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Revalidation – a Blessing or a Curse?

Greg U

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NMC Revalidation

Revalidation is the new process by which nurses and midwives on the Nursing and Midwifery Council (NMC) register will renew their registration, starting in April 2016. 

As in previous years, renewal of registration takes place every three years and on the past was achieved through the completion of a Notification of Practice (NOP) Form (now an online form).  At that time, the registrant declared that they had met the requirements for continued registration and were of good health & character and they paid their (now) annual fee.  The answer to all questions on revalidation can be found in the NMC ‘bible’ ‘How to Revalidate’ – and I would encourage all registrants to become familiar with this document.  The NMC Website has and links to PowerPoint presentations, mandatory and suggested templates / forms, guidance documents, and much more – everything you need to become an expert and controller of your own Revalidation destiny!  The following sections outline the processes in which Revalidation will take place.

RELATED: EVERYTHING YOU NEED TO KNOW ABOUT REVALIDATION

NMC Online

The first step is to set up an account via NMC Online.  This will be the only way in which your revalidation application can be made.  It is now the process in which NOP applications are being made too (last time I did mine in August 2013 it was paper form via the post).  Here is the guidance document on how to set up your account if you have not done so by now!  The NMC will keep you updated on your own revalidation and other important issues via your NMC Online-registered email address.  They will also use this email address to contact you for verification / audit, so I always advise NOT using an email address that you can only access whilst at work.

The Code

The new NMC Code was approved in March 2015 and a copy of this was sent to every registrant in April.  The Code underpins everything within the Revalidation process and is a living guide to every registrant and their practise. Many aspects of the process will require reference to pillars and sections of the code, so I advise all registrants to have their copy of the Code handy (either the leaflet version that was posted to us, a printout of the PDF referenced above, or via the e-edition) when working through the steps below.

To e- or not to e-:  Your Revalidation Portfolio

The NMC recommends that you maintain a portfolio (and this recommendation has not changed from the previous requirements in Post Registration Education & Practice (PREP).  All of the resources discussed below (and any associated evidence) could / should be maintained within the portfolio.  There is no requirement to upload anything to the NMC.  There will be some who might choose to use an electronic portfolio as a handy way to store things.  Please note that due to issues related to data protection and information management, some forms used for Revalidation cannot be scanned and uploaded electronically.  They will need to be maintained in a paper-based portfolio only.  I will explain in detail where this is relevant.  All other forms, documents, evidence etc. that you choose to upload must NOT contain any data which can identify another person, patient etc.   The NMC has produced a Guidance Document on Portfolios which some registrants have found useful.

Practice Hours

Every nurse registrant and every midwife registrant requires to have worked a minimum of 450 hours of nursing practice relevant to their area / scope of practice within the 3-year renewal cycle.  If you are a nurse and a midwife, you will require 900 hours of practice.  The NMC have provided a handy Practice Hours Template Log that you may choose to use for recording of your practice hours.  It is unlikely that you will need actual proof or evidence of the hours, but if you do, copies of job description, work plan, work rota and other documents may assist in this process.

Continuing Profession Development

Every nurse registrant and every midwife registrant requires to have completed a minimum of 35 hours of CPD relevant to their area /scope of practice within the 3-year renewal cycle.  At least 20 of the 35 hours must have been conducted with other professionals (‘participatory CPD’).  The NMC have provided a handy CPD Log that you may choose to use for recording of your CPD.  You may want to have some evidence of your CPD handy also – such as notes from your training / study, copies of hand-outs / presentations, a certificate of attendance and other items as may be applicable.  A certificate of attendance, on its own is not sufficient as you need to evidence how you used this learning / development to improve your practice.

Practice Related Feedback

Every nurse registrant and every midwife registrant requires to have documented at least 5 sources of practice-related feedback within the 3-year renewal cycle.  The feedback should come from a variety of sources, some of which could include patients, service users, students and colleagues. Feedback can also be obtained through reviewing complaints, team performance reports and serious event reviews.  Feedback can be informal or formal, written or verbal.  Feedback does not need to be specific to you as an individual it can be about a whole ward, team or organisation (such as an inspection / audit report).  The information should be recorded anonymously so as not to identify a person or patient and the NMC have not recommended or suggested a template form.  My suggestion for a template would be to include details as below:

Date Source Action Taken to improve Your Practice
01/01/1990  Patient 1  Patient commented that…

Refection & the Reflective Discussion

Every nurse registrant and every midwife registrant requires to have completed a minimum of 5 Reflective Accounts relevant to their area /scope of practice within the 3-year renewal cycle.  The NMC have provided a Reflective Account Form that you must use to document each of your reflective accounts.  You can choose to reflect on a range of issues, chosen from your Practice Related Feedback (see below) and/or a session of CPD (see above) and/or an event or experience in your practice.  I’ve done a few already and it does not take that long to do one (30 minutes on average?).  I would encourage each workplace to have spares of the Reflective Account Form handy, as ideas and opportunities for reflection will occur on an almost daily basis.  I am a natural reflective practitioner and use my own ‘model’ of reflection.  The NMC suggests that you can use any model you wish as long as you can take your documented reflection and fit it into / onto the mandatory form.

