Q: With nurse revalidation coming in for the profession on 1st April, what do providers need to know and what role do they have to play in ensuring their nursing staff adhere to the new revalidation requirements?
A: Jackie Smith, Chief Executive and Registrar, Nursing and Midwifery Council
When the Nursing and Midwifery Council (NMC) first decided to introduce revalidation, we had to consider a number of factors. At the forefront of our mind was the fact that any big change needed to be communicated, and in order to communicate a change you need to be able to reach the people you want to deliver that change. In the complex world of healthcare, and with over 680,000 people on the NMC register, we asked ourselves, who would be the trickiest people to reach?
Near the top of that list were nurses working for social care organisations. Consider for a moment any nurses working with you or the nurse working in a small, private care home. He or she may be the only nurse working in that organisation; he or she won’t be part of the NHS machine and he or she may not report to another nurse – how on earth could he or she find out about revalidation? That, of course, is where you, senior managers and providers working in the social care sector, come in. It would be remiss of me not to exaggerate how important you are in making revalidation the success it needs to be.
Revalidation represents a significant change to the way in which nurses and midwives renew their registration with the NMC. The changes have been introduced as a result of some very significant challenges that have faced nursing and midwifery in recent years, including in the social care sector. Now, for the first time, nurses and midwives will be empowered to reflect on their own professionalism, actively seek feedback from patients, colleagues and service users and discuss all of it openly and frankly with a peer.
There are a number of important new requirements that every nurse and midwife needs to know about. If you happen to be responsible for registered nurses in your organisation, you need to know about them too.
In all, there are eight key elements to revalidation that registrants will need to demonstrate. They will need to be able to show that they have practiced for a minimum of 450 hours, over a three year period, prior to the renewal of their registration.
They will also need to have shown that they have completed at least 35 hours of continuing professional development (CPD). In itself, this is not a change from the current requirement; however, revalidation now asks that 20 of these hours must be met through what’s called ‘participatory learning’. In reality, this means that the nurse or midwife undertakes the CPD alongside one or more colleagues.
For the social care provider, this could mean organising a workshop on the prevention of falls, or the risks of bedsores – as long as it is truly relevant to the practice of the nurse, it can count towards their CPD requirement.
There are also some new requirements that all nurses and midwives will have to meet. Firstly, registrants must collect five pieces of practice-related feedback over the course of three years. This feedback can be from a range of sources including patients or service users, colleagues or via annual appraisals, team performance reports or serious event reviews.
This might sound like an onerous task, but it really doesn’t have to be. Feedback can be written or verbal and registrants can think smartly and make full use of the feedback that they already collect. As well as collecting five pieces of feedback from other people, we also ask that registrants prepare five of their own written reflections on their practice. Importantly, nurses and midwives should bring the experiences back to the Code, the professional standards that nurses and midwives must uphold in order to be registered to practise in the UK, and try to understand how it is relevant to their daily practice.
Once these pieces of reflection have been produced, we’re asking every nurse and midwife to discuss them with another person who is registered with the NMC, as part of a reflective discussion. It is this element that proved to be the most powerful according to the nurses and midwives who piloted revalidation for us last year.
There are two elements to revalidation which have not been changed at all from the current requirements, namely that, as part of their application, registrants make declarations relating to their health and character, and that they have a professional indemnity arrangement in place.
The final part of the process is to identify a confirmer and hold a face-to-face confirmation discussion with them. A confirmer is the person who verifies that the registrant has met all of the requirements necessary to revalidate, and has collected all the right evidence. We recommend, wherever possible, that the nurse or midwife’s line manager acts as their confirmer.
Evolution not Revolution
For providers working in the social care sector, some of this may seem daunting. However, it is important to remember that, as a process, revalidation is more evolution than revolution. Although there are some new elements, it’s more the case that revalidation is asking nurses and midwives to evidence things that they are already doing.
In the social care setting, particularly in situations where a small number of nurses might be leading the care delivered to patients without a director of nursing above them, it will be particularly important to point them to places where they can find out more. We have a wealth of information available on our dedicated revalidation website.
The reality is that every single nurse and midwife will need to pass through this process at some point within the next three years. It affects every registrant, in every healthcare setting, across the UK. Nurses working in social care will need the support of their management team, like you. The time is now to make sure you, and your staff, are ready for revalidation.
For more information and to access the wealth of information available on revalidation, visit www.nmc.org.uk/revalidation
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