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”
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.
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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”
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”
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, 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.