Policy information
CNO’s Office – Nursing and Midwifery Policy Unit
From Department of Health
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The Nursing and Midwifery policy Unit, in the Chief Nursing Officer (CNO) division of the Department, works to shape nursing and midwifery policy around the needs of the health service.
The Strategy for the Office of the Chief Nursing Officer (CNO) provides the necessary direction for the Office in supporting the nursing and midwifery professions and maximising their contribution to health policy. Most importantly, the Strategy's ultimate aim is to help ensure that patients receive the best possible care.
The strategic priorities are:
1 Workforce Stability and Wellbeing.
2 Leadership and Governance Capacity.
3 Education, Research, Evidence and Regulation.
4 Digital Healthcare.
5 Global Partnerships and Global Health.
These priorities will be achieved through:
- Meaningful co‑design with nurses and midwives.
- Patient and service user partnership in the development and evaluation of all future policies.
- Collaboration with colleagues across multidisciplinary professions to support integrated care delivery.
- Continued assurance that all policies developed are evidence based.
Policies developed in the coming years will continue to enhance the delivery of nursing and midwifery services within the community and acute health services.
The Values Initiative is led by the Chief Nursing Officer and the Department of Health, in partnership with the Office of the Nursing and Midwifery Services Director, the Health Service Executive (HSE) and the Nursing and Midwifery Board of Ireland.
A national consultation process asked nurses and midwives to identify, agree and commit to a set of core values that underpin their practice in Ireland. Values are ingrained principles that guide the actions of nurses and midwives.
Three core values were identified by this consultation process:
- compassion
- care
- commitment
The consultation process produced a position paper. Developed in collaboration with the HSE and the Nursing and Midwifery Board of Ireland, this paper describes the core values underpinning and guiding the practice of nursing and midwifery in Ireland.
These values and their associated behaviours are the essence of nursing and midwifery practice. They form the basis for professional decision-making and actions. Taken together, these values represent the unique contribution of nursing and midwifery to safe patient care.
The HSE and the Nursing and Midwifery Board of Ireland are committed to supporting nurses and midwives to practise these values. The values are endorsed and supported by the Office of the Chief Nursing Officer.
Learn more about the core values.
Significant investment is being made in nursing and midwifery. It is therefore important to measure the outcomes and impacts of nursing and midwifery initiatives on patients.
To do this, the department has developed a framework for national performance indicators for nursing and midwifery. This ensures that their development, prioritisation, endorsement and monitoring is standardised.
Learn more about the framework.
A Community Virtual Ward (CVW) is a flexible and integrated model working across community and hospital settings, receiving admissions from both areas. It is termed a CVW as the care is delivered in the community in the person’s home and beds are not physical beds but virtual beds. The CVW operates similarly to a ward, in that a team of nurses provide care for the duration of the admission. The CVW has been adopted and adapted internationally to meet the needs of various populations, including chronic disease management, older persons care and in response to COVID-19, all with positive outcomes. This included improvements in quality of life, better symptom control and management, reduced emergency department presentations and a reduction in unplanned hospital care.
A framework to determine the nurse staffing and skill mix requirements for the nursing workforce is being developed. This means a significant change of emphasis, designed to put patient needs first, in calculating the number and skill mix of nurses and Healthcare Assistants (HCA) needed to work in each care area.
Instead of matching the number of nurses to the size of a ward, the Framework matches nurses and HCAs to the number of patients on the ward, and their care needs.
The Framework is equally focused on creating a healthier and more attractive work environment for staff by stabilising the nursing resource and providing for fairer workloads, a critical factor in recruiting and retaining this vital resource.
Phase One focused on the development of a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Adult Hospital Medical and Surgical Care Settings in Ireland.
The Phase 1 Pilot, which took place in six hospital wards, delivered significant benefits.
These benefits include:
- an increase in the amount of time the Clinical Nurse Manager spent in supervision, with resulting improvements in staff perceptions of the quality of care delivered, and a relative increase in staff perceptions of support received from nursing leadership
- an overall decrease in patient length of stay to 0.5 days
- a reduction in missed care events (referred to as Safety CLUEs), from 75% of nurses reporting that at least one necessary item of care was left undone due to lack of time on their last shift, to 32% following the framework's implementation
- a reduction in the requirement of one-to-one enhanced care, or 'specialling' for patients by more than 70%
- substantial reductions in the use of agency staff, in some cases up to 95%
Phase 2 focused on the development of the Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Adult Hospital Medical and Surgical Care Settings in Ireland.
The Phase 2 pilot, which took place in three emergency departments and one Local Injury Unit, delivered significant benefits.
These benefits include:
- a decrease of 35.4% in time to triage
- a decrease of 43.2% in Time from Triage to be Seen
- A reduction of 17.8% in time waiting by patients to being seen by a decision maker
- an overall percentage decrease of 4.6% in ED Care Time and 4% in Patient Experience Time (PET).
- A 52% decrease in patients leaving without being seen
Phase 3 will apply to general non-acute care setting. Phase 3 given the range and breath of the non-acute settings will include three different stages.
- Phase 3(i) applies to long-term residential care settings (LTRCs) for older persons.
- Phase 3(ii) applies to general community care settings.
- Phase 3(iii) applies to step down and rehabilitation care settings.
A growing body of evidence shows that advanced nurse and midwife practitioners make a substantial and positive contribution to the management of long-term conditions. They can improve patient access to services and reduce waiting times, while delivering high quality healthcare.
