COVID-19: guidance for additional nursing and midwifery workforce

Wherever you can help, you’re needed.

As a highly skilled, experienced nurse or midwifery professional who may have temporarily or permanently left the Nursing and Midwifery Council (NMC) register, we are seeking your support to join the fight against COVID-19. There are a number of different ways you can support the existing NHS workforce and local communities that include both direct and non-direct care.

COVID-19 has the potential to put huge additional demand on our NHS, health and social care systems so in response the government is granting emergency powers to allow the NMC to award temporary registration to certain groups of suitably experienced people. This includes nurse and midwives who have voluntarily left the register within recent years and may wish to return to practice. By offering to return, you can make a significant difference, not just to patients and those we care for, but to colleagues and the wider community we serve.

This isn’t only about clinically treating those with COVID-19. Members of the general public may feel anxious and welcome reassurance as a highly respected and experienced healthcare professional. Your expertise may be able to offer help and support in so many ways through a wide range of valuable roles and in a range of settings and care sectors.

We greatly appreciate the time and effort that you have already given as a nurse and/or midwife and you should be assured we are taking steps to make returning to practice as easy and safe as possible for you should you wish to do so.

Understandably, you will have important questions to ask before making your decision, whether that be around your own health and wellbeing, professional indemnity, pensions or remuneration. We have aimed to answer many of these here but if you have any further queries that are not answered here, please forward them to our mailbox: DHSS.WorkforcePlanning@gov.wales

Your expertise and experience will be valued beyond measure in these challenging times.

This process will come into effect from the 27th March 2020. If you have not been contacted about your re-registration and feel you should have been, please refer to the information on the Nursing and Midwifery Council website.

If you left our register within the last 3 years, we will send you an email on Friday 20 March 2020 inviting you to join the Covid-19 temporary register.

Please wait to see if you receive an email from us and check your junk or spam folder.

If you do not receive an email from us within 24 hours, the contact details we have for you may be out of date and you need to confirm your email address.

Register to rejoin the NHS.

Yes, this process is completely voluntary. Wherever and however you can help, you’re needed, and we would be extremely grateful for any support that you are able to offer. However, if you choose not to remain on the temporary register there will be details within the NMC letter you receive as to what you need to do next to ‘opt-out’. Of course, opting out will not be detrimental to future employment or career opportunities to those who may choose not to temporarily register.

At this point a bespoke package of support will be agreed to enable you to return to work safely. This will include:

• DBS and identity checks which will be undertaken remotely and quickly
• a fast track induction including all key mandatory training requirements to ensure you are supported to practise safely
• more specific guidance, for example, on the scope of your practice, management of coronavirus and use of personal protective equipment (PPE)

No, this will not be necessary under these emergency circumstances, this is a temporary post so neither are required.

Yes, you will be remunerated for any work you do in a way that reflects the responsibilities you undertake. This will be discussed and negotiated with you at the point of your return into work.

Yes, you will be offered a contract that reflects working hour protections, pay arrangements and annual leave entitlement, etc. Your working hours and pattern will be agreed between you and the organisation in which you have decided to work.

Where possible, you will be offered work at an organisation where you have worked before or are already linked with. There might be rare occasions where we would ask if you would consider moving to a different area to cover local needs but this will be in accordance with your identified skills and competencies and will be discussed with you beforehand.

Yes, there are also a range of opportunities for non-patient facing roles also such as manning telephone triage lines or working with NHS 111.

Given the increased risk of COVID-19 in those with co-morbidity and in the elderly population, we would of course advise against returning to patient-facing clinical work if you belong to this group. There are a range of opportunities you may wish to consider in non-patient facing roles that may be more suited and these can be discussed in more detail as part of your bespoke offer. 

With your permission, your contact details will be passed on to the teams working within your local or preferred areas so that they can begin talking through your options with you.

There are a range of different roles that you might want to consider, these include (but aren’t limited to):

• supporting clinical teams in NHS111 services
• working on wards or in care homes
• helping with outpatient clinics (this could be via telephone), providing education
• training to other clinicians
• providing routine clinical cover

Your role will be very much dependent upon your expertise and skills, what you feel comfortable doing and the need within your local areas.

