NHS Wales Nursing and Midwifery Council Revalidation and Registration Policy

NHS Wales Nursing and Midwifery Council Revalidation and Registration Policy Policy Number: 499 Supersedes: Standards For Healthcare Services No/s 7.1 Version No: Date Of Review: 1.0 March 2016 Reviewer Name: Caroline Williams Completed Action: Approved by: Date Approved: AW document Chair W&OD 24.3.16 New Review Date: Sept 2016- March 2017 Brief Summary of Document: The purpose of this policy is to set out a framework to ensure that effective systems are in place within Hywel Dda University Health Board to verify the revalidation and registration status of all staff employed as nurses and midwives To be read in conjunction with: 201 All Wales Disciplinary Policy 299 Registration & Re-registration of Health Professionals Classification: Employment Category: Policy Freedom Of Information Status Open Authorised by: Lisa Gostling Job Title Director of Workforce & OD Signature: A signed copy of this document is stored with corporate governance

Responsible Officer/Author: Contact Details: Caroline Williams Dept Nursing Support Team Job Title: Base Professional and Practice Development Nurse Glangwili Tel No 01267 227133 E-mail: Caroline.williams5@wales.nhs.uk Scope ORGANISATION WIDE DIRECTORATE DEPARTMENT ONLY COUNTY ONLY Staff Group Administrative/ Estates Medical & Dental Nursing Allied Health Professionals Ancillary Maintenance Scientific & Professional Other CONSULTATION Please indicate the name of the individual(s)/group(s) or committee(s) involved in the consultation process and state date agreement obtained. Individual(s) Group(s) Committee(s) Nursing Workforce management group Nursing and Midwifery Revalidation Steering group Date(s) Date(s) Date(s) March 2016 March 2016 RATIFYING AUTHORITY (in accordance with the Schedule of Delegation) A = Approval Required KEY Date Approval Obtained NAME OF COMMITTEE FR = Final Ratification Workforce & OD Committee A To be approved via chair s action 24.3.2016 COMMENTS/ POINTS TO NOTE Date Equality Impact Assessment Undertaken March 24 th 2016 Group completing Equality impact assessment Jackie Hooper, Equality and Diversity Policy (in light of this being a local adaptation of an All Wales Policy) Please enter any keywords to be used in the policy search system to enable staff to locate this policy NMC Revalidation; Professional Registration; NMC Registration; Nurses; Midwives; Database No: 499 Page 2 of 20 Version 1.0

How Will This Policy Be Implemented? Who Should Use The Document? What (if any) Training/Financial Implications are Associated with this document? Document Implementation Plan The policy will be disseminated via professional and operational communication structures across the HB with a request for distribution to every individual team/ward/service managers where nurses are employed. There has been an 18 month preparation period prior to launch of national revalidation system which has been communicating all the elements contained within the policy through roadshows; newsletters; workshops etc A further HDUHB newsletter will contain reference to this policy in April 2016 All registered nursing and midwifery staff; All line managers of registered nursing and midwifery staff All line-managers of NMC Registrants will need to attend the appropriate HDUHB Confirmer preparation Action By Whom By When See above What are the Action Plan/Timescales for implementing this policy? Database No: 499 Page 3 of 20 Version 1.0

