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Programme approval visit report Section one Programme provider name: Manchester Metropolitan University In partnership with: (Associated practice learning partners involved in the delivery of the programme) Maria Mallaband Care Group Manchester Learning Disability Partnership Greater Manchester West Mental Health NHS Foundation Trust Pennine Care NHS Foundation Trust Bolton NHS Foundation Trust Tameside Hospital NHS Foundation Trust The Pennine Acute Hospitals NHS Trust Bridgewater Community Healthcare NHS Trust Manchester University NHS Foundation Trust East Cheshire NHS Trust Manchester Mental Health and Social Care Trust Salford Royal NHS Foundation Trust Stockport NHS Foundation Trust Manchester University NHS Foundation Trust Bupa Partington Family Practice Beacon Medical Centre Hazeldene Medical Centre Valentine Medical Centre Urban Village Medical Practice Bedford House Medical Centre Clarendon Medical Practice The Walkden Medical Centre Heald Green Health Centre Conway Road Medical Practice The Delamere Centre Mauldeth Medical Centre West Gorton Medical Centre HC-One Manchester Mental Health and Social Care Trust Optegra Eye Health Care Hospice BMI Health Care The Chrisite NHS Foundation Trust Spire Health Care Best Care Homes
Programme(s) reviewed: Programme: Nursing associate Title of programme: FdSc Health and Care Practice (nursing associate) Programme start date: 27 January 2020 Academic level(s): England, Wales, Northern Ireland: Level 5 Date of approval 6 November 2019 QA visitor(s): Registrant Visitor: Jo Rouse Lay Visitor: Sifelani Chikunya
Recommended outcome of the approval panel Recommended outcome to the NMC: Programme is recommended for approval subject to specific conditions being met Conditions: Please identify the standard and requirement the condition relates to under the relevant key risk theme. Please state if the condition is AEI/education institution in nature or specific to NMC standards. Effective partnership working: collaboration, culture, communication and resources: None identified Selection, admission and progression: Condition two: The programme team are required to clarify and ensure consistency across programme documentation and online material to ensure that on entry to the programme, students can demonstrate proficiency in English language. (Standards of pre- registration nursing associate programmes R1.1.4) Practice learning: None identified Assessment, fitness for practice and award: Condition one: The team are required to demonstrate that there is equal weighting in the assessment of theory and practice and confirm their intention to assure this. (Standards of pre-registration nursing associate programmes R4.8) Education governance: management and quality assurance: None identified Date condition(s) to be met: 20 November 2019 Recommendations to enhance the programme delivery: There are two NMC recommendations and two university recommendations: Recommendation one: Ongoing monitoring and review of the new service user and carer provider to ensure the programme continues to be designed, developed, delivered, evaluated and co-produced with service users and other stakeholders. (Standards framework for nursing and midwifery
education R1.12) Recommendation two: Ongoing monitoring and review of the newly implemented roles and the support provided to enable practice assessors and practice supervisors to complete the requirements of their role, to ensure continuing compliance with the NMC SSSA. (Standards of pre-registration nursing associate programmes R4.2) Recommendation three: Reword documentation for clarity and seek and document any variations to the regulations that may be necessary to ensure the cohort is not disadvantaged in respect of the awarding of Distinction and Merit for a Foundation Degree. (University condition) Recommendation four: Ensure that the knowledge behind NMC-approved programmes is invested in the whole programme team. (University condition) Focused areas for future monitoring:
N/A
Standards of proficiency for nursing associates (NMC, 2018) Standards framework for nursing and midwifery education (NMC, 2018) Standards for student supervision and assessment (NMC, 2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates QA framework for nursing, midwifery and nursing associate education (NMC,
QA Handbook Partnerships The AEI works in partnership with their practice learning partners, service users, students and all other stakeholders Please refer to the following NMC standards reference points for this section: Standards framework for nursing and midwifery education (NMC, 2018) Standard 1: The learning culture: R1.12 ensure programmes are designed, developed, delivered, evaluated and co- produced with service users and other stakeholders R1.13 work with service providers to demonstrate and promote inter-professional learning and working Standard 2: Educational governance and quality: R2.2 all learning environments optimise safety and quality taking account of the diverse needs of, and working in partnership with, service users, students and all other stakeholders R2.4 comply with NMC Standards for student supervision and assessment R2.5 adopt a partnership approach with shared responsibility for theory and practice supervision, learning and assessment, including clear lines of communication and accountability for the development, delivery, quality assurance and evaluation of their programmes R2.7 ensure that service users and representatives from relevant stakeholder groups are engaged in partnership in student recruitment and selection
