NMC revalidation Frances Cannon SPO NIPEC – NI Project Lead Revalidation Working Group

NI Planning for Revalidation NI Revalidation Programme Board convened Nov 2014 – bimonthly meetings Representatives nominated by CNO NI Revalidation Working group has been set up reporting to the Programme Board - monthly meetings NIPEC is supporting DHSSPS in its oversight of the work to introduce revalidation

About the NMC The NMC is the largest professional healthcare regulator in the world – 680,000 on the register Its primary function is patient and public protection It sets standards of education, conduct and performance for nurses and midwives

Existing 3 yearly renewal requirements - Prep Nurses and midwives currently renew their registration every three years and declare that they’ve done: 450 hours of practice 35 hours continuing professional development

Revalidation = Public Protection Built on existing arrangements, revalidation focuses on: feedback from patients/women and colleagues, reflection on The Code engagement in a professional discussion with another nurse/midwife and confirmation by a manager and/or fellow registrant The NMC believes that this will give even greater confidence to the public, employers and fellow professionals that nurses and midwives are up to date with their practice.

The NMC Code The Code Professional Standards for Practice and behaviour for Nurses and midwives 4 Ps Prioritise People Practice effectively Preserve safety Promote professionalism and Trust The Code [PDF] has been updated to reflect changes in contemporary professional nursing and midwifery practice and to reflect the public expectations of care. All nurses and midwives will be sent a copy of the Code before it becomes effective on 31 March 2015 Until then, the current Code remains in place. There are also changes to the guidance which sits under the Code.

The revalidation model Meeting requirements and building a portfolio 3 years Confirmation from a third party 12 months Application for renewal of registration 45 days This is a high-level overview of the model: Over the three year period, nurses and midwives need to engage in professional development activities and meet the revalidation requirements. They should keep this information in a portfolio (the next slide explains these requirements) In the final year of their three-year registration period, nurses and midwives need to have a discussion with their line manager about their revalidation. They will need to take along their portfolio and use it to demonstrate to their line manager that they have met the revalidation requirements. NMC guidance will provide other options for registrants that don’t have a line manager. 45 days prior to the end of the date their renewal application is due, nurses and midwives will need to log onto NMC Online and apply to renew their registration. They will be asked to declare that they have complied with all of the revalidation requirements

Revalidation requirements The Code Practice Hours CPD Feedback Reflection and discussion Professional indemnity arrangement Health and character Confirmation Total practice hours required: Nurse - 450 Midwife - 450 Nurse and SCHPN - 450 Midwife and SCHPN - 450 Nurse/SCHPN and Midwife Or Midwife/SCHPN and Nurse – 900 Only hours that are relevant to nursing or midwifery practice can be counted. CPD All registrants are required to undertake a minimum of 40 hours of CPD in each three year renewal period. Of those 40 hours, at least 20 hours must be participatory learning. All CPD included in these hours must be relevant to your scope of practice as a nurse or midwife. This means that some mandatory training should not be included if it does not direct;y relate to your practice as a nurse or midwife. NMC guidance on how to revalidate will provide a list of examples of CPD, including examples that are participatory CPD. Requirement: Feedback on their practice All registrants must obtain at least five instances of feedback about their practice Feedback can come from a range of sources and does not have to be formal feedback. As well as collecting feedback directly from service users and colleagues, you can think about the feedback you get through reviewing complaints, team performance reports and serious event reviews. You are encouraged to think broadly about where to seek feedback. Requirement: reflections on CPD, feedback and the Code You will need to record at least five written reflections on CPD, feedback and the Code. Each reflective account could be about a specific instance of feedback or CPD, or could reflect a broader theme across your CPD and feedback. Each reflection should: Explain what you learnt How you changed or improved your practice; and How it is relevant to the Code You will need to discuss your reflections with another NMC registrant. If your line manager is an NMC registrant, you can have this conversation as part of your confirmation discussion. The NMC will provide a template that you can use if you find it helpful. Professional indemnity arrangements You will need to declare that you have in place (or will have when necessary) an appropriate indemnity arrangement as part of your online application. Information on the provenance of the arrangement will be requested as part of the declaration (i.e. through your employer, professional body or private insurance provider). Declaration of health and character All registrants must provide a health and character declaration as part of their online application. Any registrant who has been convicted of any criminal offence or been issued with a formal caution, over the three years prior to the renewal of their registration, must provide details as part of their renewal application. Third party confirmation All registrants will be asked to declare that they have demonstrated to an appropriate third party that they have complied with the revalidation requirements. We will provide a form to obtain this confirmation. An appropriate third party confirmer is your line manager. If you do not have a line manager, wherever possible we recommend that the third party you use is an NMC registrant. There is flexibility in the revalidation model to take into account those who: do not have a line manager work wholly overseas Have not practised through the whole three-year period Guidance will be provided by the NMC to cover these situations.

Portfolios Participants will: A portfolio to include: A record of the practice hours completed and the context and settings of practice in which it was undertaken Five reflective accounts on feedback on their practice and their CPD activities and linking this to Code requirements CPD related evidence Professional indemnity arrangement information Confirmation-related documents Each year the NMC will select a sample of nurses and midwives to provide further information to verify the declarations that they have made Does not mean there are any concerns NMC Strongly recommend that registrants use a portfolio to keep evidence of how you have nmet requirement Helpfu to develop a Portfolio Nurses and midwives Participants will: Build a portfolio of evidence including five reflective accounts relating their CPD and feedback on their practice to the Code Discuss their portfolio with their 3rd party confirmer Meet the hours and professional indemnity requirements Submit their self-declarations online l to structure under themes in the code

