Intensive and Critical Care Nursing (2005) 21, 135—139

News and IssuesThis edition of ICCN is a difficult one for which towrite copy. It is almost halfway through 2005 andby the time you read this, the steering committeeand many members of the RCN critical care nursingforum will have not long returned from the RCNevent of the year — RCN Congress, held in Harro-gate at the end of April. The difficulty however,is that print deadlines require me to write of

cludes euthanasia, equity in health care, regula-tion of health care assistants and appropriate clini-cal placements for student nurses. There should besome interesting debates and I hope to be writingabout the success of these in the next issue of ICCN.

Forum annual conference

the event before it has occurred. Nonethelessthere are some things that will have occurred inthe first half of the year that I can write aboutwith certainty. These include how Congress willshape up, our annual conference preparationsand an update on the Department of Health teamcompetency project.

RCN Congress 2005

As a UK critical care nurse, this is most definitely theyear to get involved with the Forum. The May gen-eral election in the UK ensures that RCN Congress

However, if you can not wait to hear about theseissues, they are all topics that will feature at ourown annual conference ‘‘Critical Care: shaping thefuture’’ to be held 17/18th of this month in Manch-ester. Details of our critical care conference can befound within these news pages or alternatively bycontacting our conference organiser Jeanette Stad-don at criticalcare@rcn.org.ukIt was as a result of our 2004 conference that I

found myself at the end of the year along with ChrisSmith, Chair BACCN (British Association of CriticalCare Nurses) meeting with Rosie Winterton, Minis-ter of State for Health at the Department of Health,Whitehall. The meeting had been arranged to up-

will have been a highlight with politicians of every date the Minister on several issues that had beenrfctus

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aised following her presentation at our annual con-erence. It provided an opportunity for the voice ofritical care nursing to be heard at the heart of cen-ral government and her willingness to meet withs certainly suggests that nurses are not just beingeen but being heard!The 45min meeting covered a range of diverse

ssues that included securing dedicated fundingor nurse-led outreach services, inadequate levelwo facilities, pre-registration nurse education andighlighting the key impact of critical care nursesn driving through the NHS Modernisation Agencygenda. A strategy for critical care developmentver the next 5 years was discussed and the minis-er assured us that nurses were seen as key figures

party begging for the privilege to address (and mostdefinitely seeking to impress) an audience that con-tains representatives of three quarters of the totalNHS workforce. Politicians will not just have beenthere to deliver their ideas but a general electionyear will see them truly listening to the debates ofCongress and hopefully nursing receiving some highprofile press coverage for all the right reasons.Back in November, the Forum did submit sev-

eral resolutions for debate at Congress 2005, includ-ing non-heart beating organ donation, critical caretransfers, critical care pre-registration nursing ed-ucation; unfortunately none were accepted for theopen debate but there are several debates in whichthe Forum expects to make a contribution. This in-

0964-3397/$ — see front matterdoi:10.1016/j.iccn.2005.03.003

136 News and Issues

in the development of Government healthcare pol-icy and would remain influential and involved in anyfuture critical care service developments.The meeting was timely given that a National

Critical Care Stakeholder Group was formed to-wards the end of 2004 as one means of supportingthe future continued delivery of appropriate andeffective critical care services following the com-pletion of the NHS Modernisation Agency Criticalcare programme in September 2004. The Forumhas representation on this group, which is com-prised of several other critical care organisations,as well as representation from the Independentsector, Strategic Health Authorities and PrimaryCare Trusts. The Group is in its infancy but as itis now nearly five years on from the publicationof ‘‘Comprehensive Critical Care’’ (DH 2000)this Group will surely be instrumental in shapingand leading the future direction of critical careservices. Without full awareness of the content Ican confidently conclude by predicting that futureRCN Forum news and issues pages in ICCN are goingto contain some interesting reading!

Maura McElligott

The World Health Organisation definition of ad-vanced practice has international acceptance andreflects current UK practices and therefore wouldbe appropriate to use in the UK. Were it to be-come necessary to register in order to use the title‘‘advanced practitioner’’ then several changes inlegislation will be required and the process couldtake some time to become fully operational. TheNMC will also need to ensure that competencies arein place by which means nurses can be assessed atworking at this advanced level.The consultation included the following four top-

ics:

• Registration — is it necessary?• Re-registration — how to ensure competence• Academic level — should this be at masters?• Is specialism important?

The Forum has been asked to contribute to an RCNresponse to the consultation and we have fully sup-ported the need for registration and an academiclevel at Masters as we believe this will help stan-dardise practices, bring the UK in line with othercountries and ensure that nurses working at ad-vanced level are appropriately rewarded.

