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An overview of revalidation and how Covid-19 has affected it



Revalidation wasn’t nearly as complicated as people thought it would be

Professor Geraldine Walters, NMC

As a nurse or midwife in the UK, and a nursing associate in England, you must renew your registration through revalidation with the NMC every three years in order to be able to practise.

To renew your registration and thereby demonstrate you can continue to practise safely and effectively, you must complete your revalidation process.

As for many healthcare professionals, the past year might have been the most challenging you’ll face in your career.

Whether you’ve been on the frontline caring for Covid-19 patients, supporting vulnerable patients with complex multimorbidity or working behind the scenes in a non-contact role, you might see revalidation as an added pressure you could do without.

However, extra support and resources are available to guide you through the process and make it as smooth as possible.

‘Covid has presented many challenges for our registrants, forcing them to adapt and work flexibly to meet the needs of those they care for,’ says the NMC’s executive director of professional practice Professor Geraldine Walters.

‘You have demonstrated strength and resilience, and your experiences, and what you have learned this year, can also be used to inform your revalidation.

‘In a profession where constant learning is essential, these new experiences will benefit your personal development and influence your future career.’

What is revalidation?

In its publication How to revalidate with the NMC, the council sets out the requirements of renewing your registration. With reference to its Code for professional standards of practice and behaviour, the document outlines the purpose of revalidation as:

  • To raise awareness of the Code and professional standards expected of you
  • To provide you with the opportunity to reflect on the role of the Code in your practice as a nurse, midwife or nursing associate and demonstrate that you are ‘living’ these standards
  • To encourage you to stay up to date in your professional practice by developing new skills and understanding the changing needs of the public and fellow healthcare professionals
  • To encourage a culture of sharing, reflection and improvement
  • To encourage you to engage in professional networks and discussions about your practice
  • To strengthen public confidence in the nursing and midwifery professions

If you’ve recently qualified, you’ll submit your first revalidation application three years after first registering with the NMC, and thereafter every three years as long as you continue to practise.

The NMC recommends that you work towards the requirements throughout the three-year period leading up to your application, so you can be as well prepared as possible when it becomes due.

You must complete your revalidation application online.

What are the NMC requirements of revalidation?

There are eight requirements you must fulfil to complete your revalidation application. They are:

  • A minimum of 450 practice hours, or 900 if you’re renewing as both a nurse and midwife
  • A minimum of 35 hours of continuing professional development (CPD), including 20 hours of participatory learning
  • Five pieces of practice-related feedback
  • Five written reflective accounts
  • Reflective discussion
  • Health and character declaration
  • Professional indemnity arrangement
  • Confirmation

All the following requirements relate to the three-year period since you joined the register or renewed your registration.

Practice hours

To meet this requirement, you must have practised for a minimum number of hours during the three-year period.

For nurses, midwives, those working in specialist community public health nursing (SCPHN) and nursing associates, the requirement is 450 hours.

If you’re renewing dual registration a nurse and a midwife (including SCPHNs), or as a nurse and a nursing associate, you must complete 450 hours for each – totalling 900 hours.

Any hours you work that use your experience, skills and knowledge as a nurse, midwife or nursing associate can count towards this part of revalidation. Importantly, they don’t have to be related to your original field of practice, nor do they have to be clinical.

If you spend time managing a person or a team, running a service, mentoring or teaching others in the profession, or caring for patients directly, those hours can count towards revalidation.

The impact of Covid-19 on practice hours

That is particularly pertinent at the moment, as the scope of your usual practice might well have changed completely during the Covid-19 pandemic.

Many have worked well beyond their usual hours during the pandemic – but others have had to step back from their practice for many different reasons.

Perhaps you’ve had periods of sickness yourself, had to shield at home or taken leave to look after children while schools have been closed.

Remember that the practice hours must have been met during the three years leading up to your revalidation, so you don’t have to have met any threshold in the past year alone.

However, if you’ve practised for fewer than the required hours across that three-year period, you must complete an NMC-approved return-to-practice programme before the date of your application for renewal of registration. You can find more details in the practice hours section of the NMC’s revalidation microsite.

‘We understand that there may be circumstances that make it more difficult for you to meet the revalidation requirements, not limited to Covid,’ Professor Walters says. ‘We can help you to meet the revalidation requirements by helping you to use NMC Online or, in some cases, providing a short extension to your application date.’

You can find more information on the support available here.

Continuing professional development (CPD)

To meet this requirement, you must have undertaken 35 hours of continuing professional development (CPD) that’s relevant to the scope of your practice as a nurse, midwife, nursing associate or combination over the three years.

It’s important to keep accurate records of any CPD you’ve completed, which should include:

  • The method of CPD (for example, self-learning, online learning, a course)
  • A description of the topic and how it related to your practice
  • The dates on which you undertook the activity
  • The number of hours and participatory hours
  • The identification of the part of the Code most relevant to the activity
  • Evidence that you undertook the CPD activity

You can choose your CPD – the NMC does not dictate what activities you should do, as long as they will help you to develop as a nursing professional.

However, of those 35 CPD hours, at least 20 must have included participatory learning. That means taking part in an activity that involves interaction with other professionals, rather than private study.

The impact of Covid on CPD

In the past year, the pandemic has deprived many healthcare professionals of the opportunities they’d normally have had to undertake CPD.

‘We recognise that face-to-face activities have been limited throughout the pandemic and many courses may have been cancelled at short notice,’ Professor Walters says. ‘To meet the CPD [participatory] learning requirement, registrants simply have to undertake an activity that involves interacting with one or more other professionals – and that can be virtually or physically.’

Such activity could include webinars, Facebook live events, online forum discussions, shadowing or mentoring, or practice-related discussions.

‘If people have concerns they will not meet the requirements, we first advise them to speak to their employers to get support,’ she adds.

