciality learning) for care assistants and nurses becomes more transparent across the system.
Recommendation 32
HEE should work closely with the voluntary and independent sectors, and local government, and seek lay input to provide more integrated education and workforce planning across the system.
Recommendation 33
HEE, working with HEIs, should support the development of a standardised student minimum data set, which would enable the calculation of attrition rates at HEI, local and national levels.
Recommendation 34
HEE should work with HEIs to develop a standardised exit tool to explore in greater depth the causes for leaving the pre-registration programme. Such data should be reviewed and analysed urgently by HEE to inform future student nurse commissioning intentions and processes.
Recommendation 4
Subject to the outcome of recommendation three, any future government should ensure that the Care Certificate is a mandatory requirement.
Recommendation 5
HEE should implement the Higher Care Certificate.
Recommendation 6
HEE should set the competency standards for care assistants (NHS bands 1-4) in both health and social care, and work with employers to ensure the workforce is trained to meet those standards.
Recommendation 7
NHS England should agree titles and job descriptions that align with HEE's development of a career and education framework for care assistants, as part of HEE's Talent for Care strategy for developing the health and social care support workforce.
Recommendation 8
HEE should explore with others the need to develop a defined care role (NHS Agenda for Change band 3) that would act as a bridge between the unregulated care assistant workforce and the registered nursing workforce.
Recommendation 9
HEE should work with the care sector to develop or use an existing e-portfolio tool that will allow signed-off competencies to be recorded electronically on a national database for care assistants, across both the health and social care sectors. All competencies held within the database will be achieved at nationally accepted standards (which are quality assured on a regular basis) so that they are truly transferable and accepted by all health and social care organisations; reducing the duplication of unnecessary education and training.