The proposed revalidation system for nurses and midwives is currently “inadequate” for a “significant portion” of registrants that do not have the same levels of employer support as others, according to nurses.
Registrants in smaller and non-NHS organisations risk being “unfairly disadvantaged,” because they may receive little or no help from bosses when carrying out the new competency checks that will allow them to renew their registration every three years, they said.
“For the significant portion of registrants who are outside [a particular set of circumstances] the model and guidance… are inadequate”
The concerns were raised following a Royal College of Nursing survey of 375 registrants, who trialled the new system, and in response to ongoing consultation.
Pilot participants said there was also confusion about the link between revalidation and fitness to practise procedures and also around the purpose of the “confirmer”, who signs off the registrant once they have met all the competency requirements.
They said it was unclear whether the person confirming a registrant was just stating they had seen evidence of meeting the revalidation requirements, or whether they were required to use their professional judgement to ensure it reached a certain standard.
Meanwhile, some employers taking part in the revalidation pilot claimed they were being handed the responsibility for revalidation – due to the confirmer signing off the registrant – when it should lie with the Nursing and Midwifery Council, which is introducing the system.
A lack of access to and confidence in using IT among some registrants has caused them “serious anxieties” due to current proposals requiring revalidation documents to be processed online, noted the union.
“[Organisations allocating confirmers to registrants] undermines the principle of registrants taking control of their own revalidation”
Interference from some employers was also highlighted, after it was found that some pilot organisations allocated confirmers to nurses.
“This undermines the principle of registrants taking control of their own revalidation which runs through the NMC’s draft guidance…. organisations should not manage registrants’ revalidation,” said the RCN in its response to the NMC revalidation evaluation.
In addition, the survey found there was confusion about provisional NMC guidance and what level of detail is required by registrants in their written reflective accounts and feedback.
This echoed the findings of Nursing Times’ own research into the pilots, which revealed nurses required clearer guidance from the NMC on how to complete a range of standards as part of revalidation.
In its briefing document, the RCN said: “The proposed revalidation model and draft supporting guidance is well suited to registrants who fit a particular set of circumstances, including individuals who work in a team within an NHS setting in clinical role, have a supportive and engaged line manager and employer, have regular good quality appraisals, and have online access and are IT literate.
“We are particularly pleased that members overwhelmingly found going through revalidation to be a positive experience”
“However, for the significant portion of registrants who are outside these circumstances the model and guidance as they currently stand are inadequate,” it said.
The union said it supported the principle of revalidation – to help protect the public and sustain a culture of professionalism among nurses – and was committed to helping the NMC develop an “effective and proportionate” system.
An NMC spokeswoman said it welcomed the RCN’s input on the pilots and, along with its own ongoing analysis, would review the revalidation guidance.
“We are particularly pleased that members overwhelmingly found going through revalidation to be a positive experience, and valued the opportunity to have a professional development discussion with another registrant,” she added.
Pilot organisations across the UK completed testing of the system by the end of May. The NMC will finalise standards and guidance in October, following evaluation of the pilots.