The feedback you obtain can be in any format and it can come from a range of different sources. As well as being a requirement of revalidation, feedback on your practice is a really important aspect of helping you do the best job you can.

So, when you record your feedback, you should also describe and reflect on how it helped you to improve your practice.

Feedback can be:

  • Written
  • Verbal
  • Formal or informal
  • Positive or constructive
  • From colleagues or managers
  • From patients or service users
  • Taken from your annual appraisal
  • From feedback from reports about your performance as part of a team

You are likely to get feedback regularly in the course of your job and you can obtain and record as much as you like because it will always be useful for you. But you only need to submit five pieces for the purposes of revalidation.

Written reflective accounts

To meet this requirement, you must have prepared five written accounts over the three years, which must reflect on an area of your practice. You have to record them on the approved form as part of your revalidation process.

Each written account should reflect on one or more of the following:

  • A CPD activity you’ve undertaken
  • A piece of feedback you’ve had that relates to your practice
  • An event or experience you’ve had in your professional practice

The accounts also need to reflect on the Code and describe how they relate to it. Crucially, you must make sure they don’t contain any information that could identify someone else.

Although your written accounts must cover the three years leading up to your revalidation, you probably have plenty of events or experiences in the past year in particular that afforded the opportunity to reflect.

Christine Callender, the RCN’s head of nursing (quality and regulation), says: ‘The last year has seen changes for almost everyone involved in nursing. Nurses have been redeployed to clinical areas that may not be familiar to them but in the process would have learned new skills and techniques.

‘You may have learned how to apply PPE, used equipment to treat Covid-19 patients, administered unfamiliar medications or trained to deliver vaccinations.

‘All of these can be used as part of your revalidation process.’

Reflective discussion

To meet this requirement, you must have had a reflective discussion with a colleague or peer. It should be used to discuss the five written reflective accounts that you’re submitting for your revalidation, and how they relate to the Code.

You only need to include one reflective discussion covering all five written accounts.

A reflective discussion is an important part of your job because it gives you the opportunity to look back at your experiences from the perspective of someone else. That can help you learn from experiences – good and bad – and enable you to improve your practice.

The person with whom you have your reflective discussion must also be registered with the NMC. They can be the same person who, at the final stage of your revalidation process, confirms your application (see below). In that case, your reflective discussion can form part of your confirmation discussion.

After the reflective discussion, the person you’ve had the discussion with has to sign the approved form and include their details.

Declarations

To complete your revalidation application, you have to declare that you are fit and capable of working and that you have appropriate indemnity insurance, and confirm all the information and evidence you’ve provided in your application is accurate.

Health and character declaration

To fulfil this requirement, you must provide a declaration of your health and character – which is essential to the Code.

For revalidation purposes you simply have to declare that your health and character enable you to practise safely and effectively. You don’t need to provide evidence.

You must declare if you’ve been charged with or convicted of any criminal offence – including if you’ve received a conditional discharge or been issued with a formal caution – during the three-year period.

In addition, you must declare whether a professional or regulatory body has determined that your fitness to practise is impaired for any reason.

Professional indemnity arrangement

To meet this requirement you have to declare that you have professional indemnity cover, or that you will have an arrangement in place when you’re practising.

If you’re employed, check with your employer if they have an arrangement in place that covers you. Most employers do.

If you’re self-employed, or if your employer doesn’t cover you for some reason, you must arrange professional indemnity yourself. Remember – it’s required by law in order for you to be able to practise.

You only need to confirm you have arrangements in place. You don’t have to provide or submit evidence.

Confirmation

The final stage of the process is confirmation. This means verifying that you’ve met all the other requirements of revalidation, which you’ll need to demonstrate to an appropriate third party – a ‘confirmer’.

You should do this in the final year of the three-year period leading up to your renewal deadline.

It’s recommended that your confirmer is your line manager, where possible. They don’t need to be a registered nurse, midwife or nursing associate – it could, for example, be the practice manager where you work.

You should try, wherever possible, to talk face-to-face with your confirmer when you come to confirming your revalidation application, because you need to demonstrate to them how you have met all the other requirements of revalidation so they can confirm that on your behalf.

You might decide to have your confirmation discussion with the same person and at the same time as your reflective discussion to make things easier for you. But you don’t have to use the same person for both.

There’s information for you and your confirmer in the confirmation section of the NMC’s revalidation microsite.

What to do if you’re concerned about revalidation

First of all, don’t panic. The NMC has granted extensions to people who were due to revalidate during the Covid-19 pandemic.

Those whose deadline fell in January, February or March 2021 were given an automatic 12-week extension; if that includes you, you will have received details via email.

This means that, if your deadline was in March, you would automatically have until June to complete the process.

It’s important to note that if you were due to revalidate from April 2021 onwards, you can extend by eight weeks, but you must request to do so using your NMC online account when your application is open.

‘Importantly, if you are finding it a challenge to meet your revalidation requirements, speak to your manager or colleagues and make contact with the NMC,’ says Christine Callender. ‘You will not be alone and there is plenty of help available.’

Professor Walters adds that while there is some flexibility because of the unprecedented demands of the past year, it’s a good idea to be prepared and not leave it until the last minute.

‘Most professionals will have been through revalidation already and have an understanding on how to undertake it,’ she says. ‘The feedback from those who have revalidated for the first time was that it wasn’t nearly as difficult or complicated as they thought it would be, and that there are many different activities they can use as evidence for revalidation.’

Resources

The RCN’s resources on revalidation can be found here.

The NMC’s full guidance on revalidation can be found here.

NMC information on support available to help you revalidate is available here.

The Queen’s Nursing Institute provides support for nurses during times of personal struggle or financial hardship. If you need support, you can find more information on the QNI website.