20 December 2016

TO:	National Department of Health
	Provincial Departments of Health
	Nursing Education Institutions
	All Stakeholders

 

INFORMATION REGARDING THE PHASING OUT OF LEGACY QUALIFICATIONS; AND IMPLEMENTATION OF NURSING QUALIFICATIONS ALIGNED TO THE HIGHER EDUCATION QUALIFICATIONS SUB-FRAMEWORK (HEQSF)

 

1. Purpose of the circular

The purpose of this document is to update Nursing Education Institutions and relevant stakeholders about the Council’s position on the phasing out of the legacy nursing qualifications and implementation of the HEQSF- aligned new nursing qualifications.

 

2. Background

The South African Nursing Council (SANC), as a statutory body, established in terms of the Nursing Act, 2005 (Act No. 33 of 2005), has a responsibility to liaise and communicate with stakeholders on matters pertaining to the profession.

The promulgation and subsequent proclamation of various sections of the Nursing Act brought about new provisions, necessitating a series of essential activities to implement these provisions. One such provision was the creation of new categories of nurses, making it mandatory for the SANC to develop relevant implementation measures, including but not limited to competencies, scopes of practice and regulations in preparation for the implementation of the new HEQSF-aligned nursing qualifications

 

3. Legacy nursing qualifications

The repealed Nursing Act, 1978 (Act No. 50 of 1978), provided for the following categories of nurses who may practice the nursing profession:

•	Registered Nurse
•	Midwife
•	Enrolled Nurse
•	Enrolled Nursing Auxiliary

In addition to the pre-service/pre-registration programmes that led to professional registration in the categories referred to above, the Nursing Act provided for additional qualifications obtainable after undergoing the following programmes (referred to as post-basic courses):

•	Community Health Nursing
•	Midwifery
•	Psychiatric Nursing
•	Diploma in Clinical Nursing Science, Health Assessment, Treatment and Care (Government Notice No. R. 48 of 1982 as amended). It must be noted that this programme is not similar to the Community Healthcare Programme (regarded as an ancillary course).
•	Clinical Nursing Science Programmes leading to additional qualifications* (Government Notice No. R. 212 of 19 February 1993, as amended):

•	Child Nursing Science
•	Community Nursing Science
•	Gerontological Nursing Science
•	Medical and Surgical Nursing Science
•	Midwifery and Neonatal Nursing Science
•	Occupational Health Nursing Science
•	Psychiatric Nursing Science

*The repealed Act did not specify the categories in terms of nurses who had acquired the above mentioned additional qualifications.

 

3. 1 Phasing out of the legacy qualifications

The underlying context for the phasing-out of the legacy qualifications is informed by the following:

•	The responsibility of the SANC to implement section 31 of the Nursing Act, which prescribes new categories. Such necessitated a reviewed competency framework for nurses and midwives, new scopes of practice for nurses and midwives and presented an opportunity to harmonize new nursing qualifications with health service needs
•	The need to comply with other relevant laws such as the Higher Education Act, 1997 and the National Qualifications Framework, 2008

‘’The Minister of Higher Education and Training has, in line with the provisions of the Higher Education Act, 1997 (Act 101 of 1997), declared that the last enrolment date for first time entering students into academic programmes that are not aligned to the Higher Education Qualifications Sub-Framework (HEQSF) is 31 December 2019 (Government Notice No. R. 801 of 2016, published in the Government Gazette of 06 July 2016).

 

This effectively means that no students shall be enrolled into any Legacy qualification after 31 December 2019. This refers to all the above-mentioned nursing programmes, except for the courses leading to enrolment as a Nursing Auxiliary and enrolment as a Nurse; for which enrolment dates have already expired”.

 

3. 2 Phasing out process

The South African Nursing Council has begun the process of phasing out legacy nursing qualifications in preparation for the phasing in of the nursing qualifications that are aligned to the HEQSF. The phasing out of Legacy nursing qualifications is a gradual process, as outlined below:

3.2.1 Course leading to enrolment as a Nursing Auxiliary

The end date of enrolment into this programme was 30 June 2015, as communicated in Circular 13/2014 and further published in Government Gazette Notice No. R.928 of 09 October 2015. 

