SUBJECT: Nursing & Midwifery Council (NMC) Revalidation of Nurses & Midwives

Transcription

1 Meeting of Lanarkshire NHS Board: 28 th October 2015 Lanarkshire NHS Board Kirklands Fallside Road Bothwell G71 8BB Telephone: SUBJECT: Nursing & Midwifery Council (NMC) Revalidation of Nurses & Midwives 1. PURPOSE This paper is coming to the Board: For approval For endorsement To note To provide the Lanarkshire NHS Board with assurance on local planning and actions being taken to prepare for the implementation of NMC Revalidation of Nurses & Midwives, and to mitigate organisational risk. 2. ROUTE TO THE BOARD This paper has been: Prepared Reviewed Endorsed By the Associate Director of Nursing for Person-Centred Health & Care & Professional Regulation. 3. SUMMARY OF KEY ISSUES The NMC at its Council meeting on 8 th October 2015 confirmed that Revalidation of Nurses & Midwives will go live from 1 st April Revalidation is a mandatory requirement for all Registered Nurses & Midwives and NMC registration is at risk without active participation and evidence of compliance with requirements. The purpose of Revalidation is to improve public protection by making sure that NMC registrants continue to remain fit to practise throughout their career. Nurses and midwives are personally responsible and will be held accountable for their own Revalidation. There is inherent organisational risk associated with Revalidation as reflected in the corporate risk register. In order to mitigate risk, organisational systems and processes require to be aligned to support registrants in meeting their Revalidation requirements. 4. STRATEGIC CONTEXT This paper links to the following: Corporate objectives LDP Government policy Government directive Statutory AHF/local policy requirement Urgent operational issue Other

2 The NMC is the largest health professional regulator in the world and ensures public protection through regulation of nursing and midwifery professionals. It has a registrant body in excess of 680,000, approximately 10% of who work in Scotland. Implementation of NMC Revalidation will affect all nurses and midwives in Scotland, including those who work in NHS Scotland, the care sector, and the independent and third sectors. Following a number of reviews of NMC processes (Council for Healthcare Regulatory Excellence 2012, Francis Report 2013) the NMC committed to introducing a more robust system of assurance for ensuring the on-going fitness to practise of nurses and midwives and confirmed to the Health Select Committee of the UK Parliament that this system would be introduced by October Revalidation is the new process that all nurses and midwives will need to engage with to demonstrate that they practise safely and effectively throughout their career. Registered nurses and midwives will be required to demonstrate to the NMC that they remain fit to practise. It replaces the PREP (Post Registration Education and Practice) standards and self-declaration that is currently required to maintain registration with the NMC. Revalidation seeks to promote greater professionalism among nurses and midwives and also to improve the quality of care that patients receive by encouraging reflection on practice against the revised NMC Code: Professional standards of practice and behaviour for nurses and midwives. The revised Code was published on the 29 January 2015 and has been effective since 31 March Revalidation is a continuous process that nurses and midwives will engage with throughout their career. It is not a point in time activity or assessment. It is about promoting good practice across the whole population of nurses and midwives. It is not an assessment of a nurse or midwife s fitness to practise and it is not intended to address bad practice amongst a small number of nurses and midwives. The NMC already have fitness to practise processes in place for that. 5. CONTRIBUTION TO QUALITY This paper aligns to the following elements of safety and quality improvement: Three Quality Ambitions: Safe Effective Person Centred Revalidation of Nurses & Midwives supports the implementation of NHS Scotland s Healthcare Quality Strategy (2010), Staff Governance Standards (2012) and the Route Map to the 2020 Vision for Health and Social Care (2013), ensuring a workforce fit to practise and to deliver safe, effective, person-centred care for people of all ages in a range of health and social care environments. The NMC Code: Professional standards of practice and behaviour for nurses and midwives is central in the Revalidation process as a focus for professional reflection. It contains a series of statements that taken together signify what good nursing and midwifery practice looks like. It puts the interests of patients and service users first, is safe and effective, and promotes trust through professionalism. While the values and principles set out in the Code can be interpreted in a range of different health & care practice settings, they are not negotiable or discretionary. Six Quality Outcomes: Everyone has the best start in life and is able to live longer healthier lives; (Effective) People are able to live well at home or in the community; (Person Centred) Everyone has a positive experience of healthcare; (Person Centred) Staff feel supported and engaged; (Effective) 2