CONTENTS 1. INTRODUCTION... 6 2. POLICY STATEMENT... 6 3. SCOPE... 6 4. AIM... 6 5. OBJECTIVES... 6 6. CONTEXT... 6 7. REVALIDATION OVERVIEW... 7 8. REVALIDATION PROCESS... 7 8.1. THE REFLECTIVE DISCUSSION... 7 8.2. CONFIRMATION... 8 8.3. THE PROCESS OF CONFIRMATION... 9 8.4. THE HEALTH BOARD OR TRUSTS REGISTER OF CONFIRMERS... 10 9. VERIFYING REVALIDATION AND REGISTRATION STATUS OF NURSES AND MIDWIVES... 10 9.1. PRE-EMPLOYMENT/ENROLMENT... 10 9.2. RENEWAL OF REVALIDATION AND REGISTRATION... 10 9.3. CONTINUOUS VERIFICATION OF REVALIDATION AND REGISTRATION STATUS 10 10. RESPONSIBILITIES... 11 10.1. CHIEF EXECUTIVE... 11 10.2. EXECUTIVE DIRECTOR OF NURSING AND MIDWIFERY... 11 10.3. RESPONSIBILITY OF REGISTERED NURSES AND MIDWIVES... 11 10.4. RESPONSIBILITY OF WARD SISTERS, CHARGE NURSES, TEAM LEADERS, SENIOR MIDWIVES, PROFESSIONAL LEADS AND OPERATIONAL TEAM LEADERS... 11 10.5. SENIOR NURSES/MIDWIVES... 12 10.6. DIVISIONAL NURSES/MIDWIVES... 12 11. LEGAL REQUIREMENTS FOR REGISTRATION... 12 12. FAILURE TO REVALIDATE AND LAPSED REGISTRATION... 12 12.1. BREACH OF CONTRACT OF EMPLOYMENT... 13 12.2. FAILURE TO MEET STATUTES CONCERNING PROFESSIONAL REGISTRATION.... 13 12.3. PROCESS FOR DEALING WITH LAPSED REGISTERED NURSE OR MIDWIFE 13 12.4. HEALTH BOARD/TRUSTS SUPPORT FOR REGISTERED NURSE OR MIDWIVES AT RISK OF LAPSING FROM THE REGISTER... 13 13. TRAINING... 13 14. IMPLEMENTATION... 14 15. FURTHER INFORMATION... 14 16. REFERENCES... 14 17. APPENDIX 1 - NMC REQUIREMENTS FOR REVALIDATION... 16 Database No: 499 Page 4 of 20 Version 1.0

18. APPENDIX 2 LOCAL PROTOCOL FOR SUPPORTING REVALIDATION IN... 17 HYWEL DDA UNIVERSITY HEALTH BOARD... 17 Database No: 499 Page 5 of 20 Version 1.0

1. INTRODUCTION There is a legal and contractual requirement for all individuals employed as a registered nurse or midwife within NHS Wales to be revalidated and registered with the Nursing and Midwifery Council (NMC). The purpose of this policy is to set out a framework to ensure that effective systems are in place within HYWEL DDA UNIVERSITY HEALTH BOARD to verify the revalidation and registration status of all staff employed as nurses and midwives. 2. POLICY STATEMENT The primary purpose of revalidation is to improve public protection by making sure that registered nurses and midwives can demonstrate their continued ability to practise safely and effectively throughout their careers. Revalidation gives registered nurses and midwives in Wales the opportunity to continue to develop their professional knowledge and show their professionalism to those with whom they come into contact with throughout their working lives. From April 2016 all registered nurses and midwives will have to apply for revalidation every three years at the time that their annual registration fee becomes payable for that year. Health boards and trusts will need to demonstrate they have robust internal processes that ensure their employees meet the requirements of the NMC revalidation process. The NMC hold a register of every nurse and midwife who has fulfilled the NMC registration requirements and is therefore eligible to practice in the UK. Failure to successfully complete the revalidation and registration process will result in the registered nurse or midwife being lapsed from the NMC Register. Both the individual practitioner and Hywel Dda University Health Board have a responsibility to ensure that individuals practising as a registered nurse or midwife has the necessary qualifications and registration to perform their role. 3. SCOPE This policy applies to all registered nursing and midwifery staff across the Health Board, as well as any member of UHB staff who line-manage registered nursing and midwifery staff. 4. AIM This is an all Wales policy that sets out a framework to ensure that effective systems are in place within Hywel Dda University Health Board to verify the revalidation and registration status of all staff employed as nurses and midwives. 5. OBJECTIVES This policy/guidance: Makes explicit the personal responsibility of individual nurses and midwives to maintain revalidation and registration with the NMC. Sets out the overarching responsibilities for nurse/midwife managers as to the revalidation and registration status of individuals employed as nurses or midwives within their wards and teams. Details the Senior Nurse/Midwife Managers (or equivalents) responsibility to have in place systems and processes to assure the Executive Director of Nursing of the revalidation and registration status of all individuals employed as registered nurses or midwives in their area of accountability. Database No: 499 Page 6 of 20 Version 1.0

