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CNO confirms England ready to go ahead with revalidation

  • 10 Comments

Nursing Times can confirm that the Department of Health has rowed back from plans to delay nurse revalidation in England, in light of the negative response from the profession’s leaders.

Early this week Nursing Times learnt that the DH wanted to delay the full introduction of the process for two years, in order to protect trusts that are struggling financially.

It was planning to introduce a “voluntary” system for employers to provide support to registrants – effectively creating a two-tier system and potentially stalling its full introduction. An announcement detailing the plans was due in a letter to be sent on 31 October.

“I am now content for revalidation to proceed in England from April 2016”

Jane Cummings

The move would have been in contrast to Wales, Scotland and Northern Ireland, who have confirmed they are largely ready to implement revalidation as planned.

However, revelations about the DH plans in Nursing Times were met with dismay by both senior nurses and union leaders.

As a result, the DH changed its position and sent a revised letter to the Nursing and Midwifery Council (see attached PDF, top-right).

The letter, sent this afternoon by chief nursing officer Jane Cummings, stated that England was ready to introduce revalidation. “I am now content for revalidation to proceed in England from April 2016,” said Ms Cummings.

Expected caveats allowing trusts not to support registrants through the process in very rare circumstances, for example, where the chief executive had resigned, were absent from the letter.

However, it did warn the NMC that it must assess the impact of the new system on the frontline and that regulatory bodies – Monitor, the NHS Trust Development Authority and their replacement NHS Improvement – would “monitor the ongoing financial impact of revalidation”.

In the letter, the CNO said: “We would expect the NMC to introduce robust and thorough monitoring from the point of introduction, to evaluate the revised guidance, the impact of revalidation and to ensure that it delivers the intended benefits and does not have a negative impact on frontline care.”

“We would expect the NMC to introduce robust and thorough monitoring”

Jane Cummings

She added: “We would like to work with you to undertake evaluation across the whole system to ensure revalidation does not introduce unexpected cost pressures with any subsequent impact on frontline care, particularly in the NHS.”

UK-wide revalidation for nurse and midwives was one of the recommendations made by the Francis review into failings at the former Mid Staffordshire NHS Foundation Trust and was subsequently accepted by ministers in their response. A similar system is already in place for doctors.

Under the NMC’s plans, nurses and midwives will need to complete revalidation every three years in order for them to remain on the register and, therefore, be able to practise. The new checks process, designed as a replacement for the post-registration education and practice (PREP) system, was piloted by more than 2,000 nurses working at 19 different sites during the summer.

To revalidate successfully, the NMC’s approved guidance states that registrants will have to complete at least 450 hours of practice, compile five pieces of practice-related feedback and prepare five written reflective accounts relating to the code of conduct.

A reflective discussion with another registrant is also required, as is a health and character declaration and evidence of indemnity insurance. In addition, registrants 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.

Registrants will have to complete a minimum of 35 hours of continuing professional development in the three years prior to registration renewal, with 20 of these hours being participatory.

“The introduction of revalidation is the most significant change to regulation in a generation”

Jackie Smith

At its last council meeting on 8 October, the NMC said it was “confident” that, based on the results from the pilots, the introduction of revalidation was “achievable, effective and realistic”.

Responding to the DH letter today, NMC chief executive and registrar Jackie Smith said: “We warmly welcome today’s confirmation from the Department of Health that England is ready for the implementation of revalidation for nurses and midwives, as planned from April 2016.

“With all four UK countries ready for revalidation, we look forward to continuing to work closely with them as well as employers, trade unions and professional bodies to help support the UK’s 684,000 nurses and midwives through the new process,” she said.

“The introduction of revalidation is the most significant change to regulation in a generation and we firmly believe that it will give the public confidence that the people who care for them are continuously striving to improve their practice,” she added.

“Revalidation is a hugely important step”

Janet Davies

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “Revalidation is a hugely important step – and when fully implemented will help nurses to deliver the best care to patients.

“It is positive to know that the NHS is England will push forward with this, and that all four countries of the UK will be moving forward at the same time,” she said.

“Now that there is clarity on the timescale, the RCN will work with the NMC, employers and nurses themselves to ensure that staff get the support they need to carry out the necessary updates,” she added.

  • 10 Comments

Readers' comments (10)

  • In my opinion the unions have truly failed us, appalling. The frontline is already struggling and the unions seem to divert us with calls to better payment, whilst in the meantime safety and staffing number/skill crumbles and they agree to unnecessary paperwork rather than sensible clarification through observation of doing the job. WAKE UP! Meanwhile in my opinion senior leaders not on the frontline sigh relief. Disgusting. The only result of this in my view is more nurses leaving, whistleblowers especially in the private sector will be better silenced and corporate agendas promoted. Oh well, supermarket work here I come. What we should now be looking at is how many senior leaders have their fingers in the privatisation pie. Oh well said my piece for all its worth! The end.....