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Chair RCN Critical Care ForumEmail: maural@yahoo.com

Department of Health (2000) comprehensivecritical care: a review of adult critical care servicesLondon, Department of Health

Advanced practice focus group nursing andmidwifery council (NMC)

Between November 2004 and April 2005 the NMCconsulted members on advanced practitioner statusand their considered intention to make this a regis-tered qualification in the not too distant future. Aspart of the preparation for this, the Forum was in-vited to attend several of the focus groups that havebeen held by the NMC throughout the UK to gaugeopinion on this important issue. The focus groupswere attended by a mixture of nurses from bothacute hospital trusts and the primary care trustsand a range of specialist interests were also repre-sented.Pam Walter from the NMC led the group and ex-

plained that the NMC has been approached on oc-casions in relation to concern over the many andvaried use of job titles in nursing which imply pos-session of expert knowledge and skills. Public per-ception is that a UK/National Standard exists thatassures a level of competence in practice, — this isin fact not the case in the UK to date.

Rachel Binks — critical care nurse consultant andorum steering committee member

eam competencies for adult criticalare services

kills for health and the knowledge andkills framework

kills for Health has been appointed by the Depart-ent of Education and Science as the Sector Skillsouncil for Health and has been commissioned toy the Department of Health to undertake special-st competency work for the NHS. Their currentocus is on expanding the emergency care work-orce competency framework to include urgent andcheduled care and developing workforce compe-ency frameworks linked to the National Servicerameworks. Although Skills for Health, originallyhe Education Skills Councils have been active forome time in the healthcare arena, there have beenther developments that have increased their posi-ion of influence. These developments relate to theicence from the NHS for this work and the closeinks they are now building with the Knowledge andkills Framework. Each is represented on their mu-ual boards and both are working together with theim of achieving a more consistent and integratedpproach.

News and Issues 137

Skills for Health have a strong infrastructure ofresources for developing competency work and ex-perts in the technical skills of writing competen-cies. Their expertise is in the processes of develop-ing competencies rather than the content.

Similarities between the critical careteam competency project and skills forhealth work

There are many similarities between the CriticalCare team competency project and Skills for Healthin that both:

• develop a competency framework to organise thecompetency units

• use an outcome competency model as does theKnowledge and Skills framework so emphasisingactions rather than knowledge.

• Under the umbrella of the competency frame-work, specific units of competencies are identi-fied but linked to related knowledge and skills.

• The competency framework and related unitsidentify all the competencies expected to be de-

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◦ Respiratory◦ Technical Cardiography

More recently, Skills for Health are consulting on theCoronary Heart Disease National Workforce Com-petency framework and the Emergency, Urgent andScheduled Care Workforce Competency framework,with the Renal Competency Framework in develop-ment.The Emergency, Urgent and Scheduled Care

Workforce Competency framework, is currently themost closely aligned to critical care and is being de-veloped from the perspective of four core areas:

• Musculo-skeletal and soft tissue injuries• Respiratory problems• Major causes of collapse, including stroke andsepticaemia

• Multiple pathology (caused by injuries followinga catastrophic event)

Implications for critical care teamcompetencies project

Through the second half of this project Skills forHeaK

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livered by the whole service team rather than anyone staff group. This paves the way for enabling:◦ each staff group to identify their contribution,◦ areas of overlap where flexible working is re-quired across different staff groups

◦ areas where new posts need to be developede.g. advanced practice, assistant practitionersto ensure the service has the necessary compe-tencies to deliver a comprehensive and qualityservice

kills for Health are also in a position to developnits that can be used across different frameworkso as to reduce duplication of work, re-inventionf the wheel, and enable the promotion of con-istent competency standards across all areas ofealth care.

kills for health work relevant to criticalare

o date, skills for health have developed units rel-vant to critical care that include:

BloodClinical ImagingCoronary Heart DiseaseEmergency CareOperating Development SupportOperating development practice

ealth have become a powerful influence strength-ned by its licence from the Department of Healthnd also much closer working relationships withnowledge and Skills Framework Team.Skills for health are aware of the critical care

eam competency project and have been asked toe kept informed of its development. There is anpportunity therefore for this project to influencekills for Health work which it needs to do as it islear that Skills for Health will becomemainstream.or this reason a number of tentative recommenda-ions are being made at this stage in the project tonclude the following:

the need to maintain links with skills for healthUsing the project’s proposed competency frame-work to influence any future work on critical carethat skills for health are commissioned to do.Need to map this project against the skills forhealth competency units already existing partic-ularly in the emergency, urgent and unscheduledworkforce competency frameworkIdentify those units unique to critical care andthen either build on good models where they cur-rently exist or include in a commissioning processif they do notThat there is a need for a critical care compe-tency workforce framework that stands alone andis not submerged into the emergency, urgent andunscheduled framework, although units may beshared.

