The Code and Revalidation For everyone’s protection

What is the new Code? • The NMC has updated its Code of professional

standards.

• The revised Code became effective on 31 March 2015 and all registered nurses and midwives are required to uphold its standards of practice and behaviours.

• The Code is centred around four themes, with public protection at the core, and builds on the existing foundation of good nursing and midwifery practice.

• The Code should be used as a ‘living’ guide at the heart of everyday nursing and midwifery practice.

Four themes brought together in one Code

Together they signify good nursing and midwifery practice.

The Code aims to: • Remain relevant – it was last updated in 2008 and since then society has

changed, along with public expectations of nursing and midwifery practice.

• Align with health regulatory processes across the UK and respond to high-profile reports on the state of health and social care provision in the UK.

• Acknowledge and regulate the changing, and wider role, of nurses and

midwives in the UK.

What is ? • Every three years, at the point of their renewal of registration, nurses and midwives

will need to show that, as a professional, they are living by the Code’s standards of practice and behaviour.

• This process is called revalidation and it builds on the current Prep requirements.

• Participation is on an on-going basis rather than a point in time assessment.

• Nurses and midwives will need to meet a range of requirements, designed to show

that they are keeping up to date and practise safely and effectively.

• Revalidation 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.

Revalidation aims to: • Raise awareness of the Code and professional standards expected of nurses

and midwives; • Allow nurses and midwives to reflect on the role of the Code in their practice

and demonstrate that they are ‘living’ these standards; • Encourage nurses and midwives to stay up to date in their professional practice; • Encourage a culture of sharing, reflection and improvement; • Encourage nurses and midwives to engage in professional networks and

discussions about their practice; and • Strengthen public confidence in the nursing and midwifery profession. Overall, revalidation should lead to improved practice and therefore public protection benefits.

Provisional revalidation requirements

Practice hours

Continuing professional development

Practice related

feedback

Written reflective accounts

Reflection discussion

Health and

character

Professional indemnity

arrangement

Confirmation

Revalidation Provisional Requirements Revisions to the model are still being made to reflect feedback from the pilots

Practice hours You must practise a minimum of 450 hours (900 hours for those with dual registration) over the three years prior to the renewal of your registration.

Continuing professional development

You must undertake 35 hours of continuing professional development (CPD) relevant to your scope of practice as a nurse or midwife, over the three years prior to the renewal of your registration. 20 hours of CPD must be through participatory learning.

Practice-related feedback

You must obtain at least five pieces of practice-related feedback over the three years prior to the renewal of your registration.

Written reflective accounts

You must prepare a minimum of five written reflective accounts on what you learnt from your CPD, practice-related feedback or an event or experience in your practice, and explain how this is relevant to the Code.

Reflective discussion

You must discuss these reflective accounts with another NMC-registered nurse or midwife as part of a reflective discussion.

Health and character

You must provide a health and character declaration, including declaring any cautions or convictions.

Professional indemnity arrangement

You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement.

Confirmation You will need to demonstrate to an appropriate person (Line manager) that you have met the revalidation requirements.

Keeping a portfolio

We strongly recommend that you keep evidence that you have met these requirements in a portfolio. (This is, however, optional).

Practice hours You must have practised a minimum number of hours over the three years since your registration was last renewed or you joined the register.

450 Minimum total practice hours required Those with dual registration must undertake 900 hours

Hours

Hours must be carried out in your role as a registered nurse or midwife:-

Which could include: • clinical care, for example in an acute or community setting • nursing and midwifery education and research • policy advisory roles • management and leadership roles specific to nursing or midwifery • Volunteering for a charity, for which you must be a registered nurse • Any queries that are not clear on the NMC website need to be

clarified directly with the NMC by the registrant – with email evidence of the advice given to share with the person who is requested to sign the 3rd party statement

Portfolio Record • We recommend that you maintain a

record of your practice hours in your portfolio, including:

• Dates of practice • Hours undertaken • Details of the organisation • Scope of practice • Work setting • Description of work • Evidence (e.g. timesheets)

Continuing professional development You must have undertaken continuing professional development (CPD), relevant to your scope of practice as a nurse or midwife, over the three years since your registration was last renewed or you joined the register. (excludes mandatory training such as fire lectures or general H&S )

35 Of these 35 hours of CPD, 20 must include participatory learning

Hours

35 hours CPD You must undertake 35 hours of Continuing Professional Development (CPD) relevant to your scope of practice , over the 3 years prior to renewal of registration:-

Of these hours, 20 must be through participatory learning. You need to maintain accurate records of your CPD and demonstrate how you have used it to reflect on and improve your practice in your written reflections. Participatory learning includes any learning activity which involves interacting with other people, such as: • study days • learning events, such as a conference or workshop • peer review • group supervision • coaching, mentoring and shadowing • root cause analysis / significant event analysis meeting • participation in clinical audit, practice visits and MDT meetings • quality improvement meetings etc.

Portfolio Record You must maintain accurate records of your CPD, including: • CPD method • Description of the topic and how it relates to

your practice • Dates and number of hours • Relevance to Code • Evidence that CPD has taken place – internally

evidence can be the signed copy of your appraisal document, management supervision documentation, team training records.

Practice-related feedback You must have obtained practice-related feedback over the three years since your registration was last renewed or you joined the register.

