The majority of nurses and midwives in the UK who did not revalidate this year said their decision was due to retirement, while others cited not practising or being unable to meet the new requirements as reasons for not completing the new system of checks.
In total, 15,160 nurses and midwives saw their registration lapse in the first year of revalidation – 6.9% of those eligible – according to a report by the Nursing and Midwifery Council looking at the 12 months since the new system launched in April 2016.
Of those, just under half – 7,359 nurses and midwives – gave a reason.
“If we didn’t have people who were not able to meet the requirements…it would suggest the standards might not be high enough”
Among the 6,638 registrants based in the UK who gave a reason, 59% said they were retiring, while 31% said they were not currently practising or had chosen not to practise.
Previously there have been warnings that completing revalidation – which is required every three years to stay on the register and introduces a number of new elements compared with the old system – would be off-putting for nurses and may prompt some to take early retirement.
The NMC’s new report does not, however, make it clear whether those who have retired have done so earlier than planned.
Meanwhile, around 5% gave ill health as the reason behind leaving the register, and around 3% – 223 – said they could not meet the revalidation requirements.
The most common reason for being unable to meet the requirements was not having completed the practice hours – of at least 450 in the previous three years. This was followed by many saying they had been unable to take part in a reflective discussion about their practice with another NMC registrant.
At an NMC meeting last week, where the report was discussed, council member Ruth Walker said it “gave [her] confidence” that some people did not meet the requirements.
“I would have been quite concerned if we didn’t have people who were not able to meet the requirements, because it would suggest the standards might not be high enough,” she said.
“[Non UK-based registrants] may not have easy access to an NMC registered nurse or midwife if living abroad”
NMC annual report on revalidation
Among the 721 nurses and midwives based outside of the UK who gave a reason for their registration lapsing, around 69% said it was because they were either not practising or had opted not to, while 13% cited retirement. A total of 16% – 115 – did not meet the revalidation requirements.
The most common reason for not meeting the revalidation requirements for people based outside the UK was not being able to have a reflective discussion, followed by not being able to complete the confirmation process.
“This may be because the reflective discussion partner has to be an NMC registrant, and they may not have easy access to an NMC registered nurse or midwife if living abroad,” noted the NMC in its report.
“Our independent evaluation partners are currently interviewing a sample of nurses and midwives who have declared they cannot meet the requirements to gain a greater understanding of why this was,” it said.
“We will be discussing these findings with our stakeholders to see what further action we might take in this area,” added the report.
At last week’s meeting, NMC council members agreed that further support should be given to nurses who are more isolated in their practice and whom may find it more difficult to identify another registrant for the reflective discussion.
As part of the new process, the regulator is carrying out a series of spot checks to verify that registrants have complied with all elements of revalidation.
In the past, under the old post registration education and practise (PREP) system, the NMC was criticised for only checking around 4% of registrants.
In its latest report, the regulator stated only that its analysis “so far has shown a high degree of compliance” and that it had found “a small number of instances of non-compliance”, and “we have dealt with these appropriately”.
At the recent meeting, council member Maura Devlin questioned why the report did not include information about the number of registrants being selected for verification checks.
NMC director of revalidation and registration, Emma Broadbent, told council members that an independent evaluation of revalidation by research organisation Ipsos Mori would provide details about how well the verification system was working.
She said early findings from that work had shown it was a “robust” process, but that it could be improved in some areas.
Overall, the NMC said the picture painted by the report was “very positive” with 202,699 nurses revalidating in the first year.
It represents just over 92% of everyone who was due to revalidate. The report states the average renewal rate for the previous five years – under the old system – was 90%.
As part of the new system, nurses and midwives provide information on their employment type, practice and work place settings, revealing for the first time where registrants are practising.
The report shows 93.7% are directly employed, with 4.9% employed by an agency, 1.3% self-employed and 0.1% working as volunteers.
When it came to scope of practice, 62.8% of those who revalidated said they were involved in providing direct clinical care for adults and general nursing. The next most common scopes of practice were mental health nursing – 10.6% – children’s and neonatal nursing – 5.8% – and midwifery – 5.3%.
More than half – 56.2% – said they worked in a hospital or other secondary care setting, while 17.7% worked in the community, including district nursing and community psychiatric nursing.
Nurses working in care homes represented 7.8% of those revalidated, while 5.5% worked in GP or other primary care settings.
Following discussion, the NMC council approved the report for publication.