A series of roadshows on the Nursing and Midwifery Council (NMC) revalidation process, organised by the Association of Occupational Health Nurse Practitioners UK (AOHNP), in association with Kays Medical, has identified key learning points. Diane Romano-Woodward explains.
In early 2015, the AOHNP UK participated in the new NMC revalidation pilot and 27 participants were successful in completing it. It was recognised that there was a need to use this experience in assisting OH practitioners to understand the requirements of the new process.
The perceived issue in OH circles was that there might be more of a tendency to receive negative feedback from patients and others in practice than for nurses in general. This can happen when reports to management may contain contentious advice, such as recommending a return to work when the patient is not fully accepting of this, or a manager perceiving the report as “unhelpful” if it did not support their requirements for management action. Thus, it is possible to practice well and professionally and still receive negative feedback
The other perceived difficulty is that many practitioners are not managed by nurses, but by HR or safety professionals who might not be familiar with practice. Others, such as independent practitioners, have no manager and generally do not have an annual appraisal to use as feedback or to form the basis of a “confirmation” conversation. Revalidation is the process by which nurses renew their registration. It is not a value judgment on fitness to practice and the NMC is quite clear that any such concerns should be raised separately.
The two-hour Revalidation Roadshow has taken place at about 15 locations across the UK.
Basic requirements of revalidation
The NMC now suggests that a portfolio is produced, but it is not a requirement and can form part of an existing professional portfolio. This is provided that the information can be demonstrated easily to the “confirmer”, after which it can be stored in any manner. A big change from the pilot is that no scanned information will be uploaded to the NMC website. Therefore, there is no particular advantage to having a digital portfolio although these are being sold, particularly by the Royal College of Nursing.
Revalidation roadshow outcomes
Anonymous individual feedback was collected at the roadshows. Two questions concerned delegates’ confidence about collecting five pieces of feedback and understanding the required contents of the portfolio. The other two questions concerned the number of practice hours required for a person with registration as a registered nurse and specialist community nurse public health nurse (the answer is 450); and the minimum number of participatory hours (20) of continuing professional development (CPD).
Participants showed an increase in their knowledge about the portfolio and their ability to get the required feedback in three years. The learning about the required hours was less successful. The majority of people understood that the required practice hours under the new process had reduced to 450. However, a consistent level of about three in each group of 30 delegates did not answer the question on participatory CPD hours correctly. This misunderstanding has been addressed by the lecturer.
After several roadshows had taken place, the most common concerns of the participants began to emerge.
Feedback: what can be used?
Feedback does not need to be about an individual, but can be praise given to a group or unit. It does not need to be in writing, the registrant can simply recount in writing what happened, being careful not to identify patients or staff members. The important part of the process is to reflect on the feedback in relation to the NMC code. Once this is understood, it becomes straightforward to find instances in one’s daily practice where there has been comment on the registrant’s practice. “Thank you” and “Well done” messages do happen. Negative feedback, eg complaints or criticism, offer a good opportunity for reflection on the code and should not be feared.
How much detail is needed in reflective accounts?
The NMC is anticipating one to two sides of A4 paper and there is a mandatory Word document form that must be used, so the account can be typed directly onto that. Examples of completed templates, including one filled out by an OH nurse can be found on p.16 of the revalidation materials.
These discussions must take place with another NMC registrant and good advice is given on the NMC website.
During the pilot it was found that the confirmation conversation was easily added onto the reflective discussion. Those without an NMC registrant as a manager might consider doing this instead of having a separate confirmation conversation.
This sheet can be found here on the NMC website.
What can be used as evidence of practice hours?
This can be found on pp.12-15 of the guidance.
Evidence of practice hours includes timesheets, job specifications and role profiles.
Independent practitioners who do not have these might wish to include invoices to clients with the hours/days/ weeks, but with financial details removed.
Prompt submission is important. It must be sent in by the first day of the month in which revalidation takes place (not the end of the month), but practitioners are advised to send it well before this. As approximately 20,000 nurses will be revalidating each month, early submission will prevent automatic removal from the register if it is not received. It is likely to take between two and eight weeks to get back on the register if registration lapses, during which time the nurse cannot practice.
Employers will wish to ensure that the employees do revalidate promptly and suggested help is given in a separate document called Information for employers.
Employers can register as such on the NMC website, and will then be able to access the revalidation dates of their employees.