5 Pieces

Practice-related feedback • You must obtain at least five pieces of practice-related feedback over

the three years prior to the renewal of your registration. • Feedback can come from a variety of sources, including patients,

service users, students and colleagues. • Feedback can also be obtained through reviewing complaints, team

performance reports and serious event reviews. • Feedback can be informal or formal, written or verbal. It could be

specific feedback about an individual, or feedback about a whole service, team or organisation.

Portfolio record: • We recommend that you keep notes of the content of the feedback. • You will not need to record the actual instances of feedback in your

portfolio, but you will need to demonstrate how you used feedback to reflect on and improve your practice in your written reflections.

• Be careful not to record any information that might identify a specific patient or service user.

Written reflective accounts

You must have prepared written reflective accounts on your CPD, practice-related feedback, and/or an event or experience in your practice, and explain how this relates to the Code. You should prepare these over the three years since your registration was last renewed or you joined the register.

5 Reflections

• You must record a minimum of five written reflections on the Code, your CPD and practice-related feedback over the three years prior to the renewal of your registration.

You must discuss these reflections with another NMC-registered nurse as part of a professional development discussion- usually your line

manager • Each reflective account can be about an instance of CPD or feedback, or

a combination of both. For example, you could create a reflective account on a particular topic which may have arisen through some feedback your team received, such as consent and confidentiality, and identify how that relates to the Code.

Portfolio record:- You will need to record • Five written reflective accounts that explain what you learnt, how you

changed or improved your work as a result and how it is relevant to the Code.

• A completed reflection and discussion form with details of, the person with whom you have had the discussion.

You must use the mandatory NMC templates provided online

Written reflective accounts

You must have had a reflective discussion with another NMC-registered nurse or midwife, usually your line manager,covering your five written reflective accounts and how they relate to the Code Template forms are available on NMC website

Reflective discussion

Reflective discussion

Health and character

You must provide a health and character declaration, including declaring any cautions or convictions or determinations from another regulatory body.

Health and character

You must provide a health and character declaration. You must declare if you have been convicted of any criminal offence or issued with a formal caution. Good character is important and is central to the Code because nurses and midwives must be honest and trustworthy. Your good character is based on your conduct, behaviour and attitude. In accordance with the Code, we expect you to declare any cautions and convictions to the NMC immediately, not just at the point of renewal. We expect you to be in a state of health that ensures you are capable of safe and effective practice without supervision, after any reasonable adjustments are made by your employer. This does not mean there must be a total absence of any disability or health condition. Many people with disabilities or health conditions are able to practise effectively with or without adjustments to support their practice. Portfolio record: These declarations will be made as part of your revalidation application. You do not need to keep anything in your portfolio as part of this requirement.

Health and character

Professional indemnity arrangement You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement. You must inform us whether this arrangement is through your employer, a membership with a professional body, or through a private insurance arrangement. Portfolio record We recommend that you retain evidence that you have an appropriate arrangement in place. If you work for the NHS If you work for the NHS, you will already have an appropriate indemnity arrangement. The NHS insures its employees for work carried out on its behalf. This means that you will be covered if a claim is made against you in an NHS role.

Indemnity

Confirmation

You will need to demonstrate to an appropriate person that you have met the revalidation requirements. A confirmer is being asked to assess whether you have demonstrated that you have met the requirements for revalidation, not whether you are fit to practise.

Confirmation

You will need to demonstrate that you have met the revalidation requirements by having a confirmation discussion where you demonstrate how you have met the revalidation requirements. This can form part of an annual appraisal or six monthly review An appropriate confirmer is your line manager. We recommend that you obtain confirmation from this person wherever possible. A line manager does not have to be an NMC registered nurse or midwife. If you do not have a line manager, we recommend that the person is an NMC-registered nurse or midwife. If that is not possible, you can seek confirmation from another healthcare professional that you work with and who is regulated in the UK. Portfolio record: A mandatory confirmation form is available online and can be stored electronically

Confirmation

How does this work in practice?

When the confirmer is a registered nurse or midwife: • The reflective discussion and

confirmation discussion can happen with the same person.

• Nurses and midwives might like to have these discussions at one meeting, for example, at an annual appraisal.

When the confirmer is not a registered nurse or midwife: • The reflective discussion with another

NMC-registered nurse or midwife must happen first.

• The confirmation discussion will need to happen after all other requirements are met.

Understanding the big picture

The anticipated benefits of revalidation

For the public: • Provide confidence that nurses and

midwives are up to date in terms of their skills and professional development

• Provide assurance that nurses and midwives are being regularly reviewed

For nurses and midwives: • Raise awareness of the Code and standards

that are expected of nurses and midwives • Encourage a culture of sharing, reflection

and continuous improvement • Encourage nurses to stay up to date in their

professional practice

For employers: • Increase confidence that their staff practise

safely and effectively • Encourage more consistent participation in

appraisal and professional development • Help clarify the nature and scope of

investment required in CPD

For the NMC: • Help to strengthen our regulation of nurses

and midwives • Help to raise standards of practice • Provide more insight into how nursing and

midwifery professions are practising

What should all nurses and midwives do to prepare? 1 Sign up to NMC Online at www.nmc.org.uk/nmc-

online

2 Find out your renewal date (which is when you will revalidate)

3 Read the current guidance and keep up to date at www.nmc.org.uk/revalidation