138 News and Issues

Kim Manley, Project leaderCritical Care Team Competency Project

Do not miss the forum annual CriticalCare Conference Manchester 17—18June, 2005

The Critical Care Nursing Forum disseminates goodpractice throughout critical care and the confer-ence is a vehicle for sharing examples of best prac-tice in critical care nursing. The conference will aimto explore the development of leading edge criti-cal care thinking and practice and show how excel-lence in practice can be promoted within the fieldof critical care. The conference programme con-tains several key note speakers including ProfessorGeorge Alberti from the Department of Health andthe current President of the Intensive Care Soci-ety Saxon Ridley. There will also be concurrent ses-sions, workshops and poster presentations and theconference also provides an effective forum for del-egates to network with other practitioners workingin critical care in the UK and beyond. We are partic-

The NCEPOD 2004 report — ‘scoping ourpractice’

On 13th October 2004 the latest report from theNational Confidential Enquiry into Patient Outcomeand Death (NCEPOD) was published. This report,the first to involve patients under the care of bothphysicians and surgeons reviewed deaths between1 April 2002 and 31 March 2003 that were within 30days of a therapeutic endoscopic procedure.The report looked at issues such as the facili-

ties available within hospitals, patient assessmentand consent, sedation and monitoring. ‘scoping ourpractice’ examined in detail 1818 inpatient deathswithin 30 days of the procedure, noting that thisrepresented just under 50% of all deaths in thiscategory and that these were only a small propor-tion (3%) of the total endoscopies performed dur-ing a year in England, Wales and Northern Ireland.However, NCEPOD found that the procedure per-formed in 14% of cases was inappropriate and ofthese more than half were deemed ‘futile’. More-over, two-thirds of patients who had dementia oracute confusion had provided written consent fortheir procedure.

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ularly proud that this years closing plenary presen-tation will be made by an eminent past Forum chair,Professor Ruth Endacott from LaTrobe University,Australia.The Critical Care Conference 2005 will be held

at:Manchester United Football ClubOld Trafford, Manchester17 and 18 June 2005For further information and a registration form

please contact:Jeanette Staddon, Conference and Events Organ-iserRoyal College of Nursing, Copse Walk,Cardiff Gate Business Park, Cardiff CF23 8XGTel.: +44 292054 6493Email: criticalcare@rcn.org.ukWebsite: www.rcn.org.uk/eventsForum Dates for your Diary 2005June 17/18th Critical care Conference, Old

Trafford football ground,Manchester

July 9th Forum steering committeemeeting

August Critical care mail (newsletter) arrivesSeptemberOctober 19th RCN AGM London

20th Forum steering committeemeeting

21st Link member meeting, London

November Congress resolutions submitted for 2006

The main findings of the report focused on theecessity for hospitals to ensure that appropriateonitoring and resuscitation equipment is availablen each of their endoscopy rooms and recovery ar-as. NCEPOD highlights that it is unlikely that con-ultants who perform only a few procedures perear, often less than 20, can remain proficient andkilled. The report calls for national guidelines forssuring competency in endoscopy and also for theevelopment and implementation of protocols forhe administration of sedation. It is recommendedhat only experienced endoscopists should treat pa-ients with upper GI haemorrhage.Further details of this study and/or a copy of the

ull report ‘‘Scoping our practice’’ can be found onhe NCEPOD website www.ncepod.org.uk.

ritical care forum website

he Royal College of Nursing Critical Care Nursingorum recognises the need of its members to haveccess to news updates, contact details, relevantublications and web links relevant to critical care.ll RCN members have access to the critical careursing forum web site to provide them with infor-ation pertaining to the area of critical care nurs-ng.The web site can be found either via theCN homepage at www.rcn.orq.uk or directly atww.rcn.orq.uk/criticalcare

News and Issues 139

To enter the site you will be prompted to in-clude your RCN membership number and yoursurname.Also available to members is the Discussion Zone.

This provides members with the opportunity to postcomments, ask questions or to browse through themessages left by others. Members can use the spe-cific critical care nursing forum discussion zone

where they can discuss issues relevant to criticalcare nursing. The Discussion Zone can be accessedby clicking on the ‘Discussion Zone’ icon on themainRCN Web Site.We hope that you will use the website to com-

municate with usBrian McFetridge critical care lecturer, steering

committee member b.mcfetridqe@ulster.ac.uk.