1. Northumbria Healthcare Branch
NMC Revalidation
NURSING
UNISON Nursing
Northumbria Healthcare Branch
Welcome to this session on revalidation, we hope you will find it helpful.
The Nursing & Midwifery Council will introduce Revalidation from April 2016 and it will be rolled out over the next three years as nurses & midwives renew their registration, approximately 210,00 will go through this new system each year.
UNISON is working with (name the employing organisation) to raise awareness, to help staff prepare & to answer any questions or aniexities you may have about the new system.
We are continuing to work with the NMC to ensure staff have all of the information they need so please feel free to ask any question, you may have one that the NMC has not thought of yet and that could help others.

2. Revalidation – what is it?
Revalidation is the means by which Nurses, Midwives & Health Visitors renew their professional registration & demonstrate compliance with the code of conduct. They pay an annual registration fee but are required to formally renew their professional registration every three years.
Revalidation is how nurses and midwives demonstrate in conjunction with the code of conduct that they are able to maintain their professional registration. As you know this has to be done every 3 years.
Every nurse and midwife has a registration renewal date, this is detailed in their NMC pin number, each pin number contains numbers which relate to the year the person qualified and went on to the register for the first time.
The easiest way for somebody to find out when their renewal date will be is to go onto the NMC website and register for online registration It’s easy to do
You could ask, has anyone already done this online? If yes – did you find it easy – if no one says they have encourage them to do so asap

3. Code of Conduct
31st March 2015 You will have to evidence reflection and practice against the code of conduct.
The new code of conduct came into effect 31 March 2015 from this point nurses and midwives have to relates their suitability to remain on the register to this code: .
For example in their pieces on practice feedback & reflection they have to relates their practice to the code the same in any episode of reflection.
They also need to relates their learning as part of their demonstration compliance with the code.
So you could argue that all roads in revalidation lead to the code but we would also encourage you to use this more effectively if you are concerned about anything the code requires you to raise it. So think of the code as part of your armoury, rather than something which is simply used to judge your performance.

4. Why is it changing?
The previous system of PREP did not work and was old. Post Mid-Staffs they committed to change
The NMC were supposed to audit 10% of portfolios annually, which they didn't do. When they did do this it cost almost £350 per portfolio.
Revalidation is it being introduced for a number of reasons firstly the current system PREP has proven to be ineffective. It’s also fair to say that the public enquiry into care failings at mid Staffordshire also found weaknesses in evidence about how nurses match their practice against the code of conduct finally the NMC has in the past come in for heavy criticism by the health select committee in light of the outdated methodology of PREP
Unison has always argued that any system of revalidation must be risk-based and proportionate and cannot lead to any registration fee increase. We have repeated this to the NMC in our discussions with them constantly & will be closely monitoring the revalidation implementation.
A number of our branches were actively involved in the pilot sites across the UK, and we’ve brought together a Unison group on revalidation to monitor progress and implementation. This will also help us to feed into any evaluation which the NMC undertakes

5. What will I have to do?
You will need to demonstrate the following has been achieved every three years:-
450 practice hours
35 hours of CPD
5 pieces of practice related feedback
5 piece of reflection practise
Confirmation of Health & good character
All nurses and midwives will need to demonstrate at the point they renew their registration through revalidation that they have:-
Undertaken 450 hours of practice – 900 if they wish to maintain that you will registration of nursing and midwifery
35 hours of continuous professional development – this has changed from the pilot when it was 40 hours, they chose to do this due to the increased cost that the hours might have on the service during implementation of the new system.
Five pieces of practice related feedback
Five pieces of reflection
Confirmation of health and good character
Confirmation that you have indemnity insurance in place
We will go through each of these in turn

6. 35 hours of CPD
Study days
Learning events, such as a conference or workshop
Peer review
Coaching and mentoring
Participation in clinical audit, practice visits and group meetings
Only 20 hrs have to be participatory
You have to demonstrate 35 hours of continuing professional development.
This could include examples of the following:-
A study day
Short-course
A conference you attended by describing its nature and what you gain from it
Participating or leading a workshop
Peer review
Evidence of mentoring supporting learning or coaching individuals
Evidence of clinical audits and reviewing resolving patient complaint practice meetings and departmental group meetings where you are discussing service of patient care
As you can see there are a range of ways that you can demonstrate you have achieved this
You can also use this in your development reviews to support your request for access to training, as 20 hours have to be participatory & your employer as part of your contract requires you to maintain your NMC registration

7. Practice related feedback x 5
Feedback can come from a variety of sources, including patients, service users, students and colleagues. Feedback can also be obtained through reviewing complaints, team performance reports and serious event reviews.
Feedback can be informal or formal, written or verbal. It could be specific feedback about an individual, or feedback about a whole ward, team or organisation
Practice related feedback is very new within revalidation and with that that there may be some uncertainty.
There are many examples in the service where people gain feedback from patients, women and service users as part of the care they received. It could also be feedback from students you’ve mentored or supported & feedback from individuals who have attended a training session with you
It could also be a change you have instigated or raised following an experience which you believed affected patient care. It doesn't have to be massive to be included.