As senior decision makers, advanced nurse and midwife practitioners undertake a comprehensive advanced physical and or mental health assessment of patients with complex healthcare needs, including those in crisis. They can interpret the results of different assessments and investigations to make a diagnosis, and plan and deliver care.
As team leaders they can confidently and competently make ethical, evidence-based decisions and interventions. They can use appropriate therapies when faced with complexity, and assess and manage the risk associated with these decisions.
The policy aims to create 700 advanced nurse practitioners by 2021, to meet service needs and contribute to addressing the current challenges in service provision.
Learn more about the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice .
The Nursing and Midwifery Challenge Programme (as part of the Nursing Now Challenge Programme) is facilitated by Chief Nursing Office (CNO), Department of Health and The National Clinical Leadership Centre for Nursing and Midwifery (NCLC), and the Health Service Executive (HSE).
The Nursing and Midwifery Challenge (as part of the Nursing Now Challenge Programme) programme originated as part of the global Nursing Now campaign in 2019. This was a global initiative to bring together health employers to inspire the next generation of nurse and midwives as practitioners, advocates and leaders in health.
Launched at the International Council of Nurses Congress in Singapore, the Nightingale Challenge asked every health employer around the world to provide leadership and development training for a group of young nurses and midwives during 2020 the Year of the Nurse and the Midwife.
The initial challenge was so successful it has continued and in Ireland still going strong as the Nursing and Midwifery Challenge Programme.
The aim of the NCLC/CNO programme is to encourage and enable the development of the next generation of nurses and midwives to play a more significant role in influencing by learning about health direction and policy. Investing in young nurses and midwives is essential for improving health and health care in Ireland. The programme optimises leadership development for participants, through the delivery of core leadership topics, mentoring, networking and shadowing opportunities.
The programme will be delivered using a blended approach of online and face to face facilitation, over seven half days from April 2024 to November 2024
The aim of the Nursing and Midwifery Challenge Programme is to give nurses and midwives from across services and disciplines the skills required to positively impact on Irish healthcare delivery and explore how they can empower leadership in others. The programme is designed to optimise leadership development for participants through the delivery of core leadership topics and mentoring.
Participants will have the opportunity to:
- Foster the skills required for participants to play an even more influential role on global health by raising the profile of Irish Nursing and Midwifery.
- Optimise their leadership development through the delivery of core leadership topics and mentoring.
- Enhance their understanding of nursing and midwifery in Ireland from a strategic and operational perspective.
- Collaborate with colleagues to share experiences and form a network that they can access for professional support and guidance into the future.
Mentoring:
Each participant will be given the opportunity to be mentored by a member of either the CNO or ONMSD teams and will be supported by a mentor who is best suited to them from a personal and professional perspective. Their mentor will offer them three-to-four mentoring sessions which will take place between April and November 2024. Guidance on the mentoring relationship will be provided during the course of the programme.
Who can apply?
Staff Nurse and Staff Midwives who have graduated with their first undergraduate qualification in nursing or midwifery after the 01 January 2014.
Dual qualified applicants must have been awarded their first nursing or midwifery undergraduate qualification after the 01 January 2014.
All Staff Nurse and Staff Midwives must acquire their Director of Nursing or Director of Midwifery approval to apply and support for the duration of the programme.
You can apply for the Nursing Now Challenge Programme here.
Applications close 21 February 2024.
Applicants must complete the online application form in full. Please be advised that completion of application form does not guarantee a place. Once applications close you will be informed if you have a place on the programme.
Closing Date: 12:00pm, Thursday 21 February 2024.
For more Information contact Michelle_quinn@health.gov.ie or CNO's_Office@health.gov.ie
The Minister for Health established the Expert Review Body (ERB) on Nursing and Midwifery in March 2020 to conduct a review of the nursing and midwifery professions as part of the resolution of the industrial dispute in in 2019.
The Report of the Expert Review Body on Nursing and Midwifery (ERB Report) was subsequently published in March 2022 and provides an overview of the professions, acknowledging the immense contribution of nurses and midwives and the ongoing excellence in care delivery, particularly considering the timing of the Report, evident in the response to the COVID-19 pandemic.
It contains 47 recommendations that will support nurses and midwives to continue to learn and develop in professional roles, enabling significant reform and ensuring critical Sláintecare priorities are realised.
The 47 recommendations are under 4 distinct headings Nursing and Midwifery
- Workforce, (14 recommendations)
- Education and Professional Development, (17 recommendations)
- Digital Health (7 recommendations), and
- Governance and Leadership Structures (10 recommendations)
The implementation plan for the recommendations contained within the ERB Report was approved by Minister for Health, Stephen Donnelly T.D. in September 2022. The national oversight group known as ERB Implementation Oversight Team (IOT) was established and is chaired by the Chief Nursing Officer.
The IOT consists of a small, confined group of key stakeholders including HSE and Department of Health Executive Management team members and experienced leads from clinical, operational, HR, finance, policy, education and regulation, as well as staff representation. The inaugural meeting took place November 2022.
Five Implementation Action Groups (IAGs) were established in April 2023 to progress implementation of prioritised recommendations. Implementation of these recommendations also considers national strategies. Work on these and the other recommendations progressing outside of the IAGs is underway and being monitored by the IOT.
