Willis Commission on Nursing 2012
Quality with Compassion: The Future of Nursing Education
Health & Social Care
Independent commission examining whether the graduate nurse programme was delivering compassionate care and what changes were needed to nursing education. Made 30 recommendations calling for urgent action to equip the profession.
29recommendations
29Not Yet Responded
Recommendations
Recommendation 1
Evidence of the positive impact of registered nurses on patient outcomes must be utilised by healthcare providers in planning the nursing skill mix.
Recommendation 10
A national clinical-academic career structure should be established, to ensure time and opportunity to teach in care delivery settings as well as the classroom, support engagement in research focused on improving care, and ensure education is patient-centred. Incentives should be introduced for establishing joint university-healthcare provider roles.
Recommendation 11
Greater investment is needed to strengthen the evidence base of pre-registration education. High quality research should be commissioned through collaborative partnerships between universities that also engage service users and healthcare providers in systematic and rigorous evaluation to establish how education works well, where and for whom, and leads to the desired outcomes.
Recommendation 12
The quality of many practice learning experiences urgently needs improvement. Learning to care in real-life settings lies at the heart of patient-centred education and learning to be a nurse.
Recommendation 13
The NMC standards must be fully implemented through active partnerships between NHS education and training boards at national and local levels, employers and universities, to ensure the quality of nursing education, and use and share existing tools and standards.
Recommendation 14
Managers, mentors, practice education facilitators and academic staff must work together to help students relate theory to practice. Close, effective collaboration between universities and practice settings should be enhanced through joint appointments.
Recommendation 15
Employers and universities must together identify positive practice environments in a wide range of settings. Many more placements must be made available in community settings, including general practice. The absence of funding to HEIs to support nursing students' practical learning experiences must be addressed.
Recommendation 16
Employers must ensure mentors have dedicated time for mentorship, while universities should play their full part in training and updating mentors. Mentors must be selected for their knowledge, skills and motivation; adequately prepared; well supported; and valued, with a recognised status.
Recommendation 17
Practical learning must be underpinned with relevant knowledge from clinical and social science disciplines. All students should be aware of the growing evidence base on good nursing practice. Graduate nurses, as future leaders of clinical teams, should understand how to evaluate, utilise and conduct research, and act on evidence to improve the quality of care.
Recommendation 18
A national nursing career framework must be implemented urgently by all partners and properly resourced. It should be based on the four governments' existing policies of building career frameworks and pathways that support movement between, and synthesis of, practice, management, education and research; that value and reward different career paths; and that attract and retain high quality recruits.
Recommendation 19
Employers, universities, regulatory bodies and royal colleges should recognise, fund, promote and support nurses' continuing professional development at appropriate and equitable levels as an investment for the future.
Recommendation 2
Employers must make use of the enhanced skills of the emerging graduate nursing workforce, as an opportunity to drive up standards and provide effective leadership and supervision of the clinical nursing workforce.
Recommendation 20
The NMC requirement that newly qualified nurses undergo a post-qualification 'preceptorship' period of consolidation must be fully implemented to promote safe, high quality care.
Recommendation 21
Interprofessional learning must play a key role in continuing professional development. Training professionals in teams must also have a much stronger focus in pre-registration nursing education.
Recommendation 22
The NMC standards on patient and public involvement in pre-registration nursing education must be fully implemented, as a vital step in putting the experiences of patients and the public at the heart of nursing education.
Recommendation 23
Local education and training boards (and their equivalents), healthcare providers and universities should jointly deliver a comprehensive, strategic and transparent approach to patient and public involvement in pre-registration nursing education. It should encompass training and rewards for service users and carers, and development for academic and clinical staff so they can work with service users in a meaningful way.
Recommendation 24
Healthcare providers must actively promote and support patient and public involvement in nursing education through their patient experience strategies, education strategies and board-level quality assurance processes.
Recommendation 25
The regulation and inspection of the many organizations and settings where nursing education is delivered should be streamlined and better integrated to increase effectiveness and reduce the heavy audit burden. Healthcare and education regulators should work in close partnership, and take full heed of each other's findings. Their processes should be streamlined and duplication reduced.
Recommendation 26
The culture of healthcare provider organizations should be routinely assessed, building on ongoing work to develop and standardise a 'cultural barometer' that will help their boards ensure that practice settings are suitable learning environments.
Recommendation 27
Pre and post-registration nursing education must have equitable access to resources through introducing a level playing field and fair funding mechanisms to end the wide disparities between the overall funding of different health professions' education. Sustainable funding is essential to ensure effective mentorship and support placements in community settings.
Recommendation 28
A long-term, sustainable funding model should be developed across the UK to support the education and training of future nurses, including adequate financial support for students and bursaries to support mature students.
Recommendation 29
The four UK governments should include pre-registration nursing programmes in future allocations of the service increment for teaching (SIFT) and its equivalents. This is vital to improve the quality of nursing students' practical learning experiences, especially in community settings where many will work in future.
Recommendation 3
Graduate nurses, as leaders of clinical teams, should supervise and delegate work to 'registered healthcare assistants' with clearly defined roles.
Recommendation 4
The numbers and roles of healthcare support workers who deliver patient care must be properly planned and regulated, in the interests of patient safety and care quality.
Recommendation 5
All staff at Agenda for Change bands 3-4 (and their equivalents outside the NHS) who deliver patient care should be trained to NVQ level 3 as the minimum UK standard, delivered by healthcare providers and further education.
Recommendation 6
A planned programme of regulation should begin with the mandatory registration of all staff who deliver patient care at Agenda for Change bands 3-4 (and their equivalents outside the NHS) by an independent regulator.
Recommendation 7
Governments, education institutions and employers must fulfil longstanding policy commitments to develop educational and employment models that widen access to nursing education, and provide career pathways for healthcare support workers including those who wish to train as nurses or midwives.
Recommendation 8
The public needs to know what it can expect of registered nurses educated at degree level. Stakeholders should scale up recruitment campaigns and other measures, including dialogue with the media, to promote better understanding of contemporary nursing and nursing education and dispel the myth that better educated nurses are less caring.
Recommendation 9
Urgent action is needed to support the nursing academic workforce and guarantee its future quality: halt the decline in numbers, raise morale, and attract new staff.