Revalidation – Management and leadership 11 November 2014

Context NMC is the largest professional healthcare regulator in the world – 680,000 on register we protect patients and the public by regulating nurses and midwives we set standards of education, conduct and performance for nurses and midwives currently three year renewal period (Prep) o 450 hours of practice o 35 hours continuing professional development

The Principles Extensive engagement across 4 countries of UK Developed in line with our current legislative framework (450 hours of practice) Phased approach (phase 1: Jan 2016 to Dec 2018) Built on the existing processes: o 3 year renewal cycle o appraisals Regular auditing

Policy development 6 month, two part public consultation o Revalidation model and revised Code o Online surveys, deliberative focus groups (4 country) Engagement programme o 5 stakeholder summits (1200 participants) o 100+ engagement events Outputs of consultation part 1 informed part 2 Ongoing development of revalidation policy and guidance

Proposed revalidation model Will replace the current three-yearly renewal and the NoP form. Each nurse or midwife, at the point of renewal, will declare they have met the revalidation requirements: o Practised at least 450 hours during the last three years o Undertaken at least 40 hours of CPD, with a minimum of 20 hours being participatory learning o Declared their good health and good character o Reflected on at least five instances of practice-related feedback o Had an appropriate professional indemnity arrangement in place o Obtained confirmation from a third party

Employers - Revalidation preparedness Key questions 1. What can employers do to prepare for revalidation now? 2. What do employers already have in place to meet revalidation requirements? 3. How can employers meet the needs of registrants with different management arrangements - ‘atypical groups’?

1 or 2 Person confirmation 1 person: One individual who is both an NMC registrant and the manager/supervisor of the nurse or midwife 2 person: A non NMC-registered supervisor/line-manager with responsibility for the nurse or midwife’s practice (e.g. a lay/non-registrant/HR person, GP etc.) and An NMC-registered peer who has knowledge of the registrant’s practice.

Atypical groups - confirmation Are there any groups of nurses who are managed by someone who isn’t a registered nurse or midwife and have limited access to registered peers? What steps can employers take to support these groups? How does this model fit with atypical settings, including agency nurses/midwives? Who between the agency and hiring employer is best placed to confirm?

Code and appraisals Do all your nurses and midwives receive an annual appraisal? Does this include agency/bank nurses? Who does or should carry out their appraisals? Are the appraisers most likely to be NMC registrants? How aware of the NMC Code are appraisers? Do appraisals cover Code requirements? If not, what do you have to do to ensure alignment?

revalidation will require nurses and midwives to reflect on feedback in order to affirm or improve current practice. NMC doesn’t want the feedback - instead NMC consulted on providing a minimum of five reflective accounts which are discussed as part of confirmation. When the nurse or midwife has received feedback, they should reflect on: o If the feedback is appropriate to them and their practice o What areas of their practice have been affirmed or could benefit from improvement o How they put any improvements into practice o What outcomes they have had in practice and how these have related to the Code We will develop a template for providing reflective accounts. Feedback

What feedback do your nurses and midwives currently receive – both individual, team and organisational? Does this include agency/bank nurses? How do Trusts provide feedback to recruitment agencies or individual nurses/midwives? Does feedback cover Code related aspects? Do appraisals cover reflection on feedback? What steps are needed to review existing systems?

Continuing professional development The proposed revalidation standard is: You must undertake a minimum of 40 hours of CPD within the 3 year period and at least 20 of those hours must be participatory learning - learning with others. In addition: The CPD activity must be linked to the Code and the nurse or midwife’s registration The outcome of the CPD activity must contribute to keeping you up to date within your scope of practice As part of the proposed revalidation process, each learning and development activity will need to be reflected upon as to how that learning activity has improved, or kept practice updated in relation to the Code.

Continuing professional development How does your development processes link to Code related requirements? Do appraisers and appraisees understand this linkage? What opportunities for ‘participatory’ style learning and development does your organisation offer? What evidence of CPD and its impact on practice do your nurses and midwives gather? What support, if any, does agency nurses and midwives receive and from whom?

Staff engagement Who in your organisation should lead preparations for revalidation? Establish a core group to lead this process – both HR, clinical/professional and corporate comms? What needs to be communicated to whom, when and how? Start early!!

Timeline December 2014: Council considers draft revised Code January 2015: publication of revised Code and draft guidance for revalidation January to June 2015: revalidation – pilot and testing Autumn 2015: Council decision on model and roll out End of 2015: revalidation launch

The education strategy and its alignment to the NMC strategy, November 2014

Our education function We set: Standards for pre registration nursing and midwifery education Standards for specific post registration nursing and midwifery education We: Quality assure education programmes against our standards – this includes visits to practice placements

Public protection Health care services Standards for education Higher education Regulatory interface

Interface of our education function Higher education policy and landscape four country context and resource education commissioning students as consumers Practice learning policy and landscape patient focus service delivery priorities with finite resources assessing competence and capability

Effective regulation: improving our education function Better public protection via education Pre-registration standards command public confidence and drive public protection Contemporary post-registration standards driven by need for professional regulation QA of education delivers public protection effectively, addresses risks and highlights safe and effective professional practice

Using knowledge intelligently to protect the public Use of regulatory evidence Use of research community evidence Transparent and accurate reporting Exchange of information with other regulators and relevant organisations Use of intelligence: proactive education outputs

Collaboration and communication: creating enduring connections Relationships that support our priorities Improved public profile and understanding of education Enhanced understanding and trust of key stakeholders: patients and public, commissioners, employers, students and educators Effective UK wide collaboration on strategic and operational educational matters

Effective regulation: Outcome based standards Use of intelligence: QA data Risk data Primary research & evaluation data Collaboration and communication: Proactive Engagement with education stakeholders Providing a contemporary and confident interface between education, practice policy and people Protecting the public

Next steps Development of a draft education strategy that will be presented to Council in January 2015 UK wide listening events Analyse comments to inform final education strategy which will be presented to Council in spring 2015

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