Standard 3: Student empowerment: R3.3 have opportunities throughout their programme to work with and learn from a range of people in a variety of practice placements, preparing them to provide care to people with diverse needs R3.16 have opportunities throughout their programme to collaborate and learn with and from other professionals, to learn with and from peers, and to develop supervision and leadership skills R3.17 receive constructive feedback throughout the programme from stakeholders with experience of the programme to promote and encourage reflective learning R3.18 have opportunities throughout their programme to give feedback on the quality of all aspects of their support and supervision in both theory and practice. Standard 4: Educators and assessors: R4.7 liaise and collaborate with colleagues and partner organisations in their approach to supervision and assessment R4.9 receive and act upon constructive feedback from students and the people they engage with to enhance the effectiveness of their teaching, supervision and assessment R4.10 share effective practice and learn from others Standard 5: Curricula and assessment: R5.4 curricula are developed and evaluated by suitably experienced and qualified educators and practitioners who are accountable for ensuring that the curriculum incorporates relevant programme outcomes R5.5 curricula are co-produced with stakeholders who have experience relevant to the programme R5.14 a range of people including service users contribute to student assessment Standards for student supervision and assessment (NMC, 2018) Standard 1: Organisation of practice learning: R1.7 students are empowered to be proactive and to take responsibility for their learning R1.8 students have opportunities to learn from a range of relevant people in practice learning environments, including service users, registered and non- registered individuals, and other students as appropriate Standard 2: Expectations of practice supervisors: R2.2 there is support and oversight of practice supervision to ensure safe and effective learning Standard 3: Practice supervisors: role and responsibilities: R3.3 support and supervise students, providing feedback on their progress towards, and achievement of, proficiencies and skills Standard 4: Practice supervisors: contribution to assessment and progression: R4.3 have sufficient opportunities to engage with practice assessors and
involved in delivering specific teaching sessions and contributing to assessment, for example assessing students completing observed structured clinical examinations. At the approval visit, the programme team and previous nursing associate students and current adult nursing students gave us various examples of how service users and carers were involved in learning, teaching and assessment activities. At the approval visit, the programme team told us that they interview over 800 students and it is not practically feasible to involve a service user or carer on the panel of every interview. However, service users and carers told us told us that they contributed to the development of the interview process and that they were involved as observers and provided oversight through moderation and an annual evaluation report. Previous nursing associate students, current nursing students and the programme team confirmed that all applicants are asked to discussed a video of a patient's care experience as part of the values based recruitment process. Service users and carers told us that their experiences of working with the programme team were that the team are sensitive to their contributions and receptive to comments they make about the programme delivery and recognise and respect diversity. As this is a new programme and MMU are working with a new service user and carer provider a recommendation is made for ongoing monitoring and review of the new service user and carer provider to ensure the programme continues to be designed, developed, delivered, evaluated and co- produced with service users and other stakeholders. (Recommendation one) (Standards framework for nursing and midwifery education R1.12) Documentary evidence and discussion at the approval visit confirm a shared responsibility for theory and practice learning, supervision and assessment with PLPs. Documentary evidence confirms that there are clinical placement agreements between MMU and its PLPs. Additionally, PLP representatives who were present at the approval visit confirmed that they support the approved education institutions (AEIs) intentions for this programme. PLPs confirm that they had agreed in partnership with MMU, the number of nursing associate students they are able to support in practice learning and are confident that there is