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  • Sounds like you're ready to blame everyone else including the Unions for all your woes apart from this Tory government who are systematically determined to dismantle the NHS and social care.
    I don't know what Union you're in but in my local Trust if it wasn't for the RCN things would be 10 times worse.
    If you see revalidation as a way of undermining the profession you couldn't be more wrong. This will modernize our CPD and make the profession more credible providing the NMC audit more portfolios. I have never met anyone who has had their PREP portfolio seen by the NMC.

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  • david lowry

    This is awful, having climbed the ranks over 20 years from LPN to BSC I am disgusted by this utter and complete waste of time. I have worked in the USA now for a number of years and in a variety of States holding Licensure in a variety of states. I have to undergo revalidation every two years and hold certain certifications which also require revalidation. I undergo continuing education course provided by the hospital I work for and also undergo mandatory course deemed as required by the Board of Nursing. THIS makes common sense. This is also monitored by a continuing education broker who reports youe CEU's. What is being proposed in the UK will drive Nurses out of the profession, it makes no logical sense and there has to be an hidden agenda. I have maintained my UK credentials at great expense ( significantly more expensive than in the USA ) I will not be renewing come 2016. How in the world how Nurses working overseas going to comple this -I see this as having a very negative effect on Nursing

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  • Anonymous | 30-Oct-2015 5:35 pm

    you typed the words right out of my fingers.

    Anonymous | 30-Oct-2015 6:13 pm

    the Government is of course responsible overall, the anger at the unions is that they are paid by us to protect and represent us little guys against these larger destructive forces, with powers that us as individuals do not have. They have failed us. Massively.

    Could have something to do with the unions i.e. RCN being in bed with the Tories in the first place?

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  • Dear oh dear, I believe many see RCN or its reps as a part of the issue in respect of being too close to maligned management, where it exists. And There is nothing worse then seeing reps who no longer work the front line. Are you one of them? do you sit in nice comfortable chairs and management sessions why your staff are in need? You wouldn't be trying to deduce stuff by asking - maybe I do belong to RCN maybe I dont. But I knew of reps who didn't think much to the way three countries hospital P.Carter run the show. My woes, do you know what my woes are if you did I think you might be shocked? It seems in my opinion to me the RCN only raise their head once the problems have occurred. Whose side are you on because in my opinion it doesn't seem like the frontline.

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  • I won't work in the uk again and have reluctantly felt compelled to give up on the nmc having once felt great pride on registering my SRN with the former GNC. I maintain my European registration for a single fee paid many years ago and without any hassle. Employers and especially practitioners themselves are responsible for quality control and maintaining practice and any relevant training up to date. Fall below the standards and following discussions and support, if this fails you find yourself very rapidly out of a job and with little chance of being re- employed anywhere as a registered nurse.

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  • Whatever happened to the profession I was so proud to be part of. I will retire early with some relief . On a daily basis I speak to highly professional colleagues who are at the end of their tether because they are not well supported and are unable to deliver the care they would wish.Many will leave and will be a great loss to the profession. I also see others who are less committed. The latter are just as likely to satisfactorily submit all that is asked in the revalidation process. When I trained as a nurse decades ago, a high standard was expected and overseen by senior nurses in their locality. If you weren't up to standard you were well supported but ultimately out of a job if you failed to improve.
    The NMC really needs to listen to what a huge number of nurses are saying before it's too late. Their record is pretty poor to date with the historic large backlogs of misconduct cases and their failure to properly oversee PREP .

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  • Jane Cummings also needs to listen.

    Nursing Times can you make sure she sees these comments and responds?

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  • Ive been a registered nurse since the 1980s and despite all the comments previously made about revalidation, for or against, it is a scary time for registered nurse staffing levels. I know of experienced nurses who have already approached matrons, asking to downgrade to a band 3 while others are looking into early retirement. I am considering leaving the profession because of already poor staffing levels and fear it will worsen with revalidation.

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  • David Lowry's comments are very interesting and well thought out, they represent a wise alternative to the current situation. I completed a questionnaire a couple of years ago when the NMC sought opinions about this - I said something very similar to David.

    It feels like the NMC just have not listened.

    - The NMC have decided what they think is best despite the opinions they have been sent.
    I also agree with 31 October 4:39’s comments – what a shambling mess this all is and no guarantees can be offered that standards will be maintain or improve.
    Will anyone with any coherent sense pay attention?

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