 

3.2.2 Course leading to enrolment as a Nurse

The end date of enrolment into this programme was 30 June 2015 as communicated in Circular 13/2014 and further published in Government Gazette Notice No. R.928 of 09 October 2015.

The above-mentioned two programmes/courses are at NQF level 3 and 4, and out of line with the spirit of placing nursing at a post-schooling level. 

Implications

The implications of the end date of enrolment for the above mentioned two legacy programmes are that:

•	The registers for leaners undergoing the two programmes are closed, therefore no further names will be entered into these registers after the said date.
•	Learners who are currently enrolled in these two programmes who fail more than three times will have their status terminated, and will not be able to resume their studies towards these programmes, as 30 June 2015 was the final enrolment date.
•	The last examination and repeat dates must be adhered to i.e. • Course leading to enrolment as a Nursing Auxiliary – May 2017 • Course leading to enrolment as a Nurse – May 2017, November 2017 and May 2018
•	Persons who completed these programmes and are currently enrolled as Nurses or Nursing Auxiliaries are not affected by this change.
•	The attention of the profession is drawn to the fact that the new nursing qualifications, namely Higher Certificate and Diploma, are not replacement qualifications for the above-mentioned two programmes

 

3.2.3 Bridging Course for enrolled Nurses leading to registration as a General or Psychiatric Nurse

The end date of enrolment and registration into this programme will be 31 December 2019. This is in line with Government Notice No. 801 of 06 July 2016 referred to under point 3.1 above. 

There will be no new intake for this programme from the year 2020. 

 

3.2.4. Course leading to registration as a Nurse (General, Psychiatric and Community) and Midwife (Notice No. R.425 of 22 February 1985, as amended)

The end date of enrolment and registration for this programme will be 31 December 2019. This is in line with Government Notice No. R.801 of 06 July 2016 referred to under point 3.1 above.

There will be no new intake for this programme from the year 2020. 

 

Implications

•	A learner who terminates from the four-year programme and qualifies for enrolment as Nurse or Nursing Auxiliary, in line with prescripts of Government Notice Regulation No. R.2176 and No. R. 2175 of 1993, will be enrolled accordingly.

The process is in line with concessions as articulated in the previous SANC’s Circular No. 6 of 2007 (Circular6/2007).

•	Those who do not meet the requirements in line with concessions as articulated in Circular 6/2007 will be terminated from the programme since the entry registers for the R.2176 and R.2175 programmes were closed on 30 June 2015.
•	Candidates who would have failed third or fourth year levels of the R.425 programme may be admitted through the Recognition of Prior Learning (RPL) Process into the *R.683 programme offered by Nursing Education Institutions (NEIs), and attempt the examination for the Bridging Programme in line with requirements that they would have met, provided such admission occurs prior to 31 December 2019.

* R.683 is a two-year programme leading to registration as a General Nurse

 

3.2.5 Phasing out of Post-Basic Programmes

All the programmes listed in section 3 will be phased out on 31 December 2019. This is in line with Government Notice No. 801 of 06 July 2016, referred to in point 3.1 above.

There will be no new intake for these programmes from the year 2020.

 

3.2.6 Applications for approval related to Legacy Programmes

In order to facilitate a smooth transition from legacy to new nursing qualifications, there will be no further approval for the following in respect of the legacy programmes:

•	Increase in the number of learners;
•	Increase in the number of intakes of learners per year;
•	New Nursing Education Institutions;
•	New campuses/sub-campuses;
•	Legacy nursing programmes.

N.B. Only applications for approval of additional clinical facilities for post-basic nursing programmes may be considered by the SANC.

 

4. Phasing in of the new nursing qualifications that are aligned to the HEQSF

4.1 Legislative provisions 

Section 3(1) of the Nursing Act 2005 (Act No. 33 of 2005), provides for the following categories of nurses who may practice as practitioners if registered by the Council upon fulfilment of the prescribed education and training requirements:

•	Professional Nurse
•	Midwife
•	Staff Nurse
•	Auxiliary Nurse
•	Auxiliary Midwife (N.B. There is no qualification to be offered for this category).

