Delivering responsive nursing and midwifery regulation during a pandemic

Sheila McClelland, the CEO of the Nursing and Midwifery Board of Ireland (NMBI) reflects on how far the organisation has come, delivering business continuity and regulatory responsiveness during a pandemic. But the organisation is also focused on its digitisation and modernisation agenda in 2020, with the roll out of MyNMBI for nurses and midwives. 

The role of NMBI during Covid-19

As the regulator for nurses and midwives in Ireland, our mission is to protect the public and the integrity of the professions of nursing and midwifery.

We focus on three areas specifically:

• Publication and maintenance of the Register of Nurses and Midwives and the Candidate Register;
• Education standards and requirements; and
• Complaints about the practice or behaviour of a nurse or midwife.

In a time of crisis, this statutory duty is magnified and has created a real sense of purpose among the staff of NMBI to deliver, and be part of, the national response.

There is no doubt that 2020 saw significant challenges for our business as we strove to understand and respond to Covid-19. The provision of registered nurses and midwives into the healthcare system was, and is, crucial. We worked with our partners to contribute to the national response by exploring new methods of registering and restoring nurses and midwives. We also worked with the Department of Health, the HSE and the Higher Education Institutions (HEIs) responsible for nursing and midwifery programmes to better support students during Covid-19.

Registration

In the month of March 2020 alone 1,169 nurses were added to the Register, and 385 were new registrants. The implementation of the Emergency Measures in the Public Interest (Covid-19) Act 2020 meant that previous registrants could be restored to the Register without incurring any restoration fees. This measure facilitated 784 in returning to the Register. By scaling up and increased flexibility, our staff were able to process 80 applications daily. As well as those who came to us directly, NMBI confirmed the registration status of over 500 applicants who applied to the ‘On Call for Ireland’ campaign through the HSE. We restored qualified nurses and midwives who were retired and on career breaks from all over Ireland. We were also dealing with regulators and relevant bodies daily in Ireland and abroad, to support faster processing of certificates of good standing, qualifications and language competency for those coming from the UK and beyond. This was only possible due to the immense commitment and dedication of our staff.

Education

NMBI recognised that the challenges presented in the provision of healthcare services, and in some cases the reconfiguration of services during Covid-19, had the potential to impact on student learning and the achievement of competencies to join the Register. The priority for NMBI during the pandemic, as it evolved, was to assist the education and healthcare systems to support student nurses and midwives learning while ensuring that the standards of the education experience were retained. In order to address the challenges for both the education providers and the health service, NMBI has worked with them to explore how students can achieve the competencies for registration, while not compromising on the standards of the programmes.

Many new opportunities presented during Covid-19 for students to achieve the learning outcomes of the nursing and midwifery programmes. We were able to explore these opportunities for undergraduate student clinical placements and provide guidance on how the competencies can be achieved. This includes remote environments and Telehealth. These experiences can be taken as learning events and captured by portfolio, reflective of the people encountered, the care assessed and provided, and the outcome for transferable learning. It is not the setting that is important, but the care experience for the patient/client or the learning opportunity experienced. This means that we encouraged placements that demonstrate integration of care and enhanced collaboration between the hospital system and community services, and this has been embedded. While we gave guidance on possibilities for new opportunities in the programme, we also asked the education providers to inform us of the moderations and experiences that they implemented including changes to the approved assessments for students. 

The continuance of quality and safe education for all the student nurses and midwives in the system has remained a key objective for the NMBI. We were delighted to ensure that a responsive approach to regulation of education, including providing for absence due to certified Covid-19 related absence, assisted the healthcare system and the students to achieve valuable learning experiences.

Our steps towards modernisation

Throughout the year our own journey to provide a modern model of service provision and regulation continued.

I believe it is important to embrace technology and drive positive change. In September 2020, we launched the first phase of MyNMBI, our new digital platform designed to streamline and improve processes for our registrants and stakeholders. The system allows NMBI to deliver more efficient and accessible services in areas such as online registration services, paper-free document management, efficient and transparent application processing, and enhanced reporting. The platform will deliver an integrated system which ensures that applicants and registrants can avail of a wider range of self-service options. This is a significant milestone in the progression of NMBI as a more efficient and effective regulator.

Some of the key benefits for users of MyNMBI include:

• Applicants can complete the entire registration application process online;
• Registrants can pay their annual renewal, update personal information, request Certificates of Professional Status (CCPS) online. The new approach will eliminate paper from our processes allowing registrant to access certificates and documents online;
• Employers can check the Register of Nurses and Midwives and the Candidate Register online. Both Registers, are updated in real time and are searchable on the NMBI website; and
• MyNMBI also delivers improved reporting capabilities which will allow NMBI to gain accurate data reporting, giving greater insight into the nursing and midwifery professions and enable us to make more informed policy.

MyNMBI will grow to support many other aspects of what we do, enabling us to better deliver on our mandate of upholding the high standards of nursing and midwifery in Ireland and ensuring public safety.

Phase one was introduced to students and graduates who completed their entire registration application process online. The Education module will be implemented in 2021 making further functionality available to HEIs and clinical sites.

This will be followed by digitisation of Fitness to Practise processes. As the regulator, we are legally responsible for considering complaints against nurses and midwives who practise in Ireland. A complaint is serious, and our aim is to guide people through the process with sensitivity. We understand this is an anxious time for those who are subject to a complaint and we recognise the need for improvements regarding timelines. On 14 October 2020, the Regulated Professions (Health and Social Care) (Amendment) Act 2020 was signed into law which will enable us to process complaints more efficiently, in conjunction with our digitisation of Fitness to Practise processes.

T: 01 639 8500
W: www.nmbi.ie
E: communications@nmbi.ie