6. CONTEXT The NMC is the regulator of nursing and midwifery in England, Wales, Scotland, Northern Ireland and the Islands. The NMC exists to safeguard people (the public) who use or need the services of registered nurses and midwives. The NMC is a statutory body and its responsibilities are set out in the Nursing and Midwifery Order 2001. The NMC fulfils its public protection role through a number of functions. 7. REVALIDATION OVERVIEW Revalidation is an NMC requirement. Completing the revalidation process is the responsibility of each registered nurse and midwife themselves. They are the owners of their own revalidation. Every registered nurse and midwife will be required to take part in the revalidation process. Failure to successfully do so will result in the registered nurse or midwife being lapsed from the register and it will then be illegal for them to be employed as a registered nurse or midwife. This policy statement along with systems and processes which support it ensure that any risks associated with individual registered nurses or midwives failing to comply with the process are mitigated. The NMC requirements for revalidation are set out in Appendix 1 to this policy. Staff should be clear when they are expected to revalidate and prepare accordingly. The collection of appropriate evidence should be a continual process and be taking place over the whole three year cycle prior to each revalidation date. Registered nurses and midwives will therefore be expected to produce evidence in relation to revalidation at each annual appraisal. Staff will be required to follow all local arrangements that support the revalidation process. The local arrangements for Hywel Dda University Health Board are set out in Appendix 2. Revalidation is not an assessment of a registered nurse or midwives fitness to practice. Any fitness to practice issues must be addressed as soon as they are identified, according to existing NMC and Hywel Dda University Health Board s processes and policies. By law, registered nurses and midwives can keep their portfolio and revalidation evidence in Welsh if they wish. They can request in advance that their reflective discussion and confirmation is undertaken through the medium of Welsh. If the identified line-manager is unable to facilitate this then an appropriate substitute must be identified by the line-manager. Health Boards and Trusts will record the minimum data set of renewal and revalidation information on the registered nurse or midwives Electronic Staff Record (ESR), as required by the NMC. To access the NMC service to check registration, individual managers of registered nurses and midwives will need a personal caller code. Caller codes are individually assigned by the NMC and are not transferable. 8. REVALIDATION PROCESS 8.1. The Reflective Discussion The NMC require that every registered nurse and midwife must discuss their five written reflective accounts with an NMC registered nurse or midwife in order to comply with this element of the revalidation requirements. If the registered nurse or midwife s line manager is an NMC registered nurse or midwife then the five reflective discussions can take place at the same time as the confirmation, if the registered nurse or midwife s line manager is NOT an Database No: 499 Page 7 of 20 Version 1.0

NMC registered nurse or midwife then the five reflective discussions MUST take place before the confirmation. Where possible the Reflective discussion and Confirmation should be part of the registered nurse or midwife s appraisal. Whilst the NMC has stated that it is up to the individual registered nurse or midwife to decide the most appropriate person to have their reflective discussion with. Within Hywel Dda University Health Board it is expected that any employee who undertakes the reflective discussion with another registered nurse or midwife employee:- Must be on the NMC register but does not need to be on the same part of the register (a registered nurse can have a reflective discussion with a midwife and vice versa). And And Should ideally be the registered nurse or midwife s line-manager/professional lead. Be recognised by Hywel Dda University Health Board as being suitable to fulfil the role of professional discussion partner. And Or And And Should work with the registered nurse or midwife frequently or be from a professional network or learning group, although they do not need to work with them on a daily basis or undertake the same type of practice. Should be senior to, or more experienced than the registered nurse or midwife. Must be able to facilitate a critically reflective discussion with the registered nurse or midwife. Must agree to be contacted by the NMC to provide further information if necessary for verification purposes. The record of the reflective discussion should be kept stored either in the practitioner's professional portfolio, on ESR or electronically and a copy should be retained in their personal file. If the registered nurse or midwife facilitating the reflective discussion knowingly makes a false declaration about the conduct or process of the discussion then they may be subject to internal disciplinary processes. They may also be referred to and investigated by the NMC for alleged breaches of the Code, which may involve fitness to practice proceedings being instigated against the registered nurse or midwife. 8.2. Confirmation Every registered nurse and midwife must obtain confirmation that they have demonstrated, through the production of the required evidence, their compliance with the revalidation requirements. In most cases the confirmer will be an NMC registered nurse or midwife, although the NMC specify that this is not an essential requirement. Within Hywel Dda University Health Board the Database No: 499 Page 8 of 20 Version 1.0