Revalidation Pilot Purpose To allow for the processes and tools for implementation of the agreed revalidation model to be tested with registrants “How to revalidate with NMC” WHSCT is the Northern Ireland Pilot site Outcomes The outcomes of the pilots will help ensure the practicality of the guidance, process and forms before going live at the end of 2015. For pilot participants that the: guidance and templates provide appropriate support requirements, as articulated, are perceived to be achievable online process is usable

Revalidation process overview Conversations and confirmation Familiarisation and meeting requirements Recruitment The main aim of the pilot from the NMC perspective is to learn as much as possible around the processes that support the revalidation model. To meet this aim, we have identified a research sample defined as those renewing between January and September 2015. This will be the group that will be included in the independent evaluation of the pilot. We understand that organisations also have aims from the pilot, particularly taking it as an opportunity to familiarise and prepare more widely for revalidation, and for this reason we are proposing that registrants who are not eligible for the formal evaluation are invited to take part in the pilot and provide feedback via more informal mechanisms. It will be up to organisation to define these groups but we ask that this happens in consultation with the NMC. Recruitment: mid-January to end of February All registrants will be invited to join the pilot and take part in a initial online survey run by Ipsos Mori - those whose 3-yearly renewal falls within the January-September 2015 period will become part of the formal, independent evaluation. Ipsos Mori will invite all this group of participants to take part in further surveys and individual participants will be invited to take part in focus groups and interviews to gather in-depth views and opinions on the guidance, process and forms. Those joining up, but who are not renewing their registration during January and September 2015, will not be part of the formal research but will have a more informal opportunity to provide feedback. Following completion of the initial Ipsos Mori survey, all participants, regardless of whether they are in or not in the formal evaluation, will be sent details on how to set up their NMC online account and next steps Familiarisation/meeting requirements (building portfolio): mid-January to end of March After participants have completed the initial online survey they will be sent information to set up their NMC Online account. They will also have access to NMC guidance and forms to start meeting the requirements: By the end of this period all participants should have activated their online account and: built their portfolio identified and approached their confirmer, arranged their confirmation conversation scheduled when they will make their online application submission (declarations of meeting revalidation requirements) and upload their portfolio. Conversations and confirmation: April to end of May This is the period in which the confirmation conversations should take place, confirmation should be granted and the registrant would complete the online elements of the revalidation process. Jan Feb March April May June

Evaluation of pilots independent agency to evaluate the participant experience of the process independent consultancy to explore impact on the system outputs from both independent reviews to inform refinements to the model, guidance and process

Research, policy, standards and guidance 2014 2015 2016 Pilot phase Preparation for go-live Revalidation launched Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Impact on the system Impact on system tender Supplier appointed 4 country go/no go Impact on system work underway Final report due Council go/no go Research, policy, standards and guidance Research design Pilot participant recruitment Participant online submission period Final report due Understanding nurses and midwives experience of revalidation through pilot Evidence report due Ongoing analysis of pilot findings Ongoing analysis of pilot findings Interim findings Policy review of analysis outputs Ongoing legal review Standards development Council approval of provisional revalidation standards Guidance development Exec approval of guidance, guidance distributed to pilots Revalidation launched Supporting materials developed Refinements to policy, standards and guidance based on findings from pilot Council approval of final policy and standards Exec approval of final how to guidance ‘How to revalidate’ guidance published Comms & SH liaison Comms activities Stakeholder liaison external engagement NMC business readiness Design, development, test of online system System ready for pilot submissions Provisional full requirements Final full requirements Development of requirements for full system Full system build & UAT Workable system ready Final amendments Development of full requirements, back end processes, business rules & test cases and scripts Business readiness Revalidation reminder sent to registrants

NI Planning for Revalidation NI Revalidation Programme Board convened Nov 2014 – bimonthly meetings Representatives nominated by CNO NI Revalidation Working group has been set up reporting to the Programme Board - monthly meetings NIPEC is supporting DHSSPS in its oversight of the work to introduce revalidation

Preparing for revalidation start thinking about revalidation now – individually and corporately encourage your colleagues to think about it communicate – 2016 is not far away! appreciate the benefits – revalidation will increase professionalism

Opportunities for employers – readiness assessment key areas of focus: assigning and tasking senior leaders as agents of strategic change identifying existing employer systems and processes which already align to revalidation requirements specifying changes needed to ensure any gaps are filled steps needed to identify, assign, brief and train confirmers ensuring appropriate and timely wider staff engagement

Appraisal and confirmation The revalidation model is designed to build on existing employment processes of which appraisal is an important and preferred vehicle. The NMC expects that a part of the appraisal is spent reviewing a nurse or midwife’s performance in relation to the Code and reviewing their revalidation portfolio. This will enable the appraiser to make the confirmation. It will be up to employers to decide how to build confirmation into their appraisals. We will accept a confirmation conversation outside appraisal for those who have not had an appraisal

What this means for… Managers Confirmation is a discussion between registrant and confirmer that all revalidation requirements are being met Confirmation can be linked to appraisal or be a separate conversation This will include assessing the quality of the portfolio evidence Where the line manager is not a registrant, the applicant will discuss their reflections with another NMC registrant Evidence of this will be included in their portfolio

Revalidation and fitness to practice Revalidation is a positive affirmation – it is not about searching for ‘bad’ practice It is part of the NMC’s regulatory toolkit but it does not replace or supersede our fitness to practise function. All registered nurses and midwives already have a professional duty to raise concerns about the practise of another registrant with their employer or with the NMC. As currently applies, if any serious concerns arise during the course of a nurse or midwife’s three year renewal cycle related to public protection these concerns must be raised with the NMC immediately.

Thank you revalidation@nmc-uk.org Twitter #revalidation www.nmc-uk.org/revalidation Twitter #revalidation