Publication approval reference: C0857
12 March 2020
Supporting Nurses, Midwives and Nursing Associates (England only) in the event of a COVID-19 epidemic in the UK
Let me start by thanking you, we know that you and your colleagues have been working exceptionally hard, and you should know that the work you are doing is having a real impact.
If COVID-19 becomes an established significant epidemic in the UK, NHS services across the health and care sectors will be put under extreme pressure. This pressure will inevitably be exacerbated by staff shortages due to sickness or caring responsibilities. It will be a challenge, but we are confident that nursing and midwifery professionals will respond rapidly and professionally. We want to assure colleagues that we recognise this will require temporary changes to practice, and that regulators and others will take this into account.
A significant epidemic will require health and care professionals to be flexible in what they do. It may entail working in unfamiliar circumstances or surroundings or working in clinical areas outside of their usual practice for the benefit of patients, individuals and the population as a whole. This can be stressful, and we recognise that you may have concerns about both the professional practicalities and implications of working in such circumstances.
We need to stick to the basic principles of professional practice. As registered professionals you are expected to practice in line with the NMC code and use judgement in applying the principles to situations that you may face. However, these also take account of the realities of a very abnormal emergency situation. We want nursing and midwifery professionals in partnership with patients and those individuals that we care for, to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in their professional standards. A rational approach to varying practice in an emergency is part of that professional response.
It is the responsibility of the organisations in which you work to ensure that you are supported to do this. They must bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the unique and highly challenging but time-bound circumstances of the peak of an epidemic.
We expect employers, educationalists, professional bodies and national NHS organisations to be flexible in terms of their approach and the expectations of routine requirements. Health and care professional regulators, including the NMC have already committed to take into account factors relevant to the environment in which the professional is working.
Due consideration should and will be given to health and care professionals and other staff who are using their skills under difficult circumstances due to lack of personnel and overwhelming demand in a major epidemic. This may include working outside their usual scope of practice. The health and care regulators have already released a joint statement to explain this.
We are now working with the NMC to enable people to come back to work and to invite our final year student nurses and midwives to come into clinical practice to support us over the next few months.
Finally, we would like to thank you all for all the efforts you are already making. Many nursing and midwifery professionals across the NHS and public health services have already made major contributions to the response to COVID-19. We are very proud of the response of the professions in all areas of practice in their response to this challenge. It has been exemplary. We are confident of the commitment, dedication and hard work that nursing and midwifery professionals have and will continue to have in the very testing event of a significant epidemic in the UK.
Your professionalism and work has never been more vital or more valued.
Ruth May | Chief Nursing Officer, England
Fiona McQueen | Chief Nursing Officer, Scotland
Charlotte McArdle | Chief Nursing Officer, Northern Ireland
Jean White | Chief Nursing Officer, Wales
Andrea Sutcliffe | Chief Executive and Registrar, NMC
Dame Donna Kinnair | CEO, RCN
Professor Brian Webster-Henderson | Chair, Council of Deans of Health
Gill Walton | Chief Executive, RCM