sufficient placement capacity to meet the planned target of 40 nursing associate students per year. Partnership working therefore appears robust and effective at strategic levels for the delivery of the FdSc health and care practice (nursing associate) programme. Lines of communication and accountability for the quality assurance, development and delivery and evaluation of programme are established through the Greater Manchester Practice Education Group (GMPEG). This consists of representatives from all four AEIs and practice. The GMPEG have updated all policies to reflect the NMC (2018) standards, and there is a shared audit, policies on the selection and monitoring of placements, and an online evaluation shared between AEIs and practice partners. MMU have a quarterly partnership and liaison meeting with the largest local Trust, Manchester University NHS Foundation Trust, where quality of placements and curriculum developments
are discussed. Practice representatives attend university programme committees and hear student feedback on both academic and practice elements of the programmes. MMU works alongside other GM AEIs and PLPs to provide opportunities that maximise practice learning. This includes strategic and operational infrastructures to manage the quality of the student journey. PLPs told us that their relationship with the university is strong, supportive and effective. At operational level there is effective partnership working between the GM AEIs and PLPs in the preparation and support of practice assessors, practice supervisors and academic assessors. Practice learning opportunities offer a diverse range of placements across the lifespan and enable nursing associate students to deliver safe and effective care to meet the holistic needs of a diverse range of people. These opportunities are monitored and routinely evaluated. Practice learning is recorded using the online Practice Assessment Record and Evaluation (PARE). At the approval visit, PLPs confirm they were represented during the development of the programme through attendance at programme development days and at bimonthly practice education forums. PLPs told us that they felt their voices were heard and told us of how their views had resulted in changes to the programme, for example the implementation of block placements and the development of skills teaching across the programme. MMU, in partnership with PLPs, ensure oversight for practice supervision and assessment is in place and practice learning adheres to the NMC (2018) SSSA. They have communication processes in place to ensure joint agreement on the proficiency of students as they progress through the programme. MMU, in partnership with PLPs confirm any issues that arise from external quality reviews for example Care Quality Commission (CQC) that impact on the practice learning environment are managed through a systematic partnership process. We were told that across GM and the PLPs, a process has been agreed to ensure concerns are shared effectively. The programme team told us that MMU has procured a placement management system (InPlace) that will become operational in 2019-20. Practice learning is recorded using the online PARE. We found evidence of comprehensive strategies which aim to provide students with personal, academic and practice learning support across learning environments. These are student centred. At the approval visit, current adult nursing students and previous nursing associate student spoke highly of the support they receive from their personal tutors. Students report high levels of support in practice learning environments and in the university. Students are able to describe their involvement and that of their peers in the development of the new
Student journey through the programme Standard 1 Selection, admission and progression Approved education institutions, together with practice learning partners, must: R1.1 Confirm on entry to the programme that students: R1.1.1 demonstrate values in accordance with the Code R1.1.2 have capability to learn behaviours in accordance with the Code R1.1.3 have capability to develop numeracy skills required to meet programme outcomes R1.1.4 can demonstrate proficiency in English language R1.1.5 have capability in literacy to meet programme outcomes R1.1.6 have capability for digital and technological literacy to meet programme outcomes R1.2 ensure students’ heath and character allows for safe and effective practice on entering the programme, throughout the programme and when submitting the supporting declaration of health and good character in line with the NMC’s health and character decision-making guidance. This includes satisfactory occupational health assessment and criminal record checks. R1.3 ensure students are fully informed of the requirement to declare immediately any cautions or convictions, pending charges or adverse determinations made by other regulators, professional bodies and educational establishments and that any declarations are dealt with promptly, fairly and lawfully. R1.4 ensure that the registered nurse or registered nursing associate responsible for directing the educational programme or their designated registered nurse substitute or designated registered nursing associate substitute, are able to provide supporting declarations of health and character for students who have completed a pre-registration nursing associate programme. R1.5 permit recognition of prior learning that is capable of being mapped to the Standards of proficiency for nursing associates and programme outcomes, up to a maximum of 50 percent of the programme. This maximum limit of 50 percent does not apply to applicants to pre-registration nursing associate programmes who are currently a NMC registered nurse without restrictions on their practice, and
