Nurses who have been out of the profession for more than three years and internationally trained staff in the process of applying for UK registration are being placed on stand-by to support the frontline during the Covid-19 outbreak.
The Nursing and Midwifery Council’s governing body today agreed to consider extending temporary registration to these two groups in the event that staffing shortages escalate and further reinforcements are needed.
“It is very, very important that we are able to accelerate our decision-making on these other cohorts”
The body has already put out a call to former nurses and midwives who left the register less than three years ago with more than 5,000 saying they would be willing to return to practice to help the NHS cope with coronavirus.
At today’s meeting the NMC Council also signed off plans to allow student nurses to see out the final six months of their studies as a paid clinical placement to support the response, and agreed they could be called on to join the temporary register later down the line if it is deemed necessary.
The power to set up a temporary register is set out in emergency legislation which is currently going through Parliament and is expected to pass through its final stages this evening or early tomorrow morning.
The meeting was told the temporary register would open once the law had been passed and the NMC had received official notification from the secretary state that an emergency situation was in place.
The NMC had already signalled its intention to call on the services of registrants who had recently left the register and final year nursing students.
However, a surge in the number of coronavirus cases in the UK meant NMC officials had begun work to extend that to others, the meeting was told.
NMC general counsel Claire Padley – who took the meeting through the new measures – said it was vital the regulator was able to act swiftly to extend temporary registration to other groups “given the very rapid escalation in cases that we’re now seeing” and the creation of a new 4,000-bed field hospital at London’s ExCel Centre “which clearly has to be staffed”.
“It is very, very important that we are able to accelerate our decision-making on these other cohorts if and when they become necessary,” she said.
The NMC Council agreed that people who had been off the register for three to five years could also be considered for temporary registration.
Ms Padley said the body may need to impose some conditions of practise for those who had been out of practise for more than three years otherwise the approach would be “very similar” to that taken with those who had left more recently.
She stressed the body could not rule out extending temporary registration to further groups, which could include nurses and midwives who had been off the register for more than five years.
“Obviously the longer we go past the time somebody left the register the more re-training they may need and the closer we might get to having to put conditions in practice in place,” she said.
She said another group that should be considered for temporary registration was overseas registered nursing and midwifery professionals who were already working in the UK and were part-way through the NMC’s overseas registration application process.
“These people are already in the UK and already in trusts or other organisations being trained up to sit those final tests and it is that group we’re now looking at given that the test centres are having to close,” she said.
She said the body had already started having conversations with all four chief nursing officers and health and social care employers “to see if they are a group we could add”.
NMC Council registrant member Claire Johnston, who is project director of CapitalNurse in north London, told the meeting there were as many as 3,000 nurses and midwives currently in the UK who have international qualifications and had completed the first two stages needed to join the UK register.
However, she said many had been left “stranded” because they could not complete their registration and were now worried about their immigration status.
UK Visas and Immigration has confirmed that no nurse or midwife who found themselves in this situation would be penalised, the meeting was told.
The NMC should also consider extending registration to qualified overseas nurses and midwives who were in the UK and had not yet completed the first two stages of UK registration, Ms Johnston suggested.
Anyone joining the temporary register must be “fit, proper and suitably experienced” to help out with the coronavirus emergency.
People with known fitness to practice concerns, the over-70s and those who left the register due to poor health will not be invited to sign up.
Ms Padley said her colleagues were exploring ways to ensure different groups met the core criteria for temporary registration which could include a declaration from a registered health professional.
“Although we don’t apply our normal registration requirements, we have to have some method of getting assurance they meet the test so that is what we’re looking into,” she said.
Ms Padley stressed that the decision to join the temporary register was entirely optional and no one should feel under an obligation to do so.
“We have made it very clear in all of our communications that this is optional – it is not a need or a mandate that they have to rejoin. Therefore, if anybody is concerned about their health there is no compulsion to join it,” she said.
When people joined the temporary register, they would have a choice of the kind of work they did, although certain groups may have conditions placed on their practice, she added.
“We have made it very clear in all of our communications that this is optional”
“Even when they join the temporary register, they can decide what work they want to take up in any of the four countries,” she said.
“We have developed a mechanism for them to be put in touch with the four country health services so they can volunteer their services – paid services – in the most appropriate way,” she added.
“Some of that may be on the frontline for others it may in call centres or other types of work to suit their personal situation.”
NMC chief executive and registrar Andrea Sutcliffe said it was vital to ensure the safety of all concerned, which was why the NMC was taking a step by step, risk-based approach to temporary registration.
“How do we ensure that this is safe for the individuals who may be going onto the temporary register, for their colleagues they may be working with and obviously, critically for the people they will be caring for and supporting?” she said.
It was crucial “to make sure we are balancing risks and ensuring this is as safe as it possibly can be in these most extraordinary of circumstances”, she added.
NMC Council members agreed that the decision to add other groups to the temporary register at short notice could be taken by Ms Sutcliffe with agreement from the NMC Council chair Philip Graf.
However, they said Council members should be consulted whenever possible.
The NMC’s new powers would allow it to remove temporary registrants from the register immediately if there were any concerns about their fitness to practice.
Ms Padley said the body was currently looking at how that emergency removal process would work.
“We are urgently developing our own internal policy and process for that situation. We obviously hope we won’t get referrals about these temporary registrants but if we do we want to make sure the process we have is fair, proportionate and speedy,” she said.
She said this would include being clear about what information would be shared with the NMC’s registration team should someone wish to apply to join the normal register in the future or with universities for students returning to their studies.
“Clearly we can’t disregard something which is extremely serious,” she said.