New CN/MS Grade 2 comes into effect

Following a hard fought campaign for the recognition of advanced practice nursing – which was won in the public sector pay and conditions agreement last year – a new CN/MS Grade 2 has come into effect. DONs and nurse managers need to move urgently to take advantage of this rare opportunity.

CN/MS Grade 2 is a new classification with a two-year pay scale for employees providing complex care requiring advanced clinical skills and exercising extended autonomy in decision making.

Up to 1,000 FTE positions will be created and filled in the next few months where nurses and midwives can show advanced practice is required. CNS Grade 2 is an appointed position, not a personal grade. It is expected that most of the successful applicants for the new roles will be nurses currently graded CNS and RN 8.

The new grade was developed to recognise that there are nurses and midwives operating at a higher level of practice than CNS, but below that of the CNC grade. This now means an easier career pathway to CNC, designed to reward nurses who specialise in their clinical stream.

The first step in the process of establishing CN/MS Grade 2 positions has now been completed. Approximately 250 positions, totalling 229 full-time equivalent positions have been identified by Area Directors of Nursing and approved by the Health Department and are expected to be filled by March under the transitional arrangements detailed in PD2008_044, which can be downloaded from

A further number of CN/MS Grade 2 positions have been proposed by the Area Directors of Nursing & Midwifery. A/DONs should review their 2008 proposals to check that they are submitting all possible advanced practice positions eligible for creation or upgrading. These will be assessed by the Health Department in a second round to be finalised by mid-March.

Once those positions have been processed, any individual who believes their role fits the criteria, but has not yet been identified, will be given the opportunity to have their position considered for regrading by the Health Department. The Association will distribute more information about this next month.

Funding based on the cost of regrading 25% of the current CN/MS nurses and midwives (up to 1,000 CN/MS Grade 2 positions) has already been guaranteed by the Health Department.

It’s critical that nurses and midwives work together to ensure the commitments won in our wages and conditions agreement are fulfilled. If you are practising at the advanced level then you deserve to be rewarded. If your specialty area, and your facility, has a fair number of CNS Grade 2 positions created, then NUMs and Nurse Managers will have a stronger opportunity to attract and retain experienced clinicians.

There is only one chance to access the guaranteed funding for these new roles and that is now. After the initial creation of up to 1,000 positions in mid-2009, any further applications for a CNS Grade 2 role will need to be created and funded from recurrent budgets.

Make sure your service gets its fair share of CNS 2 positions


The money is guaranteed and quarantined to create up to 1,000 FTE positions. It’s critical that you review your proposals to date and resubmit urgently if there are more incumbent nurses whose positions should be upgraded or there are new CNS 2 advanced practice roles that you wish to create.


Make sure you’ve submitted your proposal to create CNS 2 positions for your unit. These can be for existing positions, or a new position at an advanced practice level.

Does your position qualify for an upgrade?

The criteria are:

Clinical Nurse/Midwife Specialist (‘CN/MS’) Grade 2 means: a Registered Nurse/Midwife appointed to a position classified as such with relevant post-registration qualifications and at least three years experience working in the clinical area of their specified post-graduate qualification.

The CN/MS Grade 2 classification encompasses the CN/MS Grade 1 role criteria and is distinguished from a CN/MS Grade 1 by the following additional role characteristics:

  • Exercises extended autonomy of decision making;
  • Exercises professional knowledge and judgement in providing complex care requiring advanced clinical skills and undertakes one of the following roles:
    a) leadership in the development of nursing specialty clinical practice and service delivery in the ward/unit/service;
    b) specialist clinical practice across a small or medium sized health facility/sector/service;
    c) primary case management of a complete episode of care;
    d) primary case management of a continuum of specialty care involving both inpatient and community based services;
    e) an authorised extended role within the scope of Registered Nurse/Midwifery practice.

Incremental progression to the second year and thereafter rate shall be upon completion of 12 months satisfactory full-time service (or pro rata part-time service).