confirmation process will form part of the role responsibilities of all line-managers of registered nurses and midwives. Should there be circumstances whereby this approach is not felt to be appropriate, a registered nurse or midwife can make a formal request to the Hywel Dda University Health Board (see Section 10: Responsibilities) to be assigned to a different confirmer. Similarly, confirmers can make a formal request for their staff member to be assigned to a different confirmer. It is anticipated that such a situation will only arise in exceptional circumstances. 8.3. The Process Of Confirmation The process of obtaining confirmation every three years will ordinarily take place during the existing appraisal process. Confirmation can take place at any point in the 12 months prior to the registered nurse or midwife s revalidation date, providing all other requirements of the revalidation process have been met. There is no expectation that the confirmer will seek external verification of the evidence that the registered nurse or midwife provides. The confirmer is expected to act honestly and in good faith, and neither Hywel Dda University Health Board nor the NMC will take action against a confirmer who inadvertently provides information that later proves to be incorrect. Any registered nurse or midwife who is on long term sick can have their confirmation discussion as part of their regular meetings in line with the long term sickness policy. If the practitioner is too unwell to participate in the confirmation process and their revalidation date is approaching then the NMC can be contacted to consider an extension to the registered nurse or midwife s renewal date. It is expected that the line manager will support the registered nurse or midwife with this extension application process. Where staff know they will be on maternity leave and their revalidation date falls within the period where they are expected not to be in work, preparation is essential. The registered nurse or midwife should arrange with their confirmer to complete the process before their maternity leave commences or as part of the arrangements for the keeping-in-touch days. Similar arrangements may apply to staff who take career breaks. Registered nurses or midwives who take a career break of sufficient length not to be able to meet the 450 practice hour requirement will need to undertake a Return to Practice course.(see appendix 1 for dual registration requirements) Where a registered nurse or midwife is suspended from duty or undergoing a disciplinary investigation or been referred to the NMC when their confirmation is due, this should not affect their confirmation and appropriate arrangements must be put into place by Hywel Dda University Health Board. All registered nurses or midwives have the right to appeal to Hywel Dda University Health Board if they feel that an incorrect decision has been made about their confirmation. This appeal must be made in writing to the Director of Nursing, Quality and Patient Experience within two weeks of the original decision. Hywel Dda University Health Board will be required to make arrangements for a senior member of staff to investigate the appeal. This investigation should be undertaken in a time frame that is mindful of the nurse or midwives revalidation date. If a registered nurse or midwife does not submit a revalidation application before their renewal date then their registration will lapse. They will then need to either complete a re-admission (which can take between 2 and 6 weeks) or undertake a return to practice course before they can work again as a registered nurse or midwife. Database No: 499 Page 9 of 20 Version 1.0

8.4. The Health Board or Trusts Register of Confirmers All Staff who act in the role of a confirmer must complete the appropriate preparation as determined by Hywel Dda University Health Board, only after successfully completing the preparation will they be identified by Hywel Dda University Health Board as a confirmer. Employers may decide to hold registers of prepared confirmers. This should be held in the electronic staff record. Only registered nurses or midwives or other line managers who have undertaken preparation and are on the Health Board or Trust register (where one exists) may act as confirmers for another Health Board or Trust employee. 9. VERIFYING REVALIDATION AND REGISTRATION STATUS OF NURSES AND MIDWIVES 9.1. Pre-employment/enrolment All prospective employees of Hywel Dda University Health Board are required to provide details of their professional qualifications and registration details as part of the application process. The Appointing Officer is responsible for verifying the identity and professional revalidation and registration status of a successful applicant prior to offering a nursing or midwifery position within Hywel Dda University Health Board. A copy of the NMC registration confirmation must be placed in the individual s personal file. N.B. An individual cannot commence a position where the role is dependent on them being a registered nurse or midwife within Hywel Dda University Health Board until confirmation of registration is obtained. 9.2. Renewal Of Revalidation And Registration The NMC will inform registered nurses and midwives that their three yearly revalidation is due 60 days before the revalidation date. The NMC will also inform registered nurses or midwives at least six weeks before their annual fee payment and registration renewal date is due. Consequently, Hywel Dda University Health Board is not obliged to inform registered nurses or midwives that their revalidation and registration is due. It is the responsibility of the individual to maintain their revalidation and registration during their employment with Hywel Dda University Health Board, and this includes during any break of employment such as maternity leave, sick leave and/or career break. 9.3. Continuous Verification Of Revalidation And Registration Status Employers of registered nurses and midwives are required to verify the revalidation and registration status of all nurses and midwives they employ. This is a key component of public protection. Nurses and midwives may also hold recordable qualifications e.g. allowing them to prescribe, and these should also be verified. Each manager of registered nurses and midwives must maintain or have access to a record of the NMC annual registration renewal date and three yearly revalidation date of each registered nurse or midwife that they manage. N.B. Individual nurses and midwives may be liable to prosecution for claiming to be registered when they are not as this could be considered to be a criminal offence and as such may be reported to the Police and/or Counter Fraud. Database No: 499 Page 10 of 20 Version 1.0

