Flawed badge scheme sees PCNs lose out on experienced nurses

PCNs are at risk of losing out on hiring ‘many’ experienced nurses because of an NHS accreditation scheme that needs ‘urgently’ reviewing, a new report from the Queen’s Nursing Institute (QNI) has found.

The digital badge scheme was launched by NHS England (NHSE) in 2022 as a way of evidencing the ‘accredited education and training’ of advanced nurse practitioners (ANPs). It is currently compulsory for ANPs seeking employment under ARRS.

The badge can be obtained via two routes: from doing an accredited Master’s programme or via an ePortfolio which includes a 5,000-word essay.

Concerns have previously been raised that as it is largely courses post-2017 that are accredited – because they are matched to a ANP framework launched that year – ANPs who have done their education before then have to undergo the extensive ePortfolio option if they want to obtain the badge.

As reported by our sister title Nursing in Practice in the summer, some nurses have been forced to take sick leave or look for jobs elsewhere because of delays and several barriers in obtaining the accreditation, especially via the ePortfolio route.

A QNI impact assessment of the introduction of the digital badge scheme, based on a survey undertaken by the QNI’s International Community Nursing Observatory (ICNO), completed by more than 600 nurses, drew particular attention to the negative impact the scheme has had in primary care.

It explained that under the ARRS ANPs must have a digital badge to be eligible for employment. But there is ‘no funding whilst in training’, the report said.

It added that other roles, including first contact practitioners, ‘appear to have a different arrangement, with advanced practice courses funded’.

‘The national funding approach appears inconsistent,’ the report said.

Leading this assessment, Professor Leary said: ‘The current situation runs a real risk of losing many experienced workers and expertise from the nursing workforce, particularly in general practice.’

The report concluded that an urgent review of the digital badge process for advanced nurse practitioners was needed, ‘in particular within the ARRS in primary care’.

‘In general practice, the inequity in the implementation of the requirement for the digital badge before employment under ARRS between [allied health professionals] and registered nurses is unsustainable and discriminatory,’ it said.

‘The rules of the ARRS significantly disadvantage nurses who have many years of experience successfully working in an advanced practice role.’

It added: ‘A review of the digital badge requirements, funding, process, and current impact on the nursing workforce is needed.

‘Such a review should take into consideration the findings of this analysis. This will help to navigate a way forward to support the retention of nurses and prevent early retirement and unwelcome movement in the nursing workforce which will create instability, particularly in general practice.’

Data suggests badge scheme ‘is a problem’

Sandra Dyer, who qualified as a nurse in 1990 and completed her advanced practice Masters in 2015, was told last year that her ARRS ANP role could no longer be funded as she did not have the digital badge.

And despite trying to secure a place on the ePortfolio route to obtain a digital badge since September 2023, she is still yet to be offered one and is therefore left struggling to find a job in primary care.

She said: ‘It is problematic in the sense that it is affecting everybody’s ability to potentially be employed and do their job. It’s going to have an impact on retention and recruitment as well, and it looks like it is particularly affecting older nurses.’

Ms Dyer said she wanted to see the requirement for a digital badge for ANPs under ARRS to be removed.

‘That would have a very positive benefit, very quickly, on people,’ she said.

She added that she also wanted to see a review of the badge scheme and its implementation overall.

Sarah Ellison is a community research ANP who has tried and since given up securing the digital badge because of significant barriers securing it, despite years’ of experience and Masters and non-medical prescriber qualifications.

She agreed there should be an ‘immediate review’ of the scheme by NHSE.

‘I think that it needs a huge review. Nurses’ lives are being impacted by this, especially the ones that work in GP surgeries from the ARRS perspective.’

QNI chief executive Dr Crystal Oldman, said: ‘The introduction of the digital badge has had widespread repercussions for nurses, and unforeseen consequences on the health and care system.

‘Action could be taken now, supported by this evidence, to provide equitable employment conditions and equal access to the support for education under the ARRS – a scheme that has a real impact on employment prospects and careers.’

She added: ‘An excellent idea in principle, the digital badge has had unintended consequences on the nursing workforce.

‘But these consequences can be addressed, and any positive measures introduced now will boost the nurses’ morale, improve their sense of being valued, and will directly assist with retention.’

NHSE has been contacted for comment.

A version of this story was first published on our sister title Nursing in Practice.