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Exclusive: Private firms aim to cash in on revalidation 'sign offs'


Private organisations are lining up to offer nurses revalidation “sign off” services for a fee when the new system of competency checks comes into effect next year, Nursing Times has learnt.

A number of organisations have told Nursing Times they plan to offer registrants access to a network of nurses and registered healthcare professionals that can sign them off, as part of the new revalidation process.

“I can imagine there are a lot of nurses who don’t particularly want to be confirmed by line managers who they may have differences of opinion with”

Karim Stavron

But nursing unions have labelled the discovery by Nursing Times as “shocking” and the Nursing and Midwifery Council itself has cautioned against the need to pay for such services.

When revalidation launched for doctors in 2012, new companies sprung up charging sometimes thousands of pounds for revalidation appraisal sessions. It is unclear whether nurses and midwives will be charged similarly high prices.

Dr Karim Stavron, director of the Medical Support Union, said his organisation – which operates on a “not for profit basis” – would be offering an “affordable” service costing less than the £40 going rate he claimed was being charged by competitors.

He said he had already received a large amount of interest – in particular from nurses working at agencies or within the independent sector – for his organisation’s service which will include appraisal and confirmation through access to a network of registered healthcare professionals.

Dr Stavron noted that current guidance for revalidation does not stipulate that nurses must complete revalidation within their employer organisation.

“I can imagine there are a lot of nurses who don’t particularly want to be confirmed by line managers who they may have differences of opinion with,” he told Nursing Times.

“Nursing numbers in the UK are more than doctor numbers so I’m sure there will be a lot of competition”

Omar Ghazanfar

He acknowledged there had been an “initial wave of opportunism” in 2012 among doctors outside the NHS.

Some had charged “extortionate” amounts of money for revalidation services, he said, though he did not think that would be replicated with nurses due to the differences between the two revalidation systems.

Meanwhile ID Medical – an agency for doctors and nurses – said it would be offering a similar package, including sign-off services.

Licence to Practice, a company which offers appraisal services for doctors to revalidate, said it was also looking into offering appraisals and confirmations for nurses.

Dr Omar Ghazanfar, an independent appraiser at Licence to Practice, said the service would be most suited to nurses outside the NHS – such as independent cosmetic nurses – who would have less access to potential confirmers.

“It is absolutely shocking that external companies could be considering charging”

Lou Sommereux

Although provisional guidance from the NMC states nurses will be able to have their revalidation documentation signed off by a non-registrant, Dr Ghazanfar said many nurses would prefer to use a clinician.

“People I know who are working in the independent cosmetic sector are nurse prescribers and their line manager is not a clinician, which makes their life a bit more tricky as they want a clinician to confirm them,” he said.

He predicted there would be many more companies offering services to nurses than there are for doctors.

“Nursing numbers in the UK are more than doctor numbers so I’m sure there will be a lot of competition, which means the prices will need to be competitive,” he noted.

But nursing organisations have described this type of activity as “shocking” and said registrants should be strongly discouraged from handing over any money for sign-off services.

“We would be appalled if any company tried to make a profit in this way”

Gail Adams

They said registrants should not need to resort to this method because employers or professional associations should have systems in place to ensure revalidation can be completed among peers.

“We would be appalled if any company tried to make a profit in this way. It is the employer’s responsibility to ensure staff are supported to revalidate,” said Unison’s head of nursing Gail Adams.

“Companies will always seek to make a profit from a new system but that is not the intention of revalidation. Its intention is that it is local and within your employer’s organisation,” she added.

Lou Sommereux, a specialist aesthetic nurse, is a co-founder of the British Association of Cosmetic Nurses which took part in the recent revalidation pilots. She told Nursing Times: “It is absolutely shocking that external companies could be considering charging.”

However, Dr Stavron said it was “nonsense” to think companies should not be charging, noting: “If it’s a good thing for nurses and is implemented well then money should be spent on it.

“Services that are fair and help individual nurses should be costed appropriately and in general MEDSU subscribes to a not-for-profit ethos,” he said.

Dr Ghazanfar at Licence to Practice added: “[This type of service] is relevant for people who don’t have any connections to substantial organisations. The services we would offer would be very cost effective.”

“We do not envisage that anyone would be required to pay for confirmation or an appraisal in order to meet the revalidation requirements”

NMC spokeswoman

The NMC noted that there were “significant differences” between revalidation for doctors and for nurses and midwives.

A spokeswoman for the regulator said: “Our revalidation model was designed to ensure that all nurses and midwives can revalidate and, as a result, we do not envisage that anyone would be required to pay for confirmation and/or an appraisal in order to meet the revalidation requirements.