10. RESPONSIBILITIES 10.1. Chief Executive HYWEL DDA UNIVERSITY HEALTH BOARD The Chief Executive is responsible for ensuring that there is a delegated lead executive responsible for leading the implementation of a robust strategy and system of Nursing and Midwifery Revalidation within the HDUHB 10.2. Executive Director of Nursing, Quality and Patient Experience The Executive Director of Nursing, Quality and Patient Experience and Midwifery has Board level responsibility for establishing processes to ensure that all registered nurses and midwives employed by Hywel Dda University Health Board have the necessary qualifications and registration to perform their role and are compliant with the professional revalidation requirements. They are also responsible for providing the assurance to the Board that an appropriate organisational system is in place to support registered nurses and midwives in achieving revalidation and re-registration requirements They will establish and chair the Revalidation Steering Group through which the required assurance will be delivered Consider and make decision about requests made by registered nurses/midwives to be allocated an alternative Reflective Discussion Partner/Confirmer in exceptional circumstances Consider and make timely decision about appeals made by a registered nurse or midwife against a decision by a HDUHB line manager not to confirm a registered nurse/midwife s compliance with NMC revalidation requirements. 10.3. Responsibility of individual Registered Nurses and Midwives Registered nurses and midwives are personally responsible for renewing their registration with the NMC annually. Registered midwives also have a statutory requirement to notify the Local Supervising Authority (LSA) annually of their intention to practice. Registered nurses and midwives are required to notify Hywel Dda University Health Board at the earliest opportunity of any factors that might impact on their registration status including delay in renewal of registration, payment of fees, completion of revalidation requirements, or referral by any party, of them, to the NMC. 10.4. Responsibility of all direct line managers of Nurses and Midwives Ensure that all registered nurses and midwives are aware that they are individually professionally accountable for renewal and /or revalidation of their NMC registration in a timely manner; Verify that all nursing and midwifery staff working in their areas have a current registration with the NMC at all times; Provide an assurance to their Senior Nurse Manager/equivalent of the confirmed registration status of each registered nurse or midwife Database No: 499 Page 11 of 20 Version 1.0

HYWEL DDA UNIVERSITY HEALTH BOARD Initiate any immediate action in loine with this policy and escalate any issues of concern relating to registration status to their senior nurse/line manager 10.5. Senior Nurse/Midwife Managers/ Equivalent Ensure that effective systems and process in order to confirm the registration status of all nurses and midwives working within the clinical areas/teams they are responsible for are in place, and are being implemented. Provide information and assurance to the Head of Nursing/Equivalent of the robustness of these systems and ensure immediate action is initiated in line with this policy if a nurse or midwife with lapsed registration is identified. 10.6. Heads of Nursing/Community and Primary Care Senior Nurse Ensure that effective systems and process in order to confirm the registration status of all nurses and midwives working within the clinical areas/teams they are responsible for are in place, and are being implemented. Provide information and assurance to the Director of Nursing Quality and Patient Experience, of the robustness of these systems. Ensure a monitoring process is in place to identify any trends and ensure lessons learned are shared across the professional infrastructure of the HB. Consider and make decision about requests made by registered nurses/midwives to be allocated an alternative Reflective Discussion Partner/Confirmer in exceptional circumstances 11. LEGAL REQUIREMENTS FOR REGISTRATION Continuing to work as a registered nurse or midwife while not on the NMC register is illegal (article 44 of the Nursing and Midwifery Order 2001). Any registered nurse or midwife who is found to have been working whilst unregistered is required to be referred to the NMC Registrar's Advisory Group, and may be subject to a Fitness to Practise investigation. Where an individual s registration has lapsed for whatever reason and the individual has continued to work a file note must be included in the nurse/midwife s personal file to record the period of time that they practised as a registered nurse or midwife whilst not on the NMC register. They may be subject to investigation under the Health Board 201 - All Wales Disciplinary Policy. 12. FAILURE TO REVALIDATE AND LAPSED REGISTRATION Revalidation and Registration is not an assessment of fitness to practice. Any fitness to practice issues must be addressed as soon as they are identified, according to the existing NMC and Hywel Dda University Health Board process and polices. Any registered nurse or midwife who is found to have deliberately falsified evidence or made a false declaration may be subject to internal disciplinary processes and will be referred to the NMC who may subsequently investigate the registered nurse or midwife for alleged breaches of the Code. This may involve fitness to practice proceedings being instigated against the registered nurse or midwife by the NMC. The deadline for registered nurse or midwife to submit their application for revalidation on line via the NMC website is the 1 st day of the month in which their renewal date falls. E.G. If the renewal date is 31.03.17 then the deadline for submitting the on line application for revalidation is 01.03.17. Any registered nurse or midwife who allows their registration to lapse will need to make a formal application to the NMC for re-admission to the register. This process can take between two and six weeks. In addition to the NMC notification sent to a registered nurse or midwife, Health Boards and Database No: 499 Page 12 of 20 Version 1.0

