Annex A > Chapter 4 - National Accountabilities and Roles > National regulatory and professional bodies > Nursing - National Boards for Nursing, Midwifery and Health Visiting: statutory basis and functions
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Nursing - National Boards for Nursing, Midwifery and Health Visiting: statutory basis and functions
204 There are National Boards for Nursing, Midwifery and Health Visiting in each of the four countries of the United Kingdom. [270] Their constitution and functions are set out in the Nurses, Midwives and Health Visitors Act 1997, sections 5 and 6. [271] Mr Anthony Smith, the English National Board (ENB) Chief Executive, set out ENB's aims, structure and funding in his witness statement. [272]
205 In 1993 the ENB was streamlined to become a purely professional quality assurance organisation, without a role in administering the management of training courses. [273] The ENB has been concerned with matters such as the standards of training courses, [274] and the quality of student nurse clinical experience, [275] but not directly with standards of nursing care itself.
206 The main sanction available to National Boards was the de-recognition of wards or units for training purposes if they did not have sufficient appropriate staff to supervise nurses in training. [276] This is similar to the Royal Colleges' only sanction of de-recognition of medical training posts. The emphasis was on ensuring the quality of training rather than clinical quality itself.
207 The implicit assumption in the focus of the ENB on training is that training will lead to better care. So far as paediatric services are concerned, however, the theory that `attaining levels of qualifications of children's nurses actually makes a difference to the outcomes in terms of care' is based on only anecdotal evidence. [277]
208 Although the National Boards set standards for training, they do not regard themselves as responsible for compliance with them. Professor Jarman asked Mrs Le Var:
`Q. ... my general impression is that the ENB is in favour of units where children are nursed, the nurses having children-training. ... who actually is responsible for getting what you consider to be a better situation? Whose ultimate responsibility is it? Is it the ENB or the Department of Health, the RCN, or is it nobody? I just want you to give me your general impressions.
`A. It is a Health Service responsibility, so the Board does not have the power to have that responsibility; the Board can influence and the Board can certainly have responsibility in relation to the areas which are approved for training, but that is where it stops. The general availability of children's nurses is determined by the NHS Executive ...
`Q. So although it is your opinion that it should be a high proportion, it is not actually your responsibility; it is the Health Service, I think you said. You mean who, the NHS Executive or the Department of Health?
`A. The broad Department of Health, and then specifically within the Department of Health and the NHS Executive ...' [278]
209 Although the UKCC, unlike the GMC, is a registered charity, [279] the National Boards are funded by the respective Departments of Health. [280]
210 The Royal Colleges' role in medical education has similarities to the role of the National Boards in nursing education. [281] It is, however, not precisely analogous, in that the Royal Colleges have a role to play particularly in the attainment of post-registration qualifications, whereas the National Boards focus upon the attainment of an `entry' qualification.
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Footnotes
[270] English National Board for Nursing, Midwifery and Health Visiting (ENB), National Board for Nursing, Midwifery and Health Visiting for Scotland (NBS), Welsh National Board for Nursing, Midwifery and Health Visiting (WNB), National Board for Nursing, Midwifery and Health Visiting for Northern Ireland (NBNI)
[271] WIT 0052 0025 - 0027 Ms Lavin
[272] WIT 0063 0001 - 0006 Mr Smith
[273] T9 p.52-3, 136 Mrs Le Var and Mrs Marr
[274] T9 p.97-8 Mrs Le Var and Mrs Marr; WIT 0063 0010, 0738 Mr Smith. Such as the requirement in children's wards that student nurses be supervised by Registered Sick Children's Nurse at all times: 1988 ENB Circular 1988/53/RMHLV
[275] Mr Smith devotes much of the main part of his witness statement to describing courses, both pre-registration (WIT 0063 0009 - 0016 ) and post-registration (WIT 0063 0009 - 0022 ). Mrs Le Var and Mrs Marr address ENB's scrutiny of course quality at T9 p.89 and T9 p.93-6
[276] T9 p.66 Mrs Le Var and Mrs Marr
[277] T9 p.126 Mrs Le Var and Mrs Marr
[280] WIT 0052 0007, T33 p.138-9 Ms Lavin. `The Regulation of Nurses, Midwives and Health Visitors', para 2.42 (WIT 0052 0225). The proportion of ENB's funding derived from government grant has changed over the years. It has been 98% (1984 onwards), 83% (after the 1992/93 financial year); 70% (for the 1994/95 financial year); and 77% (since 1995) (WIT 0063 0003 - 0006 ). See Mrs Le Var's explanation of the figures at T9 p.137