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NMC calls on nurses to 'have their say' on revalidation

Nurses and midwives are being asked for their views on the new process under which they must prove they are fit to practise every three years.

The Nursing and Midwifery Council has today launched the first part of a consultation exercise on a system of revalidation for nurses and midwives.

Using an online survey, it asks a series of questions on how the principles of revalidation can be applied in different practice and employment settings.

The consultation also looks at potential changes to the content and structure of the NMC’s code of conduct. 

The NMC council committed itself to introduce a model of revalidation for nursing at its council meeting in September.

Under its proposals, registered nurses and midwives will have to demonstrate they remain fit to practise and continue to adhere to the professional standards set out in the NMC code. Everyone on the NMC register will need to revalidate every three years at the point of renewal of registration.

The move, which intended to increase patient protection and public confidence in nurses and midwives, follows mounting pressure for a system of checks on fitness to practise.

The Francis report into care failings at Mid Staffordshire Foundation Trust, published last February, said nurse revalidation would be “highly desirable”.

Both the Department of Health and the Professional Standards Authority – the body that oversees the NMC – have also recommended that a continuing fitness to practise measurement, such as revalidation, is necessary for all healthcare professions.

Dr Katerina Kolyva, director of continued practice at the NMC, urged registrants to take part in the consultation exercise. She said. “We will use the responses to make sure revalidation works meaningfully across the entire landscape of nursing and midwifery.”

She added: “The code is central to revalidation, so we are also taking the opportunity to ask what a revised code and supporting guidance should look like, feel like and contain.”

The consultation seeks views on:

  • Ways in which nurses and midwives can obtain confirmation of their continuing fitness to practise by someone well placed to comment
  • Using practice related feedback to improve standards of care
  • How revalidation can meet the needs of an individual’s scope of practice or setting
  • The look, feel and content of a revised code

The consultation runs until 31 March 2014. It is the first of a two part consultation, with the second part to follow in spring 2014.

Revalidation for doctors started on 3 December 2012, with the expectation the majority of licensed medics in the UK will have been checked for the first time by March 2016.

Calls for the revalidation of doctors can be traced back to the case of the former Hyde GP Harold Shipman, who was found guilty in 2000 of murdering 15 patients.


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Readers' comments (58)

  • I agree to some extent,how-ever the magority of Nurses,Clinical Practioneers, who are, i hasten to add, inteligent People do adhere to some form of Continuous Learning,and competencies in order to comply with the Guidelines and Professional Conduct.Somehow, to an extent, i feel that we are being traeted like Children.Of Course the Perception is to SafeGuard The General Public and to maintain Transparency.Just Saying Thats all.

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  • In December, a consultant colleague asked me to participate in his revalidation process. This required completion of an online assessment. Some of the questions were ridiculous and repetitive, and much of it was multiple choice answers which didn't always provide an appropriate response. There was also a comments box after each question. It took about 20 mins to complete and was very much a box ticking exercise. Two other collegues I work with were also asked to complete his assessment. So at least an hour of nursing time taken up sitting at a computer. I don't know how many more of his colleagues, bosses and patients were required to participate. How much more time will be wasted completing similar pointless assessments for the many more thousands of nurses? I have no issue with revalidation, but it needs to be relevant and fair to all and mustn't be just another waste of time and resources.

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  • Anonymous | 6-Jan-2014 9:13 pm

    Completed it before I wasted my time posting a comment here!!

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  • This comment has been edited.

  • Who is to comment on a nurses suitability to re validate? My last manager was totally hostile towards me, the company I worked for took accept her word. So that's me damned. Is it down to certificates, Ive got plenty of those. Is it patient/resident feedback -difficult with MH pts or EMI or any Pt on a bad hair day.
    Can nurses especially those in the private sector validate their company/bosses/managers Mine would not come up to standard, Grievances dont work, they are simply ignored

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  • Valerie Hindmarch | 8-Jan-2014 12:35 pm

    Absolutely, Valerie. I'm in a similar position now as you once were.

    I'm currently 'managed' by what can only be described as a 'Fishwife in a navy-dress' who possesses all the finesse and management skills of a drunken football hooligan mouthing-off on the terraces. This woman is an uncouth, vicious bully who wouldn't think twice about debasing members of her staff in full view of patients, medics and other staff - how she ended up being a Band 7, I do not know.