Trust may decide locally to issue communications outlining the requirement for revalidation to be met to their registered nurse or midwife and their managers ahead of their revalidation month. 12.1. Breach Of Contract Of Employment The All Wales Disciplinary Policy states the following as an example of gross misconduct which might lead to summary dismissal: Any fundamental breach of the Contract of Employment, which makes continuation of employment impossible. This category may include: 12.2. Failure to meet statutes concerning Professional Registration. Failure to revalidate and/or maintain registration as set out in the NMC Code of Conduct is a clear example of a fundamental breach of the Contract of Employment. In some cases the result may be summary dismissal without notice or payment in lieu of notice. An alternative method of dealing with this disciplinary offence is other form of action short of dismissal. This will be considered by Hywel Dda University Health Board on a case by case basis and may include an emergency application of unpaid leave by the nurse or midwife. Nurses, midwives and their employers must all ensure that they communicate regularly with each other during this period of lapsed registration. The employee would have the opportunity to consider this option and respond in writing within 7 calendar days accepting this variation in their terms and conditions as an alternative to dismissal. 12.3. Process for Dealing With Lapsed Registered Nurse Or Midwife A registered nurse or midwife who fails to meet their revalidation deadline, or fails to renew their registration within the specified timescales, may be disciplined under the All Wales Disciplinary Policy for failing to maintain registration that allows them to practice as a registered nurse or midwife. Where registration is a requirement of their role, any registered nurse or midwife who elects not to revalidate will be deemed to have terminated their contract of employment with immediate effect, and similarly, this will be without payment in lieu of notice. 12.4. Health Board/Trusts Support For Registered Nurse Or Midwives At Risk Of Lapsing From The Register If a registered nurse or midwife is at risk of lapsing from the NMC register they should seek advice from their Manager and Human Resources at the earliest opportunity prior to their registration lapsing. If a registered nurse or midwife believes that the NMC exceptional circumstances guidance applies to their situation, they should apply to the NMC for an extension to their renewal date. This process should be facilitated by their line-manager. Registered nurse or midwife who is unable to meet the requirements for re-registration due to any reason and are therefore at risk from lapsing from the register should seek advice from their Manager and Human Resources at the earliest opportunity prior to registration lapsing. The subsequent return to the registered nurse or midwife post of the member of staff and/or the resumption of pay will be subject to the availability of confirmation of verification of revalidation or registration status. 13. TRAINING Hywel Dda University Health Board has approved educational preparation for those staff undertaking the role of Confirmer. This is delivered in-house by members of the Nursing Database No: 499 Page 13 of 20 Version 1.0