In line with the categories outlined above, the NQF aligned nursing qualifications that will be offered in future are outlined below:

QUALIFICATIONS TYPES	NQF LEVEL (CREDITS)	NURSING ACT PROVISION	PROFESSIONAL REGISTRATION WITH SANC
Higher Certificate	5 (120)	Section 31(1)(d)	Auxiliary Nurse
Diploma	6 (360)	Section 31(1)(c)	General Nurse
Advanced Diploma	7 (120)	Section 31(1)(b)	Midwife
Bachelor`s Degree	8 (480)	Section 31(1)(a)	Professional Nurse and Midwife
Post-graduate Diploma	8 (120)	Section 31(2)	Nurse Specialist and Midwife Specialist
Master`s Degree (Professional)	9 (180)		No determined professional registration with SANC. Council to consider keeping a database
Master`s Degree (Research)	9 (180)		No determined professional registration with SANC. Council to consider keeping a database
Doctoral Degree (Professional)	10 (360)		No determined professional registration with SANC. Council to consider keeping a database

 

4.2 Progression and articulation possibilities 

4.2.1 Higher Certificate 

This qualification will lead to registration as an Auxiliary Nurse with the SANC, in line with Sections 31 (1) (d) of the Nursing Act, 2005. A nurse who holds the Higher Certificate qualification at NQF Level 5 cannot progress to an Advanced Certificate at NQF Level 6 as there is none for nursing. Such person can articulate to a Diploma in nursing at NQF Level 6 that leads to registration as a General Nurse.

The start date for enrolment of students for the Higher Certificate qualification is January 2018.

 

4.2.2 Diploma (General Nurse)

This qualification will lead to registration as a General Nurse with the South African Nursing Council. A nurse who holds a Diploma qualification at NQF Level 6 can progress, as follows:

a) Advanced Diploma at NQF L7 (Midwifery) that leads to professional registration as a Midwife [31(1) (b)];

b) From this level, a nurse can progress to a Post-graduate Diploma at NQF L8; to a Professional Master’s Degree at NQF L9; and ultimately 

c) To a Professional Doctorate at NQF L10.

 

The start date for enrolment of students for the Diploma qualification is January 2019.

 

4.2.3 Professional Bachelor’s Degree

A nurse who holds a Bachelor of Nursing degree at NQF L8 can progress to a Professional Master’s degree, provided they hold a Post-graduate Diploma (PGD) in Nursing; and subsequently to Professional Doctorate level. Without a PGD, s/he can only progress to ‘Research’ category Master’s and Doctoral degrees. 

The start date for enrolment of students for the Bachelor`s Degree qualification is January 2020. 

 

4.3 Post-graduate Diploma programmes

In the Nursing Act, 2005 (Act 33 of 2005) there are no prescribed categories for nurses with additional qualifications/specializations. The Minister of Health created a category of practitioner in terms of section 31(2) of the Nursing Act (Act 33 of 2005) which gave effect to the category “Nurse/Midwife Specialist”. This was published as Government Notice No. 368 of 15 May 2014. 

Post-graduate Programmes (PGDs) will be offered in line with the schedule of nursing qualifications, soon to be prescribed by the SA Nursing Council.

Competencies for the said PGDs have been developed and approved by the Council for the following programmes:

•	Critical Care Nurse Specialist (Adult)
•	Midwife Specialist
•	Occupational Health Nurse Specialist
•	Orthopaedic Nurse Specialist
•	Ophthalmic Nurse Specialist
•	Paediatric Nurse Specialist
•	Primary Care Nurse Specialist
•	Perioperative Nursing
•	Nursing Management
•	Nursing education
•	Psychiatric Nursing
•	Palliative and Oncology Nursing
•	Public Health Nursing
•	Forensic Nursing
•	Infection Prevention and control Nursing
•	Nephrology Nurse Specialist

These are available on the SANC website.

The new nursing qualifications will be accredited by both the South African Nursing Council and the Council of Higher Education (CHE). It must be noted that any student undergoing a nursing programme which has not been accredited by the South African Nursing Council will not be registered as such in terms of the Nursing Act, and on completion of the programme the SANC will not issue a professional registration for the acquired non-accredited programme.