R1.6 provide support where required to students throughout the programme in continuously developing their abilities in numeracy, literacy, digital and literacy to meet programme outcomes Standards framework for nursing and midwifery education specifically: R2.6, R2.7, R2.8, R2. Proposed transfer of current students to the programme under review Demonstrate a robust process to transfer students studying Health Education England curriculum onto the proposed programme to ensure programme learning outcomes and proficiencies meet the Standards for pre-registration nursing associate programmes (NMC, 2018). Evidence provides assurance that the following QA approval criteria are met There is evidence of selection processes, including statements on digital literacy, literacy, numeracy, values-based selection criteria and capability to learn behaviour according to the Code, educational entry standard required, and progression and assessment strategy, English language proficiency criteria is specified in recruitment processes. Service users and practitioners are involved in selection processes. (R1.1.1 – R1.1.6) No R1.1.1, R1.1.2, R1.1.3, R1.1.5 and R1.1.6 are met. R1.1.4 is not met. Prior to the approval visit we sought clarification of qualifications at the point of entry to the programme. The programme team told us that their AEI's entry requirements are line with those of other local AEIs offering nursing associate programmes. The programme team confirm that evidence from the HEE nursing associate pilot suggests there was is no clear relationship between entry qualifications and outcome. The programme team told us that nursing associate students receive a range of academic and study skills support and are proactive with regards to seeking support from the onset. They also told us the set entry criteria is designed to widen participation and entrants are required to have had recent study with the last five years to be considered for entry. We were unable to confirm consistently the requirement for English language proficiency criteria throughout the documentation, online materials and in discussion with the programme team.
Students wishing to submit a claim for RPL are supported by an academic adviser who is a member of MMU academic staff with relevant subject expertise and knowledge of the NMC requirements. Documentary evidence confirms that all RPL claims are assessed by at least two assessors who have not previously been involved in the claim. All RPL claims are reported to the assessment board. A record of RPL activity and a sample of claims is considered by external examiners to provide the independent assurance regarding the equability and effectiveness of the application of RPL. We saw documentary evidence and specific mapping for the FdSc health and care practice (nursing associate) to confirm how those using RPL are able to demonstrate that they meet the programme aims and unit learning outcomes. Numeracy, literacy, digital and technological literacy are mapped against proficiency standards and programme outcomes. Provide evidence that the programme meets NMC requirements, mapping how the indicative content meets the proficiencies and programme outcomes. Ongoing achievement record (ORA)/practice assessment document (PAD) linked to competence outcomes in literacy, digital and technological literacy to meet programme outcomes. (R1.6) Met R1.6 is met. Documentary evidence and confirmation by the programme team and students affirms that students are supported in both theory and practice learning in continuously developing their abilities in numeracy, literacy, digital and technological skills to meet programme outcomes. Numeracy, literacy, digital and technological skills are mapped against NMC (2018) Standards proficiency for nursing associates and programme outcomes. In year one, students are required to complete numeracy and medicines calculation and to achieve 100 percent pass mark. The England nursing associate practice assessment document (NAPAD) mapping document confirms mapping of NMC (2018) Standards of proficiency for nursing associates covering annexe A: Communication and relationship management skills and annexe B: Procedures to be undertaken by the nursing associate. The programme team told us that these skills are formatively and summative assessed in both theory and practice. Practice learning is recorded using the online PARE. During practice learning, students experience digital systems such as electronic patient records and electronic medication administration systems. The programme team told us that nursing associate students have opportunity to complete the care certificate through e-learning opportunities, as well as mental