Support Team. Staff arrange attendance at the Confirmer s Course through the Learning & Development department. A record of attendance is kept on the ESR. Approved preparation includes 13.1. For NMC registered line-managers The Confirmer s Course A one day course (7.5hrs) which includes how to facilitate a reflective discussion 13.2. For Non-NMC registered line-managers One of the options below The Confirmer s Course morning sessions only (4hrs) most appropriate for linemanagers who manage Band 5 & 6, or who have concerns about undertaking the role of Confirmer, and who need to be able to offer practical help to their staff in developing their portfolios. Face-to-face discussion (1hr) most appropriate for line-managers who manage Band 7&8, and who require more in-depth knowledge about revalidation as a key organisational process. Individual reading of NMC documentation most appropriate for staff who manage individual very senior registrants who will be able to guide their Confirmer through the process whilst it is ongoing. 14. IMPLEMENTATION The policy will be disseminated via professional and operational communication structures across the HDUHB with a requirement for distribution to every individual team/ward/service managers in which nurses are employed. The HDUHB Revalidation Steering group will continue to meet bimonthly during 2016 and will actively monitor compliance with the NMC revalidation system. Communications with registered nurses and midwives through established HDUHB communication structures e.g. Nursing and Midwifery newsletter; Hywels Voice; Global emails etc will continue to be used to raise awareness throughout 2016 and lessons learned through all Wales peer networks etc regarding successful implementation strategies will be considered at the HDUHB s Revalidation Steering group for implementation. RCN representatives will be part of these discussions and further planning regarding what is required by staff. all the elements contained within the policy through road shows; newsletters; workshops etc A dedicated, single item HDUHB Nursing and Midwifery newsletter will contain reference to this policy in April 2016 15. FURTHER INFORMATION Further detail of the Revalidation requirements are to be found on the NMC website at : http://revalidation.nmc.org.uk/ 16. REFERENCES http://www.nmc.org.uk/globalassets/sitedocuments/legislation/legislation-updated/nmc-originallegislation-and-amendments.pdf Database No: 499 Page 14 of 20 Version 1.0

http://revalidation.nmc.org.uk/download-resources/guidance-and-information/ Database No: 499 Page 15 of 20 Version 1.0

17. APPENDIX 1 - NMC REQUIREMENTS FOR REVALIDATION Every three years all registered nurses or midwives must:- Have practised for a minimum of 450hrs per registration (450hrs nursing and/or 450hrs midwifery). This is not limited to clinical practice, and includes work in non-clinical roles such as management, policy, education & research. NMC registered nurse or midwife within the Health Board or Trust who are not employed as nurses or midwives, but who nevertheless wish to remain on the NMC register, can meet the practice hours requirement if, in their roles (or for parts of it), they rely on their skills, knowledge and experience of being a registered nurse or midwife and can demonstrate this. Complete 35hrs of continuing professional development (CPD), of which at least 20hrs must be participatory learning. Obtain five pieces of practice-related feedback. Complete a minimum of five written reflective accounts (relating to their practice, their CPD activity or their practice related feedback). Participate in a reflective discussion with another NMC registered nurse or midwife about their written reflective accounts. Provide a health and character declaration. Declare that they have appropriate cover under a professional indemnity arrangement. Obtain confirmation of compliance with the NMC revalidation requirements from their line-manager by demonstrating to them that they have undertaken/completed the requirements. Further detail of the Revalidation requirements are to be found on the NMC website at : http://revalidation.nmc.org.uk/ Database No: 499 Page 16 of 20 Version 1.0

18. APPENDIX 2 LOCAL ARRANGEMENTS FOR SUPPORTING REVALIDATION IN HYWEL DDA UNIVERSITY HEALTH BOARD (NB: NUMBER OF CPD HOURS COMPLETED/PRACTICE RELATED FEEDBACK GATHERED/REFLECTIVE ACCOUNTS DISCUSSED IN ANY GIVEN YEAR ARE GIVEN AS A GUIDE ONLY: TOTAL NUMBERS GATHERED/COMPLETED DURING THE THRE YEARS HOWEVER MUST ADD UP TO THE SAME NUMBER) Database No: 499 Page 17 of 20 Version 1.0