In these challenging circumstances it is recognised that as clinicians we may be asked to work outside our normal field of practice and the regulators have published a joint statement to explain this, to support you.

If you have a joint contract between clinical and educational/research roles, your organisation will contact you to discuss whether you are in a position to provide more clinical support. Those with teaching expertise may be able to help provide induction for others including those returning health care professionals – for example, in the use of PPE, managing high flow oxygen or ventilated patients (if appropriately trained to do so).

We’d recommend you discuss with your employers under what circumstances you should temporarily suspend your external commitments in order to provide more clinical support in your employing organisation. The balance between supporting point of care services directly and delivering the business as usual work should be carefully considered on a case by case basis.

We acknowledge that you may be anxious about returning to practice especially in these unprecedented circumstances. To see up to date information regarding the NMC standards for practice for all registrants please visit their website. Please be assured that where a concern is raised about a registered professional, the NMC will always consider the specific facts of the case, taking into account the factors relevant to the context and environment in which the professional is working. The NMC will also take account of any relevant information about resources, guidelines, or protocols in place at the time. The Joint Statement made by all the regulators is at Nursing and Midwifery Council website.

Yes, arrangements are already in place to indemnify any professional working in a hospital trust or GP practice. 

The government is bringing forward emergency legislation in response to the COVID-19 outbreak that contains important information on pension arrangements for extra NHS staff.

It provides for the suspension of the 16-hour rule which currently prevents staff who return to work after retirement from the 1995 NHS Pension Scheme from working more than 16 hours per week, in the first four weeks after retirement.

It also provides for:

• the suspension of both the abatement for special class status holders in the 1995 Scheme
• the requirement for staff in the 2008 Section and 2015 NHS Pension Scheme to reduce their pensionable pay by 10% if they elect to ‘draw down’ a portion of their benefits and continue working

Taken together, these measures will allow skilled and experienced staff who have recently retired from the NHS to return to work, and retired staff who have already returned to work to increase their commitments if required, without having their pension benefits suspended.

The legislation will give the government the power to immediately bring these measures into effect, if required. 

A 6-month notice period will be given to staff and employers before these measures will cease to apply, at which point the relevant sections of the scheme regulations will take effect again. Staff and employers will therefore have 6 months’ notice to readjust their working patterns.

At this point your contract will come to an end and you will be removed from the temporary NMC register and unable to continue to practice as a registered nurse or midwife. Should you wish to continue to work and be permanently registered with the NMC, please contact them directly.

You are free to change your mind at any time. If you change your mind and don't want to work anymore you should highlight this to your direct line manager and arrange for steps to taken for you to leave work safely and as appropriate.

If you become ill while working, local policy and national guidance must be followed to ensure your safety and the safety of others. You should immediately inform your line manager and withdraw from work. If you have concerns regarding COVID-19 please follow national guidance which you can access via NHS111.

Yes, though if you have a recent DBS certificate or have maintained a subscription to the DBFS Update Service then it may not be necessary for a further application to be submitted.  An assessment will be done by your employing organisation, using guidance from NHS Employers, to determine if a further check is required.  

Where a new DBS application is required, the DBS are proposing to extend the scope of their services to include a new fast track check against the adults and/children's barred lists. These arrangements will enable employers to recruit into a regulated activity in advance of receiving the full disclosure certificate, where they have undertaken a risk assessment and put in place appropriate monitoring and supervision.

You will not be required to pay for a DBS check.

Many people are on the NMC register but don’t work in direct clinical practice – working in academia, policy, research, management, industry and a range of other areas.

If that’s you and you’d like to get more directly involved in the clinical response to Covid-19, please talk to your employer to see if you can be released so you can work in a clinical setting for the duration of the emergency.

If you are interested email the DHSS.WorkforcePlanning@gov.wales

For further information, advice or support the following may be of interest:

• NHS111 coronavirus guidance
• NMC joint statement from chief executives of statutory regulators of health and care professionals
• Royal College of Midwives: coronavirus what you need to know
• RCN publication of UK coronavirus action plan
• Council of Deans for Health: response to coronavirus news updates
• Unison: your rights at work (coronavirus)
• National Care Forum: coronavirus resources
• Public Health England: coronavirus resources