THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
Board Paper - Cover Sheet
Meeting Title / Trust Board / Date 28/09/2016Report Title / Nursing and Midwifery Revalidation / Agenda Item
A5(vii)
Lead Director
Report Author / Helen Lamont, Nursing and Patient Services Director
Suzanne Medows, Senior Nurse Revalidation
Classification / NHS Unclassified
Purpose (Tick one only) / Approval / Decision / To note / Information
P
Links to Strategic Objectives / To put patients and carers at the centre of all that we do and to provide care of the highest standard in terms of Safety and Quality
Links to CQC Fundamental Standard(s) / Well Led
Standard 18.2.c - Staffing
Identified Risk? (If yes, risk reference) / No
Resource Implications / No
Legal implications / None
Equality and diversity assessment / Has an Equality Analysis been completed Yes/No
One sentence summary of any equality issues: There are no identified equality issues
Benefit to patients and the public / Patients and the public can have confidence in the appropriate regulation of nurses and midwives and that this organisation is supporting this to happen. The Trust can be confident that its Nursing & Midwifery workforce is appropriately registered.
Report History / Previously reported to the Board in February and December 2015
Next steps / Trust Board to receive the report and note the contents
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
NURSING AND MIDWIFERY REVALIDATION
EXECUTIVE SUMMARY
In October 2015 the Nursing and Midwifery Council (NMC) gave approval to changes to the system of Nursing and Midwifery Registration by the introduction of a three yearly revalidation process. The first registrants to revalidate under this new process were those due to renew their registration in April 2016.
A number of measures were put in place in the organisation to support revalidation; these included the establishment of the Revalidation Project Board chaired by the Nursing and Patient Services Director to provide oversight and a clear steer for the introduction of revalidation in the Trust and the secondment of a full time Senior Nurse for Revalidation and a part time IT Project Manager for 12 months.
An Operational Group led by the Senior Nurse Revalidation Lead, successfully led the implementation of revalidation.
The Electronic Staff Record (ESR) has the facility to monitor progress towards revalidation, providing assurance at both ward and Board level, this facility was made available in early August 2016 and data is not yet fully gathered, interim data is provided showing that to date the majority of registrants have not yet completed this process for which the deadline is 31st October 2016.
This report will provide an update to the Board following the first six months of the revalidation process, demonstrating the success of the project.
RECOMMENDATION
To i) receive the report and ii) note the actions taken.
Helen Lamont
Nursing and Patient Services Director
Suzanne Medows
Senior Nurse Revalidation
14th September 2016
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
NURSING AND MIDWIFERY REVALIDATION
1. INTRODUCTION
In October 2015 the Nursing and Midwifery Council (NMC) gave approval to changes to the system of Nursing and Midwifery Registration by the introduction of a three yearly revalidation process. The first registrants to revalidate under this new process were those due to renew their registration in April 2016.
With the support of the Executive Team, a Senior Nurse and an IT Project Manager were identified to support the smooth implementation and rollout of revalidation across the Trust.
This report will provide an update to the Board following the first six months of the revalidation process.
2. REQUIREMENTS FOR REVALIDATION
Each Registrant is required to keep evidence in a portfolio which demonstrates they have met the requirements for revalidation. Initially, the NMC suggested that this would have to be an electronic portfolio however this position changed and the current advice is that registrants may keep their portfolio as either an electronic or paper based document.
The requirements for revalidation are that over a three year period:
· 450 practice hours or 900 if revalidating as both a Nurse and Midwife
· 35 hours CPD including 20 hours participatory learning
· Five pieces of practice related feedback
· Five written reflective accounts
· Reflective discussion with another NMC Registrant
· Health and character and professional indemnity declarations
· Confirmation by a line manager that the requirements are met
3. REVALIDATION SUPPORT IN THE TRUST
At an early stage of the NMC announcement regarding the introduction of revalidation, the Nursing and Patient Services Director established a Revalidation Project Board to provide oversight and a clear steer for the introduction of revalidation in the Trust. With support from the Executive Team, a Senior Nurse for Revalidation was seconded for 12 months. An IT Project Manager was also identified to support the anticipated IT requirements around the introduction of an ePortfolio.
Processes in place to support revalidation
i) ePortfolio - A scoping exercise was undertaken in relation to identifying a suitable e-Portfolio which would enable registrants to record evidence for their revalidation. As part of this exercise, a Revalidation Project Team developed an Output Based Specification (OBS) and reviewed a number of commercially available solutions. In spring 2016, the national Electronic Staff Record (ESR) team announced that a ‘NMC Revalidation Tracker’ would be incorporated into the ESR Employee Self Service function and a decision was therefore taken to await this solution since there were no associated costs.
In August 2016, all staff in the Trust were given access to full ESR Employee Self Service and all Registered Nurses and Midwives have been given until 31st October 2016 to answer six key questions which will provide assurance to the Board and at ward level, that registrants are making progress towards their revalidation. Although the timing of this report means that the process of gathering this information is not yet complete, the data to date is shown below. Managers have been asked to remind staff of the deadline for completion of this information.