    This moron has surrounded herself with a gaggle of HCA and one or two qualified sycophants who report back - at regular intervals - anyone who dare not heed her petty rules and ridiculous ways of working. She maintains her little crew by means of allowing them to pick their off-duty.

    Am I really expected to allow an idiot such as this to have the power to end my entire career 'on a whim' just because she's hungover from the night before or for some petty 'slight' - she's more than capable! I'm sorry, but there is no way I'm letting that happen.

    As per usual, the NMC is completely out of touch with what is going on in real life.

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  • Valerie Hindmarch | 8-Jan-2014 12:35 pm

    "Who is to comment on a nurses suitability to re validate?"

    Precisely. Which is why it is important to get your tuppence worth in.

    Like I said, I don't have a problem with revalidation per se. Done properly, then the 'manager' (whom I'm sure we all recognise) described so well by Anonymous | 8-Jan-2014 1:44 pm, would find it difficult to be revalidated herself and decent nurses like you guys would correctly be passed as competent. Done wrongly and pointlessly, as I feel it is being done for the medics, it defeats the purpose and could be open to abuse from all sides.

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  • tinkerbell

    Anonymous | 8-Jan-2014 1:44 pm

    Allowing someone like this to revalidate staff will just reinforce the bullying culture.

    Who is going to revalidate her?

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  • seems the idea sounds better in theory than it is in practice and could have disastrous consequences for hard working nurses. it needs very carefully consideration and sorting out with input from everybody before any such system is adopted.

    whilst openness, honesty and transparency should be encouraged it seems the industrial managerial model of 'customer is king' opened up a can of worms as far as patients' entitlements, speaking out, complaining and bullying staff and aggression are concerned. Some have abused their privileges instead of using them wisely and now anything goes.

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  • tinkerbell | 9-Jan-2014 6:36 pm

    Absolutely tinkerbell, this is why revalidation will be a meaningless, tick-box exercise and a complete and utter waste of time and money. Worse still, I genuinely believe that it will run counter to the new 'speak out safely' culture and will put patients at more risk of institutionalised abuse than they are now.

    Thinking about revalidation, it's likely that we'll have to provide between 3-5 references to prove that we're fit to remain on the register for another three years. It's almost a given that one of these referees will have to be your line manager or supervisor.

    Taking the manager mentioned above as an example - we'll refer to her as 'Donna' for the purposes of discussion. Undoubtedly she'll choose her referees carefully so her fitness to practice will be beyond question. If a Matron [her manager] has the guts to raise concerns about Donna, it will be the Matrons word against 2, 3 or 4 others who will have provided glowing reports.

    Donna will then go scuttling-off to personnel accompanied by her union rep who will - quite rightly, you could say - argue that if there were concerns about her practice, why weren't they raised before now and that this is nothing but a witch-hunt etc., etc. Donna will argue that the Matron doesn't work closely with her, but her other referees do, so who is best-placed to comment on her FTP? Supplant the two characters mentioned her with any other staff members who are unhappy at a revalidation decision and it will be the same argument. So, do you think the Matron is likely to raise concerns about Donna? I don't think she will as it will call into question her ability to manage her staff - can you see where this is going?

    The NMC can't cope with the fitness to practice cases they've got to deal with now, what makes them think that these proposals won't double, triple or quadruple their workload? Like most things that emanate from the NMC, nice idea in theory, but doesn't translate well into the real world.

    All revalidation will do is create a 'climate of fear' in which people are less likely to raise concerns about patient care, being short-staffed or other unsafe working practices for fear of upsetting those who will have the power to end their career!

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  • Anonymous | 9-Jan-2014 8:34 pm

    If 'Donna' has nothing to fear from revalidation, then neither have you for the same reasons.

    There has to be some effective system of revalidation/proof of competence/or whatever they want it call it, to prevent the 'Donna's' of the profession remaining in post and being allowed to continue. The current system of self declaration and, let's face it, very few checks isn't robust enough. Into my 32nd year of nursing and no one has checked me once. I have only known one nurse who had to send off her CPD folder at re-registration. There are too many incompetent numpties causing too much damage.

    mags | 8-Jan-2014 4:25 pm

    Agree. Revalidation is a positive thing if done properly, but a waste of time if it isn't.

