What it means for you.

Aim of the Information Session 2 Provide an overview of the revised NMC Code and proposed Revalidation model Increase awareness of the requirements for Revalidation Identify how you might begin to prepare for Revalidation Share learning from the local Revalidation pilot project Provide information on how to get further information.

The Code and Revalidation 3 For everyone’s protection

What is the Code? 4 The Nursing and Midwifery Council (NMC) has updated its Code of professional standards. It sets out the revised universal standards expected of nurses and midwives, which they must uphold every day in order to be registered to practise in the UK. The revised Code became effective on 31 March 2015.

What’s new in the Code? 5 Duty of Candour Every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care which causes, or has the potential to cause harm or distress. Social media The Code recognises the changing nature of communications and sets standards for acting responsibly including the use of social media. Fundamentals of care The Code sets standards of fundamental care and provides examples of what this includes such as nutrition, hydration and environmental cleanliness.

What’s new in the Code? 6 Medicines management and prescribing Standards that clearly set the context for prescribing, supply, dispensing and administering medications. Conscientious objection Nurses and midwives must act in the best interests of people at all times and can only make conscientious objections to a particular procedure in limited circumstances. End of life care Specific reference is made to the needs of those in the last days and hours of life.

What changed in the Code? 7 A greater focus on: Compassionate care – kindness, respect and compassion Teamwork – work co-operatively Record keeping – six clear standards to support all record keeping Delegation and accountability – delegate responsibly, be accountable Raising concerns – this aligns the Code with the re-launched Raising Concerns Guidance published in 2013 Cooperating with investigations and audits – includes those against individuals or organisations and acting as a witness at hearings.

Four themes brought together in one Code 8 Together they signify good nursing and midwifery practice.

Prioritise People 9 You put the interests of people using or needing nursing or midwifery services first. You make their care and safety your main concern and make sure that their dignity is preserved and their needs are recognised, assessed and responded to. You make sure that those receiving care are treated with respect, that their rights are upheld and that any discriminatory attitudes and behaviours towards those receiving care are challenged

Practise Effectively You assess need and deliver or advise on treatment, or give help (including preventative or rehabilitative care) without too much delay and to the best of your abilities, on the basis of the best evidence available and best practice. You communicate effectively, keeping clear and accurate records and sharing skills, knowledge and experience where appropriate. You reflect and act on any feedback you receive to improve your practice. 10

Preserve Safety You make sure that patient and public safety is protected. You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk. You take necessary action to deal with any concerns where appropriate. 11

Promote Professionalism and Trust You uphold the reputation of your profession at all times. You should display a personal commitment to the standards of practice and behaviour set out in the Code. You should be a model of integrity and leadership for others to aspire to. This should lead to trust and confidence in the profession from patients, people receiving care, other healthcare professionals and the public. 12

NMC professionals mirror organisational priorities of safety and care through the new Code 13 Personalisation Access Involvement Rights Clinical guidelines Learning Innovation Quality control Safety systems Safety culture Monitoring Transparency Leadership Governance Care Compassion Listening Dignity Evidence-based practice CPD Technical skills Experimentation Safety behaviours Human factors Team orientation Reporting Honesty Probity Professionalism

What’s new in the Code? 14 Duty of Candour Every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care which causes, or has the potential to cause harm or distress. Social media The Code recognises the changing nature of communications and sets standards for acting responsibly including the use of social media. Fundamentals of care The Code sets standards of fundamental care and provides examples of what this includes such as nutrition, hydration and environmental cleanliness.

What’s new in the Code? 15 Medicines management and prescribing Standards that clearly set the context for prescribing, supply, dispensing and administering medications. Conscientious objection Nurses and midwives must act in the best interests of people at all times and can only make conscientious objections to a particular procedure in limited circumstances. End of life care Specific reference is made to the needs of those in the last days and hours of life.

Why are we introducing revalidation? 16 The public expect all nurses and midwives to remain up to date and fit to practise throughout their careers Revalidation strengthens professionalism through ongoing reflection on the Code Revalidation encourages engagement and challenges isolation A positive affirmation – not about searching for “bad” practice Positive impact on public protection: 680,000 nurses and midwives engaging with their professional standards and reflecting on their practice on an ongoing basis.

What is Revalidation? 17 Every three years, you will need to show that, as a professional, you are living by the Code’s standards of practice and behaviour. You will need to meet a range of requirements, designed to show that you are keeping up to date and actively maintaining your fitness to practise. This process will be called revalidation and will replace the current PREP requirements and Notification of Practice form.

