The Nursing and Midwifery Council has today approved plans for the introduction of a major new system of competency checks for registered nurses and midwives, with the regulator’s chief executive describing it as a ‘historic’ moment.
The new checks system, called revalidation, will need to be completed every three years by nurses and midwives in order for them to remain on the NMC register and, therefore, able to practise.
NMC council members yesterday unanimously agreed to introduce revalidation next spring. They also approved standards for the new system.
It will replace the current system of post-registration education and practice in April 2016, after NMC council members signed off guidance.
The guidance for revalidation 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.
This represents a change from the original proposal of 40 hours of CPD, following feedback from organisations which tested the system and said there was no evidence of the benefits from this increase.
The new system has been piloted by more than 2,000 nurses working at a range of different sites prior to its roll-out nationally. It was tested in 19 sites across the UK this summer.
The NMC said it was “confident” that, based on the results from the pilots, the introduction of revalidation was “achievable, effective and realistic”.
The NMC council today also approved changes to standards for readmission to the register.
This included closing a loophole which could have enabled nurses to avoid revalidation by allowing their registration to lapse and then reapplying to the register within the next six months. Those attempting this will now be required to complete revalidation.
Meanwhile, midwives who have dual registration and work only as a school nurse or health visitor will now not be required to submit an annual intention to practise midwifery form to their supervisor.
They will remain on the NMC register, but their entry will say they are not entitled to practise as a midwife –unless they then complete a return to midwifery practice programme.
Nearly 16,000 nurses and midwives will be the first to revalidate in April 2016. All 685,000 nurses and midwives on the NMC’s register will go through the new process as their registration becomes due for renewal over the course of the next three years.
Before approving the system, some council members raised concerns about the “one size fits all model”, as well as potential difficulties for registrants in smaller organisation in completing the 20 hours of participatory CPD.
NMC corporate legislation adviser Clare Padley said the regulator would be evaluating the revalidation model “from the outset” and that it would also carry out a formal review.
Director of continued practice Katerina Kolyva said that while participatory CPD would be more difficult for some registrants, it was an important new element of revalidation designed to “challenge professional isolation”.
Council member Quinton Quayle predicted there would be some “minor glitches” with the system and NMC chair Janet Finch said the regulator’s evaluation of the pilots found many organisations were still yet to implement their plans meaning they would have “quite a lot of work” to do ahead of April.
NMC chief executive and registrar Jackie Smith later told HSJ’s sister title Nursing Times the regulator noted there had been “a lot of anxiety” around the burden of revalidation on employers and individuals.
But she said the NMC’s guidance approved today made it clear that organisations and registrants did not need to go to great lengths to be able to support or complete revalidation.
However, she reiterated the regulator would monitor revalidation, including the “crucial” element of CPD.
She said the decision to introduce revalidation from April was an “absolutely tremendous, historic moment”.
“It reflects where the NMC is and the progress that we’ve made. Many thought the NMC couldn’t do this and we’ve demonstrated we can,” she said.
“It’s also important to say just how significant this is for the profession and the public. It simply can’t be right that you sit on a register for years and there is no way that anyone ask questions about how you are living the standards set out in the code,” she added.
“Importantly for the profession [there is] huge support for this and that’s great because it has enabled us to deliver something they value.
“[The profession] absolutely want to demonstrate what the vast majority of them do which is practise to a very high standard.”