3 Healthcare is safe for every person, every time; (Safe) Best use is made of available resources. (Effective) 6. MEASURES FOR IMPROVEMENT Under Revalidation, nurses and midwives will be required to declare that they: Practise for a minimum of 450 hours over the three years prior to the renewal of registration (900 hours for dual registered registrants) Undertake 35 hours of continuing professional development (CPD) of which 20 hours must be participatory Obtain five pieces of practice-related feedback Record a minimum of five written reflective accounts on The Code, Professional standards of practice and behaviour for nurses and midwives (NMC 2015) Provide a health and character declaration Declare appropriate cover under a professional indemnity arrangement Gain confirmation from a third party that revalidation requirements have been met. 7. FINANCIAL IMPLICATIONS Not yet known, however staff time will be taken up completing the requirements of revalidation including professional reflective discussions and a proportion of continuing professional development activity. In addition, if linked to existing appraisal processes it is likely the time for this will need to be extended. Time will also be required for the confirming process to check that revalidation requirements have been achieved. 8. RISK ASSESSMENT / MANAGEMENT IMPLICATIONS The following management implications and key risks have been identified: Failure to support registrants that we employ to revalidate on time would have significant implications on the ability to safely staff our services Staff may choose to retire or staff who have already retired and returned part-time may choose to leave rather than complete the Revalidation process Staff may not complete the necessary Revalidation requirements to enable them to maintain current registration for a number of reasons e.g. appraisals may not take place on time, staff may be unclear how to write a reflective account. To mitigate these risks NHS Lanarkshire is supporting staff around the Revalidation process by: Establishing an NHS Lanarkshire NMC Revalidation Implementation Steering Group and providing regular updates in the Staff Briefing, The Pulse and through line management structures Setting up a FirstPort site to help signpost staff to up to date resources and information Developing a programme of staff awareness and education sessions Profiling all NHS Lanarkshire NMC registrants revalidation dates. Identifying and providing initial targeted support to registrants who are due to revalidate in Quarter 1 of 2016/17 including identification of those in the over 55 age profile (See Appendix 1) Developing an NHS Lanarkshire policy on pre-employment checks, maintaining professional registration/revalidation including extenuating circumstances, registrant contractual obligations, financial implications, independent contractor assurance requirements Ensuring that existing development opportunities support staff to use the NMC Code to reflect on their practice 3

4 Identifying which development activities are participatory and those which are nonparticipatory in order to assist staff to meet their revalidation requirements Providing professional indemnity cover for NHS Lanarkshire staff who require active NMC registration to undertake their contractual role Enabling access to another NMC registrant for reflection and discussion Enabling access to a third party confirmer. 9. FIT WITH BEST VALUE CRITERIA This paper aligns to the following best value criteria: Vision and leadership Use of resources Sustainability Effective partnerships Performance management Governance and accountability Equality 10. EQUALITY AND DIVERSITY IMPACT ASSESSMENT An E&D Impact Assessment has been completed Yes No The principles of Revalidation are equally applicable to all, irrespective of age-group; disability; gender reassignment; marriage or civil partnership; religion or belief; pregnancy or maternity; race; sex, sexual orientation; or on the grounds of social origin, or other personal attributes, including political opinions. 11. CONSULTATION AND ENGAGEMENT Membership of the NHS Lanarkshire NMC Revalidation Implementation Steering Group includes partnership representation as does the short life working group developing organisational policy. Further opportunities for engagement will exist at the awareness and training events and any policy developed will go through the existing staff and organisational governance structures prior to ratification. 12. ACTIONS FOR THE BOARD The Board are asked to: Approval Endorsement Identify further actions Note Accept the risk identified 13. FURTHER INFORMATION For further information about any aspect of this paper, please contact Noreen Kent, Telephone: Noreen Kent Associate Director of Nursing Person-Centred Health & Care & Professional Regulation 4

5 APPENDIX 1 WORKFORCE PROFILING (as of 8 th October 2015) As of the 8 th of October 2015 we had profiled Revalidation dates across 72% of our nursing & midwifery staff. Table 1 below shows the number due to Revalidate in each quarter over the next three years. As expected there are periods in each year, namely Q2 & Q4 where we have peaks in the number of registrants due to revalidate as these are aligned to graduation dates in the university year and subsequent NMC registration. Table 1 No of Staff Staff Revalidation Dates (based on valid dates submitted so far) Year & Period We have extrapolated the information from the confirmed Revalidation dates obtained so far to project what the overall figures may be for NHS Lanarkshire and these are shown in Table 2 below. It is anticipated that by the end of October most Revalidation dates will be known across the organisation and following this we will target awareness raising and support for those due to Revalidate in Q1 in the first instance. Table 2 Staff Revalidation Dates (based on all staff named in June proportioned in same way as those with dates submitted) No of Staff Year & Period 5

6 Tables 3 & 4 profile the number of staff due to Revalidate across different age groups. As indicated in the main paper, there is a risk that staff who are in the latter stages of their career may choose not to go though the Revalidation process with subsequent organisational impact. Again once all data complete we will provide targeted support where required. Table 3 NHSL Revalidating staff No Of Staff thru thru thru thru thru thru 44 Age Category thru thru thru Table 4 Age Groupings of All NHSL Revalidating Staff 55 thru 59 11% 60+ 3% 20 thru 24 3% 25 thru 29 8% 30 thru 34 11% 50 thru 54 22% 35 thru 39 12% 45 thru 49 18% 40 thru 44 12% 6