health first aid (MHFA) and acute illness management (AIM) though simulated learning opportunities. Proposed transfer of current students to the programme under review There is evidence that students learning in theory and practice on the HEE curriculum is mapped to the programme standards and Standards for pre- registration nursing associate programmes and support systems are in place. N/A There are no current nursing associate students. Assurance is provided that Gateway 1: Standards framework for nursing and midwifery education relevant to selection, admission and progression are met Yes Outcome Is the standard met? Not Met We were unable to confirm the requirement for English language proficiency criteria consistently throughout the documentation, online materials and in discussion with the programme team. Condition two: R1.1.4 is not met: The team are required to clarify and ensure consistency across programme documentation and online material to ensure that on entry to the programme, students can demonstrate proficiency in English language. Date: 10 November 2019 Post Event Review Identify how the condition is met:
R2.6.2 no less than 50 percent of the minimum programme hours required of nursing degree programmes, currently set under Article 31(3) of Directive 2005/36/EC (4,600 hours) R2.6.3 consonant with the award of a foundation degree (typically 2 years) R2.7 ensure the curriculum provides an equal balance of theory and practice learning using a range of learning and teaching strategies, and R2.8 ensure nursing associate programmes which form part of an integrated programme meet the nursing associate requirements and nursing associate proficiencies. Standards framework for nursing and midwifery education specifically: R1.9, R1.13; R2.2, R2.14, R2.15, R2.18, R2.19; R3.1, R3.2, R3.4, R3.7, R3.9, R3.10, R3.15, R 3.16; R5.1 - R5.16. Standards for student supervision and assessment specifically: R1.2, R1.3, R1.7, R1.10, R1. Evidence provides assurance that the following QA approval criteria are met There is evidence that the programme complies with the NMC Standards framework for nursing and midwifery education (R2.1) Yes There is evidence that the programme complies with the NMC Standards for student supervision and assessment (R2.2) Yes Mapping has been undertaken to show how the curriculum and practice learning content meets the Standards of proficiency for nursing associates and programme outcomes. (R2.3) Yes Provide an evaluative summary from your documentary analysis and evidence
AND discussion at the approval visit to demonstrate if assurance is provided that the QA approval criteria below is met or not met There is evidence to show how the design and delivery of the programme will support students in both theory and practice to experience a non-field specific nursing associate programme, across the lifespan and in a variety of settings. (R2.4) Met R2.4 is met. Documentary evidence, the programme team, PLPs and previous nursing associate students confirm that the proposed design and delivery of the programme supports students in both theory and practice to experience a non-field specific nursing associate programme, across the lifespan and in a variety of settings. Documentary evidence confirms that the curriculum is designed to ensure that students obtain a broad base of theory and practice, with the unit content designed to ensure that students gain skills across the lifespan and in a range of settings. Documentary evidence confirms that teaching and learning strategies promote nursing associate students’ understanding of the application of knowledge and skills across a diversity of practice setting. The curriculum is designed to ensure that nursing associate students will provide care for people who have mental, physical, cognitive and behavioural care needs, for children, those living with dementia, the elderly and for people at the end of their life. Students will be able to care for people in their own home, in the community or hospital or in any health care settings where their needs are supported and managed. Documentary evidence confirms that in the university setting learning includes; tutorials, seminars, lectures, workshops, simulated practice digital learning, technology enhanced learning directed and independent study. The programme team and students affirm that students are asked to complete unit and programme evaluations. Responses to student evaluations are provided via ‘you said – we did’ feedback on the programme virtual learning environment site. The programme team and students told us that MMU have a system of elected student course representatives. Students told us that programme committees provide an opportunity for course representatives and staff to discuss any issues which impact upon the student experience, and are held twice a year. The programme team told us that student experience interdisciplinary learning (IDL), with a new initiative being implemented for this academic year in which students will attend mandatory IDL sessions each week.
