Nursing and midwifery unions have said they are “extremely disappointed” and “very worried” that the introduction of revalidation may be delayed by two years in England, while other parts of the UK go ahead with the system in the spring.
As exclusively revealed by Nursing Times yesterday, government concerns over NHS finances could mean employers in England are not required to support registrants through the new system of competency checks from next year.
“Many patients will rightly be questioning why processes designed to keep them safe can be delayed in this way”
That is despite the Nursing and Midwifery Council having agreed just a few weeks ago to introduce revalidation across all of the UK.
Nursing Times understands that in the interim, the Department of Health is planning to introduce a “voluntary” system for employers to provide support to registrants, with “minimal cost and no impact on taking staff from the frontline”.
Royal College of Nursing chief executive and general secretary Janet Davies said it appeared revalidation was “seen as yet another thing” that needed to be “put on the back burner”, because of “the dire financial straits the NHS and other employers are in”.
“Although we do want employers and nurses to be ready to do revalidation properly, many patients will rightly be questioning why processes designed to keep them safe can be delayed in this way,” she said.
Ms Davies said good employers should already be providing appraisals for staff, but that the reality of frontline pressures on healthcare services meant that “even quite basic supervision processes” were not taking place.
However, she said: “Revalidation [costs] must not be used as an excuse for poor management practices to be left to continue – nor should it be seen as a tick box exercise which can be dropped if not convenient.”
“Revalidation [costs] must not be used as an excuse for poor management practices to be left to continue”
Ms Davies said the potential delay of revalidation revealed a “very worrying” situation in England, in which NHS budgets were prioritised over patient safety measures during financially challenging times.
“Given that the financial crisis has no end in sight, this raises real concerns about when the NHS in England will feel it can afford to carry out this process in the long term interests of patients,” she added.
Royal College of Midwives’ director of midwifery Louise Silverton echoed the RCN’s concerns and said the union was “extremely disappointed” by the potential delay in England.
“Yet again it is nurses and midwives being let down by employers… This leaves nurses and midwives in England feeling they are not valued by the NHS,” said Ms Silverton.
She noted revalidation was based on the current system of checks – post-registration education and practice (PREP) – and questioned whether employers would need to invest a significant amount of money to support registrants through the new process.
“What’s this got to do with finance? Everyone is already supposed to have an appraisal, everyone is already supposed to do 35 hours of CPD”
She said: “What’s this got to do with finance? Everyone is already supposed to have an appraisal, everyone is already supposed to do 35 hours of continuing professional development [every three years] – what’s not to do?
She said that while some trusts that had taken part in piloting revalidation had “gold-plated” their systems which needed additional investment, this was not required to fulfil the requirements laid out by the NMC.
“And why did England leave it so late – having already provided the NMC with an assurance [of its readiness]? It seems unbelievably inept,” she added.
Ms Silverton said that for midwives in England, the delay could also threaten the profession’s ability to maintain supervision standards, which will no longer be a legal requirement in the future.
She said that, while the statutory midwifery supervision was due to be removed in the next year or so, it had been hoped revalidation would ensure the supportive elements of supervision continued.
Unite professional officer Jane Beach said the late notice from the government to the NMC – almost three weeks after the NMC council meeting – that some organisations were not financially ready for revalidation “totally undermined” the regulator.
“We’ve got a UK-wide system of health regulation so the idea that one part of the UK can decide to opt out of something is unacceptable”
She said Unite was writing to health secretary Jeremy Hunt calling on him to shelve any plans to delay the introduction of nurse and midwife revalidation.
The government supported doctors’ revalidation, said Ms Beach, adding that “not to do the same for nurses and midwives is unacceptable” and shows a “lack of respect” for the profession.
She noted that the introduction of nurse revalidation was a recommendation made by the Francis report into care failings at the former Mid Staffordshire NHS Foundation Trust – and one which the government had said it supported.
She also questioned whether the government was trying to dictate how healthcare regulation worked – which she pointed out was UK-wide and an individual’s responsibility.
“We’ve got a UK-wide system of health regulation so the idea that one part of the UK can decide to opt out of something is unacceptable,” said Ms Beach.
“[The government] should be putting more into supporting those organisations to be able to meet the extra requirements for revalidation”
She suggested the possibility of a delay in employers supporting revalidation in England was a “kneejerk” reaction by the government to just a few trust concerns around finance.
Nurses and midwives in England will still have to complete revalidation from April – with or without support from their employer – to be able to continue to practise, she noted.
“They [the government] should be putting more into supporting those organisations to be able to meet the extra requirements for revalidation,” added Ms Beach.