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How valid is nurse revalidation?

In addition to re-registering every three years, nurses will soon be required to revalidate to continue practising 

Revalidation is the buzzword in nursing circles this week. And there is certainly a lot of buzzing going on since the Nursing and Midwifery Council (NMC) made the decision to introduce a new system of revalidation from 2015. Unfortunately, it does not make for positive reading.

Rarely do dramatic changes get wholesale welcome. To counterbalance recent poor nursing press this change comes from the NMC, the UK's nursing regulatory body covering 670,000 registrants, the most respected and revered authority for nurses and the protection of the public, with government support and backed by legislation and statute. 

Unfortunately, the NMC itself has been found to be in need of review as failing to effectively monitor professional standards. It has been accused of poor morale within the workforce, seen a chief executive and senior staff resignations, had a government two-year improvement challenge, new Chair, and a completely new council of registrants and lay members. 

Moreover, it has not been seen as a supportive body to nurses having hiked up the price of annual registration and the backlog of serious delays for professional practice hearings. It is unfair to those nurses held in limbo and eager to serve the public.

It is therefore no surprise that the decision on revalidation is being scrutinised carefully - the reputation of the profession and the NMC could depend on it.

The NMC agreed a consultation will now follow into 2014 and the first nurses and midwives going through the agreed new revalidation system will revalidate by the end of 2015.

What will that look like to you and me as registrants? Nurses and midwives will continue to renew their registration every three years. This seems reasonable.

Nurses will still declare that they have practised for 450 hours during those three years. Again no change here so probably welcomed.

The amount of continuing professional development (CPD) required will be reviewed over the consultation period and the existing 35 hours is very likely to be increased. The definition of a suitable CPD activity will be clarified. This will be extremely welcome for employers and nurses.

There will be an increased audit of post-registration education and practice portfolios. This will be welcome to the nurses who work hard to maintain their learning and implement it into practice. However the NMC track record for portfolio reviews is poor and likely to become more problematic. Of 670,000 registrants, only 400 portfolios were reviewed in 2012 and the majority were of those returning to practice after a break. 

Revalidation will require registrants to collect feedback from patients and colleagues every three years. This will require an employer or manager to confirm that the nurse or midwife who is revalidating is complying with the NMC code and is fit to practice. This is new. This verifier is not required to be a registered nurse and the fitness to practice confirmation is required to part of formal appraisal. 

Though the 2012 NHS staff survey indicated 83% of staff had appraisals, 37% indicated they were poor and badly constructed and 17% had no appraisal. The NMC are aware of the limitations and risks but believe revalidation could help drive up the quality of appraisal.

Revalidation will take account of feedback from patients, service users, carers and colleagues. This is a genuinely well-intentioned element - but a mammoth task and fraught with risks and difficulties, depending on where the nurse works. Nurses working in research, academia, working with those lacking mental capacity or transient populations need more guidance. So far the nursing network web conversations are sceptical.

The registrant's self-declaration of fitness to practise will still be in place - revalidation requires a declaration they have had an appraisal. 

Before that, the NMC code and standards will be revised and guidance for revalidation will be developed. Look out for the consultation on these changes, have your say and feedback your constructive criticisms. This is our chance to inform our regulator and assure the public.