Revalidation process 18

19 Practice hours Continuing professional development Practice related feedback Reflection and discussion Health and character Professional indemnity arrangement Confirmation

Practice hours 20 You must practise a minimum number of hours over the three years preceding the date of your application for renewal of your registration. 450 Minimum total practice hours required **Those with dual registration must undertake 900 hours HOURS

Continuing professional development 21 You must undertake continuing professional development (CPD), relevant to your scope of practice as a nurse or midwife, over the three years prior to the renewal of your registration. 35 Of these 35 hours of CPD, 20 must include participatory learning HOURS

Practice-related feedback 22 You must obtain practice-related feedback over the three years prior to the renewal of your registration. 5 PIECES

Reflection and discussion 23 You must record written reflections on the Code, your CPD and practice-related feedback over the three years prior to the renewal of your registration using the NMC template. You must discuss these reflections with another NMC-registered nurse or midwife. 5 REFLECTIONS

Reflection and discussion 24 What was the nature of the CPD activity/ practice-related feedback? What did you learn from the CPD activity and/or feedback? How did you change or improve your work as a result? How is this relevant to the Code? 5 REFLECTIONS

Health and character 25 You must provide a health and character declaration, including if you have received any cautions or convictions. HEALTH AND CHARACTER

Professional indemnity arrangement 26 You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement. INDEMNITY

Confirmation 27 You will need to demonstrate to a confirmer that you have met the revalidation requirements. NB: A ‘confirmer’ is being asked to judge whether you have demonstrated that you have met the requirements for revalidation, not whether you are fit to practice. CONFIRMATION

28 How does this work in practice? When the ‘confirmer’ is a registered nurse or midwife: The reflective discussion and confirmation discussion can happen with the same person It is recommended that this process happens at one meeting, for example, at an annual appraisal. When the ‘confirmer’ is not a registered nurse or midwife: The reflective discussion with another NMC-registered nurse or midwife must happen first The confirmation discussion will need to happen after all other requirements are met.

29 RevalidationProposed Requirements (currently being piloted) Practice hours You must practise a minimum of 450 hours (900 hours for those with dual registration) over the three years prior to the renewal of your registration. Continuing professional development You must undertake 40 hours of continuing professional development (CPD) relevant to your scope of practice as a nurse or midwife, over the three years prior to the renewal of your registration. Of these hours, 20 must be through participatory learning. Practice-related feedback You must obtain at least 5 pieces of practice-related feedback over the three years prior to the renewal of your registration. Reflection and discussion You must record a minimum of 5 written reflections on the Code, your CPD and practice-related feedback over the three years prior to the renewal of your registration. You must discuss these reflections with another NMC registered nurse or midwife. Health and character You must provide a health and character declaration. You must declare if you have been convicted of any criminal offence or issued with a formal caution over the three years prior to the renewal of your registration. Professional indemnity arrangement You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement. Confirmation from a third party You will need to demonstrate to a third party that you have met the revalidation requirements. Keeping a portfolio We strongly recommend that you keep evidence that you have met these requirements in a portfolio (this is, however, optional).

How will revalidation help you? 30 By following a stronger process, the work that you do and the reflections you make will lead to: Enhanced professionalism Improved personal and professional development An opportunity to talk to other professionals and learn – particularly if you work alone An opportunity to show the best work you do and build up a portfolio Pride in your profession through a positive impact on public protection An enhanced set of skills Up-to-date knowledge of standards and changing needs of the public.

Understanding the big picture 31

When will revalidation start? 32 In October 2015 the NMC Council gave the go ahead to launch revalidation. From this point, you will need to familiarise yourself with the revalidation requirements and start to develop your portfolio. It has been proposed that the first nurses and midwives to revalidate will be those with a renewal date in April This will give everyone time to prepare and familiarise themselves with the requirements.

Revalidation pilots The Revalidation model was piloted in 19 organisations across the four countries of the UK. The pilots were completed at the end of May Pilot organisations were selected to cover a variety of settings and employment circumstances for nurses and midwives. Nurses and midwives taking part used the provisional revalidation guidance to compile a portfolio of evidence that meets the requirements. Learning from the pilots have been used to refine the revalidation model. The finalised guidance is now published.

What should you do now? 34 1Register at NMC online, where you can also find out your renewal date 2Read the new Code and practise according to its principals 3Ensure you are up-to-date on revalidation developments and tools by checking regularly on our website

NIPEC’s Online portfolio can help YOU with revalidation The Code Practice Hours CPD Feedback Reflection and discussion Professional indemnity arrangement Health and character Confirmation Record YOUR Hours of Practice Record, reflect & upload CPD & calculate total including participatory Record feedback in Reflective diary Record YOUR reflections on The Code, practice related feedback/CPD Populate NMC template with YOUR information Create YOUR revalidation period and

NIPEC’s online portfolio - updated th May

For more information: #newCode #revalidation NIPEC website 37