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Revalidation could spark initial surge in referrals to NMC


The chief executive of the nursing regulator has said fitness to practise referrals are expected to increase in number after revalidation is introduced in April, but that in the long term it is hoped they will reduce.

Nursing and Midwifery Council chief executive Jackie Smith said that in the initial stages of the new system of competency checks, referrals to the regulator were expected to go up as registrants were encouraged to reflect on their own and others’ practice.

But, she said, over time revalidation would likely result in organisations dealing with more concerns locally, meaning less are escalated to the regulator.

However, Ms Smith stressed the revalidation process – which nurses will need to complete every three years in order to stay on the register and continue to practise – was not designed to create a new way to raise concerns.

”We always said our long-term ambition and aspiration is that we’d like to see a reduction in the number of fitness to practise referrals”

Jackie Smith

Speaking at Nursing Times’ revalidation conference today in London, she said: “We always said our long-term ambition and aspiration is that we’d like to see a reduction in the number of fitness to practise referrals.

“Because, if this works in the way we’ve articulated it, you’ve got the regulator, individual registrant and employer all working together in the interests of professionalism and public protection – so issues are identified early enough and dealt with locally rather than coming to the NMC.

“But I think the reality of the position is we will see an increase initially, because when you are faced with the prospect of thinking about someone’s revalidation then it makes you think about their practice in the round. And, although revalidation is not about fitness to practise, it will make individuals think about it,” she added.

“Although revalidation is not about fitness to practise, it will make individuals think about it”

Jackie Smith

Ms Smith was asked whether the NMC would be “tougher” on the first cohort of registrants going through the process in April, when the regulator would be sampling some nurses’ portfolios for verification.

She said the NMC “did not intend to be tough on anybody” and that it would “have an even hand across the board”.

“There will be problems initially and we want to work those through. We aren’t marking a pass or fail. We are not expecting people to write a dissertation in their reflective accounts,” she added.


Readers' comments (14)

  • So if in the reflective pieces a nurse writes about an error made and how they learnt from it, the NMC will penalise them for that?

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  • Good point!

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  • I have recently been involved in a drugs error, and have used the experience to write a reflective account. I would not use that in my portfolio, only for personal reflection. Although I think that incidents like this are extremely valuable to nurses and would I believe help to eradicate the "blame culture" that we still encounter in practise.

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  • In my opinion I think this person should not penalized because he/she owned up and obviously followed the protocol of drug error i.e,if a patient was involved this person monitored vitals signs,reported to the GP appropriate action taken.If this person is then in future the patient s' safety is going to be jeopardy as people will not report such incidents.Thumps up for this person that's what we call "Duty of Candor"

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  • Unfortunately, there will be all sorts of issues with this. When has the NMC got anything right recently? The CEO is the precise person who mismanaged the fitness to practise system which is in disarray and now she is elevated into the top position. So far the NMC takes our money, increases fees when we have not had a fall in our pay and no increments and does nothing much to ensure good practice. We are all going to be in a mess. We are governed by a poor organisation. Look at the difference with the BMA? Huge pay rises for Consultants and GP's a few years ago and the NHS is suffering. Now campaigning for the junior doctors. The NMC is not good enough on its' own. Nurses need good leadership and excellent, efficient monitoring, I would then be pleased to hand over money to feel supported. Our Unions are weak and ineffectual. Sadly, I am looking for a way out, much as I love nursing to my core but I cannot cope with the destruction of the NHS by politicians and feeling more and more vulnerable as a practitioner and ashamed of some of the nursing standards. Everything is so demoralising and depressing and who suffers? Ultimately the patients we are trying to help.

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  • Well said 8:22hrs
    What are we promoting here?
    If I read right it looks like subjective reflections that can be based on tall stories or tell tale stories. In a time where nurses are needed, talk of referrals is not a good sign, where a faulty approach is being taken i.e revalidation.
    I remember consultation type forms by the NMC being sent out, but no question of whether we wanted it or not - not exactly democratic.
    The only thing I see is the illusion of objective egotism and 'pat myself on the back' behaviour by regulators and alleged leaders - some might say tyranny where no opposition is voiced or perhaps allowed. Harm is being done and continues, what we need now more than ever is a pragmatic approach and not an approach that allows the false leader language of defensive positivity. It's is like those more privaledged at the top are simply putting fingers in their ears and creating an even greater divide of them and us (not helpful). And what of the educators who where in agreement with this seem to be promoting blind instruction rather than education! Time to get positive but not in the way they dictate it - WAKE UP NURSES the language of lawyers is taking over. peace & love not this divisive unhelpful approach.

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  • I think this would be useful for the NMC to clarify. Perhaps we should ask the NMC?

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  • I would love to ask the NMC directly, but I think I might need a law degree, professorship and diplomatic immunity.

    Real learning surely comes from the not so straight forward and messy experiences that give us real pause for thought, partly due to the reality that life is messy. I should think it obvious -reflections built on fear of not offending the NMC or organisations end up one way, which is the limiting of understanding and real learning to such a point that anything messy but real will present as extreme, when in fact necessary. It will be curious to see what will happen next year.....

    I think the only best way we can democratically stop the NMC is a government poll of no confidence in revalidation, but who is willing to start it?

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  • Oooh well done Jackie Smith!
    Still labouring under the delusion that RNs are 'excited and positive' about re-validation she now enhances the whole malarky with the promise of even more referrals.
    Just how did this woman get where she is? She doesn't appear to have a 'nursing' bone in her entire body.

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  • Suggest it's now the right time to start serious discussion why different branches of nursing in a world containing many grey areas no longer fits in with concerns to black and white thinking by the NMC. Maybe NMC better fitted for adult nursing only? If we can't change the NMC why can't we change the regulator?

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