An impact assessment of the introduction of the Digital Badge scheme in England, published by The Queen’s Nursing Institute (QNI), raises concerns that it will prompt senior nurses to quit general practice.
The Impact Assessment is based on a survey undertaken by the QNI’s International Community Nursing Observatory (ICNO) led by Professor Alison Leary MBE.
Over 600 nurses completed the ICNO online survey in July 2024. The responses revealed that many nurses found obtaining the Digital Badge to be a difficult process, and many believed it was unnecessary and bureaucratic. It has also caused stress to many individuals and may be an exit trigger, particularly for experienced nurses in the later part of their careers.
Background
The Advanced Practice Digital Badge was introduced in England in 2022. Its objective was to enable practitioners to evidence – via a number of different routes – that they were practicing at an advanced level, according to the criteria of the England Centre for Advancing Practice.
The Digital Badge has become of increased importance in relation to the ARRS – Additional Roles Reimbursement Scheme – whereby certain categories of healthcare workers may be employed through a subsidised national scheme in Primary Care. One of the categories is Advanced Nurse Practitioners, but only if they hold a digital badge.
QNI Impact Assessment
The Queen’s Nursing Institute decided to carry out an Impact Assessment of the introduction of the Digital Badge, following concerns that it was proving problematic for a number of reasons for individual nurses. The Impact Assessment is based on responses from 615 nurses submitted online over a ten-day period. Most respondents worked either in hospital or in General Practice.
The QNI’s report summarises key metrics from the survey, and also includes some of the comments made by respondents, and overall sentiment, which show that the scheme has caused significant stress to nurses.
The experience of applying for the badge was overall reported as negative. Only 18% found obtaining the Digital Badge to be straightforward. Respondents noted a lack of support, lack of clarity on requirements (particularly the e-portfolio route), delays and process issues.
The effect on some groups appears considerable, impacting current work and future job opportunities. Those with less experience were more likely to undertake the work of applying for the badge; those with more experience less so, preferring to leave employment or retire. This may have serious consequences for workforce function and service delivery.
Professor Leary said: ‘There was an overwhelming response to this impact assessment, it shows the benefit of doing an impact assessment pre policy implementation rather than dealing with the aftereffects. The current situation runs a real risk of losing many experienced workers and expertise from the nursing workforce, particularly in General Practice.’
Dr Crystal Oldman CBE, the QNI’s chief executive commented: ‘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.
‘If nurses working at an advanced level of practice are considering retirement as an alternative to the onerous evidencing process to obtain a Digital Badge, it is a major concern given the workforce shortages across the system. 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. This ICNO Impact Assessment presents an independent analysis of the issues and will support measures to improve the scheme as it develops.’
QNI. Digital badge scheme viewed negatively by advanced practitioners (press release); 23 September 2024. https://qni.org.uk/news-and-events/news/digital-badge-scheme-negatively-viewed-by-advanced-practitioners/
