Industry Knowledge

The Digital Badge scheme

Many very highly experienced Advanced Nurse Practitioners (ANPs) working in Primary Care are really struggling to secure new roles, and have been for a while now, and this is largely due to the introduction of the digital badge scheme which was introduced back in 2022.

Its purpose was a way of evidencing the ‘accredited education and training’ of ANPs to ensure employers and patients that ANPs were all “officially” working to a nationally recognised advanced level.

It is not a requirement for all ANPs in Primary Care, however, it is compulsory for any ANPs seeking employment under the additional roles reimbursement scheme (ARRS) in general practice. But, it is interesting to look at the view of ANPs on this controversial recognition to see just how many people have been negatively affected.

The Digital Badge scheme is having a ‘discriminatory impact’

The digital badge can be obtained via two routes:

Completing a Master’s programme in Advanced Practice at certain accredited universities.

Via an ePortfolio route which effectively backdates experience and certain qualifications and includes a 5,000-word essay.

The following figures and data are from Nursing in Practice but just highlight the negative impact this is having on a lot of ANPs.

“Figures from Nursing in Practice reveals that 1,157 ACPs have been awarded the badge via the accredited programme route, typically for nurses completing their Master’s post 2017.

Meanwhile, 259 have secured it through the ePortfolio pathway – which is more likely to be completed by experienced ANPs.

And only 95 of those 259 ACPs are from a general practice or community background, meaning that of the 432 ANPs in general practice, fewer than 100 have obtained the badge via the ePortfolio route.”

NHSE data

Furthermore, those who did have to go through the ePortfolio route have faced waits – further NHSE data showed there were 147 ePortfolios in the ‘post-submission quality and standardisation process’.

NHSE said it typically took between 8-12 weeks from the time of submission to be notified of the outcome.

While figures on the number of ANPs in England are hard to pin down, a report from the Nuffield Trust last year suggested there were, as of May 2022, around 8,000 nurses with a job title either recorded as or suggested as an advanced practice role. And it stressed this was likely to be a ‘significant underestimate’.

QNI

The QNI said there had been several examples where experienced ANPs have been interviewed for jobs in general practice only to have their offer withdrawn because they don’t have the digital badge and therefore do not qualify for ARRS funding.

QNI chief executive Dr Crystal Oldman said: ‘We have been contacted by many ANPs over the last few months who have experienced the discriminatory impact of this requirement.

‘Nurses from outside primary care with the digital badge are able to apply for a role under the ARRS that an expert ANP without a digital badge but with an ANP Masters and more than 20 years of experience in primary care cannot,’ she told Nursing in Practice.

‘This unintended discriminatory impact has got to be addressed urgently to not only win back the hearts and minds of the nurses working in primary care, but to retain our highly valued expert nurses working at an advanced level.’

Early findings suggest ‘that this is a widespread issue impacting on their opportunities for employment and an unequal playing field’, added Dr Oldman.”

Commenting on the wider concerns about the digital badge scheme, Professor John Unsworth, chair of the QNI, said:

“At a time of considerable pressure on general practice the NHS should be doing everything it can to support patient access but instead it has chosen to play politics by restricting who can apply for posts. The restrictions are such that it is unlikely there are sufficient staff who can meet the requirements.”

It certainly seems backwards to me that in an industry where there are shortages of staff (in this case, highly qualified Advanced Nurse Practitioners), that many of them are been asked to jump through extra hoops on top of all the stresses and pressures that come from working in a Primary Care setting. Surely, each individual can be assessed on their current qualifications and experience, as is the case for every ANP I have worked with who has been directly employed by a GP surgery. This would prevent long unnecessary waits to gain a specific “proof of experience” to appease those needing everything to be so regimented and “official”.

How has the badge been viewed?

I reposted an article from the Queens Nursing Institute about how the digital badge is viewed mostly negatively by ANPs and the comments to the post highlighted the frustration of certain individuals surrounding the introduction of the badge, asking very highly experienced clinicians with already recognised qualifications to meet yet more tick box requirements, adding the already high pressure roles that ANPs endure. A lot of advanced clinicians have had enough!

ARRS Funding

The ARRS funding has been great in certain circumstances and when it was announced that ANPs would be added to the list of ARRS funded roles, the initial reaction was very positive, however, with the need for the digital badge to be compulsory in order for the ARRS funding to cover the role it has had a very negative impact overall on a lot of nurses who has described it as ‘discriminatory’ and ‘deeply flawed’.

From numerous conversations I have had with ANPs recently there have been ‘huge delays’ and several barriers in ANPs and Advanced Clinical Practitioners (ACPs) accessing the digital badge. One ANP I spoke to back in May said she had been told that she may not receive her digital badge until October/November.

What’s the future for the digital badge?

In summary, it is very clear from the data from Nursing in Practice, from Professor John Unsworth, and also from a vast number of ANPs that I have spoken to that the digital badge scheme has been viewed much more negatively that was maybe initially expected.

It seems like another example of a scheme that is introduced that in theory sounds reasonable and in an ideal world would work well. However, in reality, there have been far too many barriers put in the way of clearly very experienced clinicians, many of which have been working at an advanced level in Primary Care for years without any problems. This has prompted many to rethink their careers and has even pushed some out of the profession, further reducing the number of experienced nurses needed to keep up with the demands of a very demanding patient base currently across the UK.

The number of ANPs obtaining the badge is increasing, usually after long drawn out processes, so it will be interesting to see moving forwards how things develop and whether the feeling of discrimination continues to grow or whether the strict requirements for the ARRS funding is eased slightly. Only time will tell…