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Berlin – Medical services that suitably qualified nursing professionals will be allowed to provide in the future are to be brought together in a special catalogue. This is stated in the draft bill for the Nursing Competence Act, which the Federal Ministry of Health (BMG) has now published.

Accordingly, the National Association of Statutory Health Insurance Funds, the National Association of Statutory Health Insurance Physicians and the national associations of outpatient nursing services and inpatient nursing facilities are to present a catalogue of medical services that nursing professionals can provide independently after a medical diagnosis and indication by 31 December 2025.

They should also create a further catalogue of services that nursing professionals can independently order as follow-up prescriptions, including the aids required for this. Finally, they should develop framework specifications for interprofessional cooperation.

The catalogues should also contain the qualifications that the caregivers must have acquired in order to be able to provide the respective services independently. In addition to training, the qualifications can also include professional experience and further training.

The respective services can be provided by the nurses to licensed doctors, in medical care centers, in outpatient care services or in inpatient care facilities. Contracted doctors can delegate the independent performance of the medical services agreed in the catalogs to a nursing professional who has the appropriate qualifications.

Extended medical services

In the future, the Social Code Book V (SGB V) will distinguish between three services that nursing staff may provide depending on their qualifications: “nursing services”, “medical services” and “extended medical services”.

Nursing professionals who have completed three years of general nursing training should therefore be allowed to provide medical services. This includes, for example, home nursing and medical treatment services.

The BMG defines nursing services as all services that are not medical services: activities that can also be carried out by nursing assistants. Advanced medical services are activities that are reserved for nurses with a university education.

They concern, for example, the areas of diabetic metabolism, chronic wounds and dementia. “The term extended medical services refers to tasks that were previously reserved for doctors,” the draft law states.

Consider reserved tasks

The explanatory memorandum to the law points out that with regard to the performance of nursing activities, the reserved duties under the Nursing Professions Act must also be taken into account.

These tasks include the assessment and determination of individual care needs and care planning, the organisation, design and control of the care process as well as the analysis, evaluation, assurance and development of the quality of care.

“The reserved tasks are designed as absolute reserved tasks under professional law,” the justification for the law states. “This means that other professional groups are not allowed to perform these tasks. The reserved tasks are performed by nursing professionals on their own responsibility, including liability for incorrect decisions, in compliance with the principle of economic efficiency.”

Making the profession more attractive for foreign nursing staff

With the Nursing Competence Act, the government wants to contribute to making better use of “the diverse skills of nursing professionals in care” – also against the background of ongoing demographic change.

The law also aims to make work in nursing more attractive for foreign nurses.

“Internationally, nursing professionals, especially those with a bachelor’s or master’s degree, often take on more extensive, independent tasks in care and thus not only ensure better care, but also help to relieve the burden on doctors by working together in multi-professional teams,” the draft law states.

“This is not about curtailing the powers of other professional groups in the health care system, but rather about expanding the pool of competent people in care.”

The draft law contains various other provisions from the area of ​​nursing. Among other things, the BMG wants to support the professionalization of nursing in Germany by uniformly regulating the representation of nursing professions at the federal level.

For example, a legal ordinance with the consent of the federal states is to determine which organization or organizations should in future be considered the relevant organizations for the nursing professions at the federal level.

In addition, the Federal Association of Nursing Care Funds will be required to submit a report on why the number of people in need of care has recently increased more than expected. The report will answer the question, among other things, of what impact the nursing care assessment instrument introduced in 2017 has had on this development. © fos/aerzteblatt.de