The following points are specific to this All Wales policy as it has been approved within Hywel Dda University Health Board and should be read in conjunction with the flow chart. These additional points are intended to provide for greater clarity on the process to be followed within the HDUHB The role of the individual NMC registrant employed in HDUHB 1. Register with NMC on-line 2. Know when you are due to revalidate and prepare accordingly 3. Collect evidence towards your revalidation over the whole 3 yr period and produce your portfolio with each years evidence at your annual PADR 4. Prepare and engage in a reflective discussion every year, either during your PADR (or shortly before if your line-manager is not on the NMC register) 5. It is expected that your line-manager will act as your confirmer and reflective discussion partner. You can make a formal request to Head of Nursing/Senior Nurse Community and Primary Care to be assigned to a different confirmer if there are exceptional circumstances 6. During the 3 rd year (maximum of 12 months prior to revalidation date) ensure that you have a summary reflective discussion with your line-manager about all 5 of your written reflective accounts and obtain a signed Reflective Discussion Form summarising the discussion; also that you obtain a signed Confirmation Form stating that all your evidence is in place. Keep the original signed documents in your portfolio 7. When your 60 day window opens apply for revalidation The role of the NMC registered line-manager in HDUHB 8. It is expected that within HDUHB all line-managers will act as confirmers for the staff that they directly manage. You can make a formal request to Director of Nursing,Quality and Patient Experience/Head of Nursing/Senior Nurse Community and Primary Care for your staff member to be assigned to a different confirmer if there are exceptional circumstance 9. Know when your NMC registered staff are due to revalidate 10. Attend HDUHB approved preparation for confirmers the Confirmer s Course. Only staff who are on the HDUHB register may act as Confirmers for another HDUHB employee 11. At every PADR a. review and discuss the registrants portfolio of evidence b. Facilitate a reflective discussion around the registrant s written reflective accounts c. Ensure the minimum data-set about NMC revalidation on the registrants ESR is completed Database No: 499 Page 18 of 20 Version 1.0

d. Provide appropriate advice and support to enable the registrant to meet the required standard of evidence for revalidation 12. At the PADR during the 3 rd year (maximum of 12 months prior to revalidation date) facilitate a summary reflective discussion with the registrant about all 5 of their written reflective accounts, and provide a signed Reflective Discussion Form summarising the discussion; also provide a signed Confirmation Form stating that all their evidence is in place. 13. During the month prior to the 1 st of the month in which their revalidation date falls, check that the registrant s application for revalidation has been successful and that they remain on the register 14. The role of the non-nmc registered line-manager in HDUHB 15. It is expected that all line-managers will act as confirmers for the staff that they directly manage. You can make a formal request to Director of Nursing, Quality and Patient Experience/ Head of Nursing/Senior Nurse Community and Primary Care for your staff member to be assigned to a different confirmer if there are exceptional circumstances 16. Know when your NMC registered staff are due to revalidate 17. Attend HDUHB approved preparation for NMC confirmers see below for options. Only staff who are on the UHB register may act as Confirmers for another UHB employee 18. At every PADR a. review and discuss the registrants portfolio of evidence b. Ensure the NMC registered staff member have had a reflective discussion with the person who holds their professional accountability c. Ensure the minimum data-set about NMC revalidation on the registrants ESR is completed d. Provide appropriate advice and support to enable the registrant to meet the required standard of evidence for revalidation 19. At the PADR during the 3 rd year (maximum of 12 months prior to revalidation date) provide a signed Confirmation Form stating that all their evidence is in place. During the month prior to the 1 st of the month in which their revalidation date falls, check that the registrant s application for revalidation has been successful and that they remain on the register 20. The role of the NMC registered senior nurse / midwife with professional responsibility for other NMC registered staff in HDUHB 21. It is expected that all line-managers will act as confirmers for the staff that they directly manage. 22. Facilitate the reflective discussion for staff managed by non-nmc registrants for whom you have professional responsibility Database No: 499 Page 19 of 20 Version 1.0

23. Undertake HDUHB approved preparation for confirmers the Confirmer s Course. Only staff who are on the UHB register may act as Confirmers for another UHB employee 24. Prior to/during the registrants PADRs a. Facilitate a reflective discussion around the registrants written reflective accounts b. Provide appropriate advice and support to enable the registrant to meet the required standard of evidence for revalidation 25. Prior to the PADR during the 3 rd year (maximum of 12 months prior to revalidation date) facilitate a summary reflective discussion with the registrant about all 5 of their written reflective accounts, and provide a signed Reflective Discussion Form summarising the discussion Lapsed Registrations In order to ensure consistency across the Health Board the final decision as to the appropriate course of action for any registrant who allows themselves to lapse from the register (See point 12.2) will be taken by the Head of Nursing/Senior Nurse Community and Primary Care, with appropriate Human resources advice, after reviewing all supporting evidence. All such situations will be reviewed by the HDUHB Revalidation Steering group in order to ensure consistency of decision making across the HB Database No: 499 Page 20 of 20 Version 1.0