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  • Anonymous | 9-Jan-2014 10:01 pm

    My concern is that revalidation will be used as a weapon to silence staff who dare rock the boat by raising concerns about patient care; an ever-present threat to oppress the rank and file!

    Wouldn't it be ironic if the very proposals meant to help safeguard patients had the total opposite effect?

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  • tinkerbell

    I would prefer not to be revalidated by a manager I don't get on with, you know, just in case they lack any objectivity, I would prefer to be validated by a jury of my peers or even better by my patients. I think all managers though should be validated by the staff who are under their management Are they making your job in providing safe care harder or easier?

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  • Anonymous | 9-Jan-2014 11:32 pm

    "My concern is that revalidation will be used as a weapon to silence staff who dare rock the boat by raising concerns about patient care; an ever-present threat to oppress the rank and file!"

    Threats to nurses are already happening and weapons to silence staff are already being used!! Which is why the issue is NOT revalidation, but the potential methodology which is my concern. There really does need to be an effective process in place. I am tired of the incompetent, dangerous idiots who exist in too large numbers in our profession. Proper checks of competence (whether they want to call it revalidation/re-registration) need to be carried out in a robust, fair manner, by a competent and relevant regulatory body. So my first recommendation would be to abolish the NMC and replace it.

    Fear of consequences cannot continue to be an argument for doing nothing.

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  • Anonymous | 10-Jan-2014 11:53 pm

    I take the points you raise.

    Unfortunately, I find myself working as part of a team which for the most-part consists of some of the nastiest, bitchiest, rumourmongering - just downright unpleasant people you could wish to meet. I literally have nothing whatsoever in common with the vast majority and struggle just to go into work everyday.

    My concern is just because I am unable to engage these individuals socially, this will be viewed in a negative way when it comes to revalidation by the ward manager

    Revalidation should be about knowledge, skill and competence, not whether you're Facebook friends with people and I fear that's what it will ultimately come down to in many cases.

    In my opinion, revalidation should - in part - take the form of an NCLEX-style online assessment where your knowledge of anatomy and physiology etc., is tested and any areas of a nurses practice that need to be developed would form the learning goals for the next three years.

    Secondly, I think nurses should have several sessions of observed practice by a practice development facilitator or a senior nurse from another ward or department who could provide an objective critique. Obviously your colleagues and manager would also form part of the revalidation process too.

    Personally, I think revalidation will end up being another quick form you stick in the envelope with your £100!

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  • Wonder if this will cause registration fees to rise again, due to admin + processing ? ... could be another £100 per year to be administered by what feels like an inefficient NMC.
    This, like MOTs, is only good for a limited time and does not guarantee safe care. It will create more stress for those who are conscientious and like to deliver better care.

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  • michael stone

    This is a sound idea, which will probably be either ineffectual or very dubious in its outcomes in practice.

    But, there have been a lot of stories/comments about how difficult it currently is, to actually remove incompetent nurses from the NHS - they seem, I gather, to tend to either be left alone to continue displaying their incompetence, or else 'just get shunted to another bit fo the NHS'.

    Presumably this revalidation is intended in part, to solve that problem ? But I think the general theme of your comments - 'this won't work properly' - is likely to be right.

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  • Anonymous | 11-Jan-2014 9:21 am

    "Unfortunately, I find myself working as part of a team which for the most-part consists of some of the nastiest, bitchiest, rumourmongering - just downright unpleasant people you could wish to meet...."

    Surely more reason to assess competence and suitability? The present system of registration does nothing to prevent what you describe, so why not change it? You are actually agreeing with what I am saying. Revalidation isn't the problem. The methodology could be. That's why a 360 degree validation isn't the answer.

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  • Hardly any nurses will actually take part in this 'consultation exercise'. They never do.

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  • Anonymous | 12-Jan-2014 11:42 am

    Any advice from one so wise and experienced in such matters - as you clearly are - would be greatly appreciated. Tell me: what do you suggest we do to prevent this - as I'm all out of ideas?

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  • Anonymous | 12-Jan-2014 10:19 pm

    Thanks for demonstrating my point so clearly.

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  • This comment has been edited.

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