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Government decision on revalidation will leave nurses 'completely confused'

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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”

Eileen Sills

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”

Trish Morris-Thompson

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

Eileen Sills

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

Trish Morris-Thompson

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”

Sue Smith

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

Morecambe Bay

Sue Smith

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.

  • 10 Comments

Readers' comments (10)

  • There is a side to every story and I'm increasingly concerned that the NTs reporting presents and is becoming one sided. You speak of unions, senior nurses and opinions, are we saying they are at the crux they are all the same people blowing their horns of annoyance? And if that is the case then why do the NT keep trying to revamp the same story? There are those of us increasingly who query if revalidation is yet another arm of control and not patient centred as it should be. If you are going to do keep reporting the pro speakers then at least give the dissenters a voice to.

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  • And when are you going to update your website so nurses can have more meaningful direct dialogue here with one another and signal their agreement/disagreement and approval or otherwise of other comments?

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  • Reading the news look like everyone agree with the revalidation, but then you go down and you read the comments everyone disagree with revalidation. So what I should believe?

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  • Its a godsent delay for whistleblower RNs working for private providers

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  • With respect, I think my colleagues comments above are missing the point. We are supposed to be a well trained, well structured, disciplined and committed profession, yet our own regulator is not allowed to devise and implement a modernized revalidation process without Govt interference. This shows a complete lack of respect to all nurses. Revalidation came from the Mid-Staffs recommendations not from some airy-fairy task and finish group. The whole ethos of revalidation is that it underpins lifelong learning and reflection which is essential to every proper profession. To dilute and delay is unacceptable, unwise and will end up costing more money to Govt in the long term as standards will fall, patients suffer and we all know that poor care always costs more in the end. Can you imagine doctors or solicitors having no up to date CPD process? They would not accept it and nor should we.

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  • With respect revalidation doesn't stop poor care and arguably promotes corporate agendas via line management. There was hope that the government was starting to respect nurses but it seems that has changed again with it being rolled out once more. And so we just have to watch to see how many nurses will now leave in the period of its introduction. I'm confused isn't the nmc funded in part by government? How independent is the NMC?

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  • PREP didn't stop poor care either but that is not an argument to ditch ongoing CPD for any profession - that's the politics of the madhouse!
    Incidentally, nurses are not leaving the profession and will not leave because of a slight modernization to PREP (which is in effect all that revalidation is). They are leaving because of age demographics, pay freezes, cuts to pensions, more punitive HR policies, increased patient demand and expectations, higher acuity and complexity/dependency levels and poorer job satisfaction. Within that context it appears that Govt still arrogantly believes that it can tell us what to do even though there are 22,000 less of us than they need.
    Have they not realized yet that there are only so many overseas nurses that can be imported at huge cost to the UK taxpayer and to their own home health care systems?

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  • Tiz arguably a nail in the coffin with the other stuff you mention (which the prior comment makes no mention of disagreeing with). Nobody I think wants to stop prep but it is the conditions of corperate interference that is a worry. I fear the house that you mention has already the upper hand and it isn't with those who disagree with cpd via revalidation.

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  • Steve Ford

    Regarding the initial comment that our coverage is one-sided on the issue of revalidation, I would like to point out that we have, and will continue, to try and publish the views of those are not necessarily in favour of the new system.

    See, for example, this recent letter: https://www.nursingtimes.net/opinion/thisis-a-blow-to-the-profession-and-most-of-all-to-patients/5091067.article?blocktitle=Letters&contentID=14116

    regards
    Steve

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  • Yes, but Steve where are the leaders who disagree? Or even ex-leaders maybe? There is no way that every leader in nursing or related organisations can agree with this. Don't you find it odd no one else is saying different? In fact what about any politicians who disagree? The question to ask is how can there be total hegemony, by definition is that not a tyranny?

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