For each of the Reflective Accounts, you must have had a professional discussion with a reflective partner (who must be on the NMC register).  The NMC have provided a Reflective Discussion Form that you must use to document your discussions.  You can use one form for one or more discussions and it is the reflective partner who is expected to complete the detailed parts of the form.  The NMC has produced a Guidance Document on conducting reflective discussions which some registrant have found very useful.  Because the Reflective Discussion form(s) contain(s) details that can identify another individual (your reflective partner), you cannot save this document electronically.  You will need to print it off and have the reflective partner complete the form(s) manually and save it (them) in your ‘paper-based’ portfolio.

I feel that reflection and the ensuing discussion are the most important and potentially powerful vehicles for development and improved practice.  I wold suggest that you choose your reflective partner according to who you think will be effective or you; and to use one form /partner for each discussion / reflection.  I would also encourage you to complete these as you move through your triennial renewal cycle and not save them up and rush through them when you realise revalidation is imminent!

Confirmation

No more than 12 months in advance of your Revalidation Date, you should arrange to have a Confirmation Discussion. This cannot be arranged until you have gathered the evidence above and have the required forms filled in and ready for review.   The Confirmer should be the person who normally does your appraisal / supervision (e.g. your line manager) and it does not matter if this person is not an NMC registrant.  The NMC has produced an Information for Confirmers guide that is very useful.  In the main, the confirmer’s role is to act as a third party to confirm that the requirements set above have been met.  They are not there to grade or assess the elements of revalidation that you present to them nor are they there to assess your fitness to practice; simply to confirm that they have seen them.

At the completion of the confirmation discussion, the Confirmer will then be asked to complete and sign a declaration that they have confirmed your readiness to revalidate.  The NMC have provided a Confirmation Form that must be used to document your discussions.  Because this form contains details that can identify another individual (your confirmer), you cannot save this document electronically.  You will need to print it off and have the confirmer complete the form manually and save it in your ‘paper-based’ portfolio.

Revalidation Application

Once the confirmation process has been signed off, you are effectively ready to revalidate.  Your Revalidation Date is a fixed date (e.g. 18th May 2015).  In this example, your registration would expire on the 31st May 2015.  Your deadline to revalidate (your Revalidation Application Date) is therefore the 1st of the month (1st May 2015).  The NMC will send you a notification you that you can revalidate 60 days before your Revalidation Application Date (e.g. 1st March 2015).  From this notification date, you then have that 60-daty window in which to complete the Revalidation Application.

In completing the Revalidation Application, in addition to declaring that the requirements above have been completed and subsequently confirmed by a third party, you will also require to make a declaration that you are of good health & character and that you have an appropriate level of professional indemnity (as you would through NOP).  Once you have completed the online Revalidation Application, you should receive confirmation soon thereafter that your revalidation has been successful and that your registration has been renewed.

I would recommend that every registrant logs in to their NMC Online account to verify (well in advance of the registration expiration date) to ensure that their statement of entry has been successfully updated; a printed copy of which could be  retained within the portfolio and provided to your line manager / confirmer for their records.

Verification / Audit

As with the PREP portfolios, the NMC will select a small percentage of registrants for verification / audit.  It is envisaged that if you are selected, you (and your confirmer) will be sent an email within 24 hours of your Revalidation Application submission.  You will both be required to follow the link provided by the NMC in order to provide additional information to support the verification / audit process.  There is no set timescale for you (and your conformer) responding to this request, but remember that (either of you) not responding can put your registration at risk!

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NMC says Nurses must accept concerns about their practice

Ian Snug

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NMC says Nurses must accept concerns about their practice

Legislative changes designed to speed up fitness-to-practice (FtP) cases will only work if Nurses accept concerns about their practice.

Controversial changes including a new measure that will allow the Nursing and Midwifery Council to issue ‘public warnings’ against registrants who have breached professional standards came into force this week, be able to offer informal advise to Nurses for less severe cases and agree restrictions on practice with registrants directly.

The reforms will enable case examiners to resolve issues earlier on in the FtP process and will mean the NMC will only have to take the most serious cases to a full hearing but the NMC boss says this can only happen in Nurses accept concerns about their practice earlier in the process.

This years financial report shows noted a significantly higher spending on fitness to practices cases and part of the new process is to minimise this spending.

Several concerns have been raised that the new system may result in over-use of warnings and the fact they may disadvantage staff when applying for employment.

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NMC

NMC Chief gets £20,000 pay rise to bring pay into “alignment”

Sarah J

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NMC Chief gets £20,000 pay rise to bring pay into “alignment”

Jackie Smith, the chief executive and registrar of the Nursing and Midwifery Council received a £20,000 pay rise this year.

The Nursing and Midwifery Councils financial reports reveal that its CEO and Registrar, Jackie Smith, received a pay rise of around £20,000 bringing her total basic salary to £192,850 for 2016-2017.

However, Ms Smith final remuneration is expected to be significantly more due to pension benefits and annual leave reimbursements.

In a report from the NMC, the regulator said the pay increase for its chief executive followed a review of its senior salary structure.

The report, which is created by the NMC’s remuneration committee, compares the pay of its own executives with those in similar roles.

In total, the NMC’s executive team was paid £1.2m in 2016-2017.

The report went on to state that the NMC has maintained financial stability and noted a significantly higher spending on fitness to practices cases.

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