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Quality assurance in the CPD of nurses and healthcare assistants

The RCN Accreditation Unit was established to quality assure learning and training opportunities offered by healthcare organisations. In doing so nurses and healthcare assistants can easily keep up-to-date with their continuing professional development

Mercy Jeyasingham
Formerly Head of Accreditation, RCN
Nonexecutive Director
King's Fund
Assessor for Burdett Trust for Nursing

Tina Stanton
MA BA(Hons)
Accreditation Manager
Royal College of Nursing

In a seminar at the RCN on the supply of nurses in the future the Deputy Director of NHS Employers said that what worried employers was not the number of staff but their level of skill. It was an interesting debate, which included discussion on the sharp rise in healthcare assistants (HCAs). In the policy paper Modernising Nursing Careers,(1) a strategy developed by the Chief Nursing Officer in the UK, the flexibility of a nursing career, from hospital to primary care and perhaps back again, was one way to address the expansion of primary care and the further specialisms of hospital care. But this flexibility can only happen if nurses have competencies that make them effective in their career paths - wherever that may take them. 
It is also essential that nurses not only gain new skills and competencies but that they keep them up-to-date. The nursing career of the future promises much to people who are willing and able to do this. Currently registered nurses are expected to keep their skills up-to-date and their continued registration with the Nursing and Midwifery Council (NMC) is dependent on this.(2) They need to record 35 hours of learning activity relevant to their practice to demonstrate their continuing professional development in the three years before renewal of registration. This is in addition to the 450 hours of practice they should complete in relevant settings. Portfolios kept for continuing professional development can be audited by the NMC.
The new white paper on healthcare regulation, Trust Assurance and Safety,(3) raises the issue of revalidation. This is meant to be a testing of the continuing competency of the healthcare professional. The idea of testing came about because of the Shipman enquiry into the standard of doctors, but it is affecting all health care professionals, including nurses. What will this retesting of nursing skills and competence look like? At the moment no one knows as it is being developed by a working group at the Department of Health England.
No matter what system is introduced, however, nurses will need to ensure their skills are up-to-date. Although at the moment it is important to choose learning and training opportunities that are clinically up-to-date and support the development of competent and confident staff, it will become even more so in the future.
HCAs are being asked to take on a number of tasks under the direction of nursing staff. However, training for them is not mandatory and is very variable. Quality assuring the training they receive can reduce corporate risk and ensure nursing staff, who take responsibility for healthcare support staff are protected. For the HCA, this can offer a career path into nursing, and independently-accredited training might lead to transferability of the recognition of this learning and reassure new employers.

RCN accreditation
The RCN Accreditation Unit was established in 2000 to quality assure learning and training opportunities offered by healthcare organisations. Accreditation covers conferences, study days and learning material produced by charities, NHS trusts or private companies. RCN accreditation ensures that learning and training is up-to-date, highlights good practice and is educationally sound.
RCN-accredited initiatives contain a "model for structured reflection" for delegates to use, to reflect on their experiences and to capture their learning. At the moment this can be kept in nurses' postregistration education and practice (PREP) portfolio as part of their evidence to the NMC on their continuing professional development. Certificates are provided to nurses who attend RCN-accredited events, demonstrating evidence of the hours required to keep their PREP up-to-date.
Courses intended for HCAs and allied health professionals are also accredited by the RCN, ensuring that appropriate standards are maintained. There is sometimes confusion on the use of study hours as opposed to having a points or credits system used in higher education. The study hours system is based on continuing professional development and practice and not necessarily academic credits. RCN accreditation is based on nursing skills and although this incorporates knowledge it is important to distinguish it from a university academically CATS-based points system. Accreditation can fit well with university courses, and in fact there are a number of university courses that incorporate practice elements that are accredited by the RCN. Fiona Smart from the College of St Martin, Lancaster has an advanced nurse practitioner BSc accredited by the RCN. "Being an RCN-approved course is undoubtedly an attraction for prospective students. In the absence of a regulated nurse practitioner role and required educational input, an alignment to the RCN and its standards provides a benchmark and a measure of security". A practice nurse who recently contacted the accreditation unit wanted to know which advanced practitioner courses were RCN accredited as her GP had recommended that she find one.

RCN learning and development
The RCN accreditation service is complementary to learning and training initiatives produced by the RCN. For instance, RCN congress, other RCN conferences, and training programmes are accredited. But the main part of accreditation is to quality assure learning and training initiatives that are not developed by the RCN. This enables nurses and HCAs to choose from a wide range of subjects and formats. This includes members and nonmembers alike. Although there are other accreditation and validation schemes RCN accreditation ensures that the initiatives accredited are relevant to nursing practice.

Key learning points
The RCN accredits learning and training initiatives for a diverse range of educators who want to guarantee that their initiatives are up-to-date, of the highest quality, effective in educating nurses and the wider healthcare family, and promote best practice.
Accreditation involves peer review by expert representatives drawn from clinical, management and educational fields of practice who have the appropriate professional background and experience.
The RCN accreditation unit uses a rigorous process of checking the quality of resources, courses and events through both subject and educational reviews.

For more information about RCN Accreditation, phone 0207 647 3647 or visit the website:



  1. Department of Health.Modernising nursing carers - setting the director. London: DH; 2006.
  2. Nursing and Midwifery Council. Standards to support learning and assessment in practice. London: NMC; 2006.
  3. Department of Health. Trust assurance and safety. London: TSO; 2007.