The start date for enrolment and registration of students for the Post-graduate Diploma is January 2020.

 

5. Accreditation

5.1 Legislation underpinning accreditation

The Nursing Act (Act 33 of 2005), provides that the Nursing Council may accredit Nursing Education Institutions and Nursing Education Programmes in accordance with the Act and any other laws.

The relevant laws referred to in this context are the Higher Education Act, 1997 and the National Qualifications Framework Act, 2008.

 

5.2 Accreditation process

The accreditation process will be in line with the regulations relating to the accreditation of institutions as Nursing Education Institutions, promulgated in terms of Government Notice No. 173 of 08 March 2013.

It must be noted that the Council reserves the right to call for preliminary discussions with a prospective Nursing Education Institution; as well as the right to allow for representation to the Education Committee by the applying institution, where clarity is either sought or provided from and by either party. 

Please note that there will be:

•	No more dual submission to both the CHE and SANC;
•	No more issuing of provisional endorsement letters by the SANC. The Council will undertake a full evaluation of a submission before any pronouncement is made in respect of compliance or not of the submitted application.

 

6. Progress on regulations

6.1 The following regulations were promulgated by the Minister of Health:

•	Regulations relating to the approval of and the minimum requirements for the education and training of a learner leading to registration in the Category of Auxiliary Nurse (Government Notice No. R. 169 of 08 March 2013);
•	Regulations relating to the approval of and the minimum requirements for the education and training of a learner leading to registration in the Category of Staff Nurse (Government Notice No. R. 171 of 08 March 2013);
•	Regulations relating to the approval of and the minimum requirements for the education and training of a learner leading to registration in the Categories of Professional Nurse and Midwife (Government Notice No. R. 174 of 08 March 2013);
•	Regulations relating to the accreditation of institutions as Nursing Education Institutions (Government Notice No. R. 173 of 08 March 2013);
•	Regulations regarding fees and fines payable to the South African Nursing Council (Government Notice No. R. 170 of 08 March 2013).

 

6.2 The following regulations are at various stages of processing between the SANC and the National Department of Health (NDoH):

•	Draft Regulations regarding the Register for Learner/Student Nurses and Learner/Student Midwives;
•	Draft regulations for Post-graduate Diploma: Nurse or Midwife Specialist;
•	Draft regulations relating to the approval of and the minimum requirements for the education and training of a learner leading to registration in the Category of Midwife and
•	Regulations Relating to the Scope of Practice for Nurses and Midwives

 

7. Withdrawal of Circulars

The Circulars listed below are herewith withdrawn, only to the extent of and in respect of the content that is replaced/updated by, or conflicting with this document; on the date of implementation of this circular:

•	Circular 3/2009: Implementation of the nursing qualifications registered on the NQF.
•	Circular 3/2010: Update on the status of offering of legacy nursing qualifications and implementation of the new nursing qualifications registered on the NQF.
•	Circular 3/2011: Extension of date for Nursing Education Institutions to offer Legacy nursing qualifications.
•	Circular 6/2012: Dual submission of programmes for accreditation to South African Nursing Council (SANC) and Council on Higher Education (CHE).
•	Circular 9/2012: Extension of the date of submission of new nursing programmes for accreditation by the South African Nursing Council (SANC) and Council on Higher Education (CHE) – [Dual submission: Circular 6/2012].
•	Circular 11/2014: Extension of offering of the Education and Training programme leading to registration as a Nurse (General, Psychiatric and Community) and Midwife (Government Notice No. R. 425 of 22 February 1985, as amended).
•	Circular 12/2014: Extension to offer supplementary and Post-Basic (additional) Qualifications, including the Bridging Course for Enrolled Nurses leading to Registration as a General Nurse or Psychiatric Nurse.

 

8. Implementation date

This circular becomes implementable on the date of issue. 

For further information on this circular, you are advised to contact the Senior Manager: Education and Training, Ms SJ Nxumalo at 012 426 1022 or jnxumalo@sanc.co.za

 

Kind Regards

(Signed)

Ms SA Mchunu
Acting Registrar and CEO
South African Nursing Counci