Status / Headcount / Percentage of TotalNot started / 4562 / 96.26%
In progress / 97 / 2.05%
Completed / 80 / 1.69%
One of the functions of the NMC Revalidation Tracker is to email registrants and their managers at intervals of, one year, six months and four months prior to their revalidation date. This additional reminder which mirrors the reminders sent by the NMC to the registrant, will serve to prompt the registrant and their manager to finalise the essential confirmation discussion in a timely way.
ii) Communication – Communication with registrants and managers has been pivotal in ensuring that staff were well informed about the process and requirements of revalidation, as well as the support available to them. Communication methods have included;
a. Establishment of an Intranet site for Nursing and Midwifery revalidation. The site contains links to the NMC revalidation website as well as key resources developed in the Trust including examples of documentation.
b. Key information has been shared via the intranet as well as being published regularly in the Nursing and Midwifery Newsletter.
c. Personal emails have been sent by the Senior Nurse Revalidation Lead to all Nurses and Midwives due to revalidate in 2016 offering support at workshops and giving details of information sessions and individual support if required. Of the 1078 registrants contacted, 477 attended a workshop.
d. Information ‘drop in’ sessions have been delivered to registrants and also those managers who will be acting in the role of Confirmer. Attendance has been good with over 1700 registrants attending ‘drop in’ sessions and over 500 attending Confirmer workshops.
e. The Staff Bank offered individual support to all nurses and midwives whose employment was solely through them. In the five month period, April to August 2016, 15 registered nurses who did not have substantive posts elsewhere, were supported through the revalidation process.
f. Nurses working in non-nursing roles have been identified and targeted for advice and support.
g. Revalidation has been discussed at Trust Communication Forum and also at every Nursing Forum on a regular and frequent basis.
h. The Trust’s Appraisal Policy has been updated to reflect the expectation that revalidation progress should be discussed at each annual appraisal.
i. Liaison with the NMC has also been important in relation to emerging concerns and issues identified as the revalidation process becomes established.
j. The Cumbria & NE England Regional Revalidation Group was established to encourage networking and share good practice.
iii) IT Skills - Through discussion with staff and managers, it became apparent that a small number of Nurses and Midwives were extremely anxious about their ability to access documents online, create, open and save documents. The IT Trainers developed a programme entitled ‘IT Skills for Revalidation’ which has been directly targeted to meet the needs of these staff and delivered to 30 participants to the end of August 2016.
iv) Development of resources - Core training materials were developed and have been shared with the Clinical Educators who are now able to deliver targeted support to staff within their Directorates. Examples of completed documentation have also been made available.
Staff who revalidated in April 2016 have shared their experience for colleagues in a video, the purpose of this is to inform and offer reassurance that the revalidation process is neither onerous or complicated. The video also signposts staff to appropriate resources both in the Trust and on the NMC website.
4. REVALIDATION PROGRESS IN THE TRUST
A key factor in managing any risk whereby registrants might unintentionally lapse from the register has been the identification of those due to revalidate each month. Not only has this allowed us to target information and support most appropriately, but it highlighted two significant peaks during each year when very high numbers of nurses and midwives in the Trust were due to revalidate. These peaks, which can be seen on the table below, coincide with University qualification dates and this picture is replicated throughout the country.
Between April and August 2016 a total of 343 Nurses and Midwives working in the Trust renewed their registration through revalidation. The numbers for September will not be known until 1st October 2016 since, even though revalidation applications must be submitted by 1st of the month, registrations remain valid until the last day of the month.
5. MAKING REVALIDATION BUSINESS AS USUAL
Although the initial implementation of revalidation has caused some anxiety for nurses and midwives, the fact remains that this is a process which will become the norm for all NMC registrants. It is therefore essential that the process becomes part of the normal maintenance of registration which is the responsibility of individual registered nurses and midwives.
Arrangements have therefore been put in place to ensure that support for registrants extends beyond the duration of the Senior Nurse Revalidation Lead secondment (August 2016) and the Clinical Educators will be providing support within their Directorates. The Senior Nurse Practice Development will continue to provide advice where it is requested.
6. SUMMARY
The Nursing and Midwifery Council implemented revalidation for Nurses and Midwives with effect from April 2016. Although individual Registrants have a responsibility to compile a portfolio of evidence to demonstrate that the requirements of revalidation have been met, the Trust, as a good employer, had a responsibility to support them in doing this. A number of measures were established in order to communicate with and support registrants in the Trust and the impact of this has been the successful revalidation of staff in the five months since the introduction of revalidation, with ongoing Revalidation now becoming firmly established as ‘Business as usual’ for the Trust’s 4,500 (approx.) Registrants.
7. RECOMMENDATION
To i) receive the report and ii) note the actions taken.
Helen Lamont
Nursing and Patient Services Director
Suzanne Medows
Senior Nurse Revalidation Lead
14th September 2016
1