“An appropriate third party confirmer is your line manager,” she said. “We strongly recommend that you obtain confirmation from your line manager wherever possible.”

The NMC completed its pilot of the proposed system of revalidation earlier this summer, with early results concluding it is an “achievable”, “desirable” and “realistic” process.

The regulator’s council will decide in October whether to launch revalidation in April 2016 as planned.


Readers' comments (20)

  • How on earth can nursing continue to be considered a profession when any Tom Dick or Harry can sign off.Its insulting actually and I despair we pay to be on register and now it looks like there's more charges in pipeline.
    Bring on retirement my sympathies are for the students and future qualified staff.
    What a mess we've become!

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  • If nurses are with a less than effective employer who shows little understanding of revalidation issues I can understand how their personal responsibility for demonstrating they have met requirements drives them into the arms of service providers like this (whenever we have a new regulatory development in healthcare there is swiftly a crop of people willing to offer their input for a price). I am even prepared to believe that some of these will offer support which might be of genuine value to their customers (though having proper support from an employer is far better). What I do not understand (perhaps the NMC can enlighten us) is how on earth the NMC will differentiate between those offering a proper check and scrutiny and those who will just offer sign-off for cash - maybe as a sideline from arranging fake ID, blue badges (I exaggerate but certainly feel some will be of very small value). Having depended on employers to police this process for them, the NMC will now have to watch out for sign offs which add very little public protection. That will not come for free either - have you guessed yet who I think will end up paying?

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  • We are already going nuts about paying the amount we do to re-register, it is unlikely in the extreme that we will pay someone else something extra to actually get it done.

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  • What a minefield! I am on register but self-employed, so finding someone to sign off my work will be hard - my manger can be a cow (esp when coffee levels are low!).

    Joking aside, well, it's like PPI isn't it. There will always be someone who will make a buck or several by exploiting change. Unless the NMC is going to check every single sign-off (and we know how well that worked with previous checks), it won't really matter who signs the paper - it is up to us to live with our consciences - we either do it properly or pay to fudge it.

    In the meantime, let's hope that the NMC go back to the drawingboard in relation to this revalidation nonsense and thus obviate the need for such cowboy organisations

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  • I am desperately trying to get my trust competencies signed off. at this point i would pay some one as i have begged for someone - anyone to spend the 20 minutes it takes to do some of them and i have managed to get half done. No one seems to have time to invest in their own employees. I will not be surprised if nurses in busy acute wards will start paying and doing the paperwork on their days off, as it will be that or not being able to work. The NMC is holding nurses to ransom, as if we haven't got anything else to do to prove our worth, on the wards we are constantly told off for this audit not being done, tooo long complicated MRSA pathways not correctly filled in or having three ways to record notes, two computer programmes and a folder of paperwork to complete. Wake up NMC, Trusts, auditors, we are struggling. To lump this on top with the full knowledge that nurses on the ground will not be given days scheduled as 'paper' days to get them complete, there is going to be an even greater enforced exodus.

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  • We have been so short staffed of late you are lucky to get your pay signed off! I cannot see this extra workload fitting in to already over worked wards it is just too much ,in fact I am looking in to down grading to avoid revalidation altogether we are not valued and don't get paid much for what we actually do anyway .

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  • I have thoroughly enjoyed being a nurse & looking to retiring. This revalidation debacle has certainly made me think about accelerating the process. There are some great nurses out there who may be tempted to leave the workforce, especially if revalidation is coming into force. Who on earth is going to police this nonsense. Rest assuresd the unscrupulous folk out here will have no problem paying for some company to 'sign off' to say they are fit to practice. The genuine nurses will be the idiots who struggle to get their evidence together.

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  • This is food for thought for re thinking the re validation as as previous comment the good nurses whom have got nothing to worry about will get it signed off properly but the unsafe nurses will gladly pay to get signed off by these companies whom do not care about the consequences just there profits coming in. So revalidation will just be a waste of time as does not guarantee a good nurse. What about untrained nurses whom is monitoring them in meantime. Yea roll on retirement no wonder there is a shortage of nurses.

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  • I was going to work for another 5 years..However I think I will take early retirement in 2 years time. I would rather have a reduced NHS pension than jump through all these ridiculous hoops. I'll go and stack shelves somewhere until I get my stack pension

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  • EeAll I can say is ,
    It's a sad day in nursing, I'm nearly the end of my career , thank goodness , but I wonder what is coming next ?
    It may as well be a carnival. I am sorry for those coming behind , please mind keep up the caring as you wish to be cared for . X

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