Right now, national registration is a hot topic and every nurse and midwife registered in Australia will have received letters regarding the changes happening next month. This article seeks to address some of the questions and concerns raised about the new scheme.

The Nursing and Midwifery Board

The Nursing and Midwifery Board of Australia has been formed to replace individual state and territory registration boards in order to create a more-flexible, sustainable and responsive health workforce. It will commence on 1 July 2010, along with boards for nine other health professions, including pharmacists, physiotherapists and medical practitioners.

There have been twelve board members appointed for a term of three years, consisting of eight practitioner members, representing each state and territory, and four community members. The Chair is Ms Anne Copeland, a registered nurse and midwife representing Queensland.

The board will oversee registrations and the development of professional standards. It will also approve accreditation standards and courses of study, and maintain a public register that will be available online. Overseas-trained nurses wishing to practice in Australia will be assessed by the board and the mutual agreement arrangement with New Zealand will continue.

The board will also handle notifications and complaints, and conduct investigations and disciplinary hearings, with the power to check the criminal history of any nurse or midwife on application of registration or renewal, or at any time during the period of registration.

The impact

National registration will mean one annual registration and payment, due every year on 31 May, reducing red tape and removing the necessity and added cost of multiple registrations for nurses wanting to work across borders. In a national context, this will improve response times to major health emergencies across state lines.

Individual nursing registration types may change in the transition to the national scheme. This has been made clear in a letter sent out to every registered nurse and midwife in Australia, which requests that individual details listed, such as suburb of workplace, are changed if incorrect. All current registrations will automatically be transferred to the national register.

For the first time, there will be a separate midwifery register, and while it is not yet clear how the board will implement this, it is probable that midwives will have a choice about whether to list on one or both registers. At this stage, registering twice is not likely to incur extra costs as one fee will entitle midwives to register as both a nurse and midwife if they wish.

There will also be new professional development requirements and mandatory reporting guidelines. Indemnity insurance arrangements will in most cases be met by the health employer, although it will be the responsibility of every nurse and midwife to ensure that they are covered.

While the ANF has been closely involved in the process and is largely very supportive of the move, the feedback from members reflects uncertainty about some aspects such as how specialty areas will be listed and whether special conditions will be clear. As questions arise, they are being forwarded to the Australian Health Practitioners Regulation Agency, which is the agency supporting the board, and posted with answers online.

Registration and renewal

In July, all nurses and midwives will receive a new national registration number and certificate together with the date for renewal.

For nurses and midwives currently registered in more than one state or territory, registration will be valid until the latest end date of those registrations. If the renewal date is close to the 1 July 2010 start date of the national scheme, early renewal will be encouraged for easy transition into the national scheme.

Once in the new scheme, renewal is only necessary when current registration expires. The first renewal may be for more or less than 12 months in order to bring every nurse and midwife into the new 31 May registration cycle (paying a pro-rata fee accordingly). A reminder will be sent when reregistration is due. If a nurse or midwife fails to preregister on time, they have a one-month grace period, but they will incur a late fee and there is no extension of the registration period.

Registration will be accessible online, although there will be a call centre and each state and territory will have an office for queries about registration with any of the ten new health boards.

While the fees for national registration are not yet available, they will be announced and every registrant will be notified before 1 July. As there are already significant variations in the cost of registration across states and territories, the national fee should not significantly increase and may even decrease depending on where the nurse or midwife is registered or whether they are presently registered in more than one location.

Professional development

Under national registration, all practicing registered nurses and midwives will be required to undertake at least twenty hours per year of continuing professional development which is relevant to their area of practice, including participating in learning activities that will maintain and enhance their knowledge and skills.

Although these hours have not been a requirement in the past, professional development has been a recognised part of professional practice. Now nurses and midwives may include activities such as fire drills and evacuation procedures in those hours. On renewal of registration, they must be able to produce evidence of their professional development hours, including dates and a summary of outcomes.

If registering as both a nurse and a midwife, professional development requirements will include twenty hours for each registration, although some hours attended may be relevant to both areas. For nurse practitioners, an extra ten hours will be required.

Education accreditation

The move to national registration for nursing and midwifery is not without complications. Education requirements and even titles can vary between states. In the past, as many nurses know, this has often made applying for work interstate complicated.

Until now, nursing and midwifery courses have been accredited by the nursing and midwifery regulatory authorities in each of the states and territories. While the development of the Health Training Package has improved consistency in education nationally, there are still variations in overall requirements for several area of nursing and midwifery.

In an April media release, the ANMC stated that ‘only an independent accrediting authority has the capacity and remit to ensure high standards in nursing and midwifery education are maintained. Without high education standards, the skill, competency and safety of nurses and midwives will be compromised, as will the care they provide.’.

The future

As nursing practice continues to evolve, divisions on the national register should be able to recognise and accommodate additional conditions such as medication endorsement and IV therapy for enrolled nurses, prescribing rights and areas of specialisation.

Time will tell whether the transition to national registration is smooth and straightforward, and how quickly true national consistency for nursing and midwifery can be achieved.

By Bridget Willett