Senior nurses have hit out at government plans that could potentially delay the full introduction of revalidation in England by two years, labelling it a “travesty” and claiming the move would have an “incredibly negative” impact on the workforce, leaving staff “completely confused”.
As revealed exclusively by Nursing Times earlier this week, the Department of Health is understood to be concerned about the impact the new system of competency checks will have on NHS finances.
“The poor staff nurse is caught in the middle between the NMC and the DH”
As a result of these concerns, Nursing Times understands that it is therefore planning to introduce in the first couple of years a “voluntary” system for employers to provide support to registrants, with “minimal cost and no impact on taking staff from the frontline”.
Nurse leaders that we spoke to have said, despite the proposals, they will continue to provide full support to their registrants to meet the requirements for revalidation when it is enforced across the UK by the regulator in April.
But concerns were raised by one chief nurse that in some smaller or more isolated settings in England, such as GP practices, the government proposals could mean nurses are unable to meet the requirements if they are not fully supported by employers.
A director of quality and clinical governance at a social care organisation and former chief nurse said the “interference” in the introduction of revalidation in England demonstrated the “poor status” of nurses in the eyes of senior NHS England management.
Another director of nursing at an NHS trust disputed the government’s reasons for a potential delay, saying revalidation would cost organisations very little to introduce.
Registrants will need to show they have met the revalidation standards every three years in order to remain on the Nursing and Midwifery Council register.
“The impact on the nursing profession is incredibly negative”
Revalidation is based on the NMC’s current PREP system and the minimum time spent on continuing profession development training has remained at 35 hours.
The new system includes some additional checks, such as evidence of a reflective conversation with another NMC registrant, five pieces of feedback and five written reflective accounts in relation to the professional code of conduct.
In addition, nurses and midwives must have all of the revalidation requirements “confirmed” and signed off by a third party, who is preferably their line manager but does not have to be an NMC registrant.
Eileen Sills, chief nurse at Guys and St Thomas Foundation Trust – which was one of the pilot sites for revalidation this summer – reiterated that most elements of revalidation should be happening within organisations anyway.
She said she had converted just one post within her workforce to lead revalidation and said that, although the trust was financially stable “as a pilot site, we took the situation responsibly and deliberately did not spend more money on it”.
“It’s a shame that we have not been given funding given the amount of money that went into medical revalidation, but most of us are resourceful enough and we see the benefits,” added Ms Sills.
“We will work hard to try and get the Department of Health to review its position. Senior leaders in the NHS says this is valuable and matters. This is the most important professional change in years and it is a travesty to go backwards,” she said.
Ms Sills said that, despite a successful engagement strategy from the NMC, the government plans now risked the profession becoming “completely confused”.
“The poor staff nurse is caught in the middle between the NMC and the DH,” she told Nursing Times.
Trish Morris-Thompson, director of quality and clinical governance at Barchester Healthcare, said the proposal demonstrated further “interference” influenced by the NHS.
“This interference with the NMC is a step that never should have been accommodated,” she said.
“The regulator’s independence must be protected at all times. The NHS does not have the authority of the profession beyond the NHS and, therefore, cannot represent and articulate views on our behalf,” she said, noting that around half the nursing workforce worked outside the NHS.
“The impact [of these proposals] on the nursing profession is incredibly negative,” she added.
“We don’t have a budget for this – we don’t need something with bells and whistles”
Meanwhile, Morecambe Bay NHS Foundation Trust executive chief nurse Sue Smith told Nursing Times her trust did not plan to spend a significant amount of money on revalidation.
“We don’t have a budget for this – we don’t need something with bells and whistles. We just need a register of who is due to revalidate, to support them in understanding what is required, and align it to appraisal,” she said.
Ms Smith said that, while there would be some small financial investment required by organisations, this was
far overshadowed by the benefits revalidation would bring to patient safety.
“What revalidation will help me to do is have a much clearer picture of when nurses and midwives are reflecting and how they understand their practice relates to the code and will help me to understand whether I need to support people with additional training,” she told Nursing Times.