8. Reflections x 5
5 written reflective accounts that explain what you learnt, how you changed or improved your work as a result and how it is relevant to the Code. You can use the template provided or your own (see full guidance for criteria)
A completed reflection and discussion form with details of the person with whom you have had the discussion - registrant.
Reflective practice is not new and there are many articles you can read on the best & current methods of undertaking it. It also doesn’t have to be a major piece of written work, it can be something that is relatively simple. The most important thing is you need to relate it to the code,
For example if you’re working a shift and you do not believe that there are adequate staff in place to deliver safe care, you could reflect on how you raised your concern, how you went about this, what information you provided and why referencing this to the relevant section of the code.
It could also be how you met a particular person’s needs, for example at end stage of life, or during delivery of a baby how you met the person’s particular requests and wishes or those of their family. Again you must reference it to the code.

9. Indemnity Insurance
You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement.
Remember your employer retains vicarious liability for your practice UNISON information
Indemnity insurance became a requirement of the NMC in October 2014 you have to demonstrate that you have sufficient cover in place or will have when you practice. If you’re working in the NHS you simply need to say that you’re covered by the NHS scheme, even if you are working bank or agency in the NHS, you will be covered again covered by the NHS
It will only be individuals who work independently, for example independent midwives or those who are completely self-employed in independent practice that you will need to provide actual evidence that they have cover in place

10. Health & Character
Evidence that your health enables you to practice to the required standard
Good Character now a requirement in the code
You must declare to the NMC any convictions and cautions – even if they are not related to nursing or midwifery
You do not have to provide actual evidence of your health in your portfolio but you do have to confirm that nothing in your health precludes you from practising safely. For example you could have a back injury which precludes you from undertaking certain nursing duties and have reasonable adjustments in place by the employer this does not mean that you cannot practise or revalidate.
You could have a long-term condition that again this does not mean that you cannot revalidate
Good character can be quite subjective and the most important thing is that you declare any convictions or cautions including those which may have been spent as part of your revalidation application to the NMC. If information subsequently comes to light that you didn’t declare then your fitness to practice could be called into question. Also remember that changes to the code now make it a requirement that you should self declare any new information to the NMC. UNISON has always supported this, as by doing so we also believe you are demonstrating to the NMC your professional actions.

11. Confirmation
You need to demonstrate to a third party that you have met the revalidation requirements
You need to have a confirmation discussion with a third party where you discuss how you have met the revalidation requirements. This can form part of an annual appraisal.
An appropriate third party confirmer is your line manager. The NMC recommend that you obtain confirmation from this person wherever possible. A line manager does not have to be an NMC registered nurse or midwife.
If you do not have a line manager, we recommend that the third party is an NMC-registered nurse of midwife. If that is not possible, you can seek confirmation from another healthcare professional that you work with and who is regulated in the UK.
You need to demonstrate that you have discussed your revalidation with a third party, as they have to confirm that you have met revalidation requirements.
The NMC believe that this should be your line manager. However it does not have to be if for some reason this might cause you difficulty. For example they may be your friend etc. It may also be difficult for someone who works in a rural setting or in isolation, in this case it could be somebody else who knows you & your role well. We would avoid using personal friends to act as your confirmer. They could however be a colleague or peer.
Most important thing is that they know your practice and can confirm the evidence you provided is accurate and complies with the required standard

12. What happens if I cannot revalidate
If for some reason you know you cannot revalidate e.g. You have been on maternity leave or long term sick – contact the NMC as soon as you receive your renewal letter (90 days before its due)
The NMC have systems in place for exceptional circumstances but as revalidation is new not all of these have been tested yet
We are working with the NMC to develop further information about what might happen in these circumstances, remember all of your evidence should be looking back at the previous three years. So be pro-active where you can, for example if you are pregnant you could discuss access to your CPD now to make sure you get your 20 hours of participatory learning in before your leave commences. If you will be on maternity leave let your manager know so you can schedule well ahead of time your confirmation discussion.
If you are worried make sure you speak to your local unison rep as they will be able to help you raise any concern you have with your manager locally. At the same time make sure you let the NMC know as soon as you hear from them.

13. What to do right now
Get your prep portfolio and divide it into the new headings
Identify where your gaps might be and start to populate them now
Go onto the NMC website & join the NMC online
Put your revalidation date in your diary now & set yourself a 3 month reminder
Do Not Panic – everyone is in the same boat, You are not alone
Ok so these are the things, which UNISON is suggesting you do right now.
Get your current prep portfolio & re order it into the new headings
Hours
Practice related feedback
Continuous professional development
Reflections
Confirmation
Start to populate these new sections from your existing evidence, from this you will see where you may have some gaps and you can focus your time between now and when you revalidate to populate the information.
Go onto the NMC and register for NMC online
You can immediately see when your revalidation is due, make a note of this in your diary and start preparing.
All of the documents for you to use are on the NMC web site, some of these are options e.g. Hours of practise but others you will need such as the reflections and confirmations.
If you are worried about anything Ask UNISON

14. Be Revalidation Ready with UNISON
Not a member but want to be join here
or call