On Thursday, 16 April 2026, Melissa Hammond (Chair IAANMP) and Caroline Fraser (Vice-Chair IAANMP) met with Chief Nursing Officer, Rachel Kenna at the Department of Health to discuss the IAANMP submission, Independent Nursing and Midwifery Practice: A National Framework Proposal to Empower the Profession and Strengthen the System.
The IAANMP would like to thank Dr. Susan Kent of ArrowHealth for her expertise and help in the development of this document. Her extensive experience and leadership in nursing practice were instrumental in shaping the document structure and ensuring the recommendations reflected both current best practice and future service needs.
The framework outlines a structured, evidence-informed approach to enabling independent nursing and midwifery practice within existing statutory authority and demonstrates clear alignment with the recommendations of the Expert Review Body (ERB) for the period 2022–2026.
The proposal is positioned within the context of sustained and increasing pressures across the Irish health system, including the rising prevalence of chronic disease, emergency department overcrowding, delayed hospital discharges, and high levels of preventable hospital activity.
A central component of the framework is the operationalisation of ERB Recommendation 28, which calls for the evaluation, development, and implementation of independent practice models. More broadly, the proposal advances key ERB priorities relating to professional autonomy, leadership visibility, expansion of advanced practice roles, doctoral and research pathways, optimal utilisation of nursing and midwifery skills across integrated care, digital transformation, governance reform, and contractual modernisation.
The evidence base underpinning the proposal draws on national data and established Irish service models, including ANP-and AMP-led services, community specialist teams, minor injury units, maternity care pathways, and independent providers. Reported outcomes associated with these models include hospital avoidance rates of 25–35 per cent, high levels of patient satisfaction, reductions in emergency department presentations and hospital readmissions, and positive social return on investment.
The proposed model establishes a whole-profession, three-tier continuum of autonomous practice across generalist, specialist, and advanced levels. PCRS-enabled independent contracting would support tariff-based reimbursement, enhanced visibility of clinical outcomes, integrated diagnostic and referral pathways, and improved continuity of care across the health system.
The meeting was productive and constructive, and the IAANMP looks forward to continued engagement with the Chief Nursing Officer as the proposal progresses through consideration, development, and potential implementation pathways within the Department of Health. The association welcomes the opportunity for ongoing collaboration and further dialogue with key stakeholders and anticipates a positive and structured outcome arising from the Chief Nursing Officer’s review of the framework.
