To ensure the provision of high quality safe care for patients it is essential that all clinicians are competent, with clarity around roles and responsibilities and ensuring that they can provide evidence of continuous professional development (CPD). This also fits with the NMCs recommendations for revalidation. http://revalidation.nmc.org.uk/
According to the NMC 2022, revalidation is there to promote good practice and strengthen confidence in the nursing and midwifery professions. To help you develop and reflect on your practice, we ask you to revalidate every three years to stay on the register. So, however long you have been qualified, it’s important that you reflect and familiarise yourself with the latest version of the standards of proficiency for your profession, to make sure you meet the latest knowledge and skills requirements for your scope of practice.
The new standards of proficiency are there to help you to identify any gaps in your knowledge and skills, and any Continuing Professional Development (CPD) requirements. These can then be discussed and planned with your confirmer and/or line manager in preparation for your revalidation.
Using the latest standards of proficiency in your revalidation will help you to (NMC – November 2022):
- ensure that your practice remains up to date, which is a requirement of the Code;
- support your own CPD and develop your career; and
- supervise and assess students who will be learning in line with the new standards of proficiency.
Providing a portfolio of evidence demonstrates your competencies and how you meet the NMC standards. We have written a Lunch and Learn Training Resource around revalidation and appraisal that you can download here wessexlmcs.com/lunchandlearn
To help you reflect on the standards when you revalidate, The NMC have updated two of their revalidation templates; the practice hours log (these are relevant to your scope of practice, including if you work outside of clinical practice) and continuing professional development log . These are both available to download from the NMC website (NMC Nov 2022)
The CQC will want to see evidence of annual appraisal and will ask individuals of their views on the appraisal process. https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-18-staffing
On 2nd February 2021, the NMC launched a new fitness to practice resource for employers
The Value of an Appraisal
“It is very important that it is recognised from the outset that this appraisal process is not to replace a performance review. An appraisal is to help identify areas for improvement and development and to demonstrate areas where improvement and development has already been made.” wessexlmcs.com/practicemanagerappraisals
It is recommended that all nurses have an annual appraisal, the process can be enhanced and benefit from the involvement of another nursing colleague. The appraiser may vary depending on the individual practice. In a larger nursing team, it is likely there will be a lead nurse or nurse manager who can fulfil this role, but in many GP practices this will not be possible and nurses’ appraisals will be carried out by a GP, a practice manager or both. ( Appraisal tips for practice nurses | Nursing in Practice )
In an “ideal world” this would adopt the same format as the GP appraisal and have an external person undertaking the appraisal. Individuals may choose to do this in addition to their annual appraisal and performance review with their employer.
An effective appraisal and review of performance can have a potential impact on patient outcomes as it addresses any learning needs and training to undertake the role.
Outcomes of the Appraisal
- Clinicians have a clear understanding of their role and how they should function as part of a team
- Mutually agree objectives that are measurable and can be reviewed and updated
- Identifying any areas for future development and ‘gaps’ in skills that may need to be developed and or updated
- Identify and agree future training and development needs to fulfill their role
- Address short and long term goals and what is required to put these in place and ensure they are met
What Should Happen at the Appraisal?
The meeting should be a two way discussion between the appraiser and the manager and or nurse colleague. Some organisations will provide a summary prior to the appraisal of things that may require discussion.
The discussion will normally open with a review of what has happened over the last year for example;
- What were the objectives set in the last appraisal?
- Were these achieved if not what were the reasons?
- For example, were they personal or down to lack of support and or direction from the organisation?
As an individual you could prepare information prior to the appraisal and have a clear aim of what you want out of the discussion. Prior to the appraisal it is worth thinking about what you want to discuss this may include:
- A review of your current role and does this meets your job description if not what is different and what needs to change?
- What have you achieved over the last year?
- What have you found challenging and present some ideas of how this could be resolved – be honest and open
- What training have you attended and have you made any changes to your practice as a result of this?
- Have you influenced any changes in the delivery of care to patients in the practice? Do you have any future ideas/plans?
- What ‘gaps’ are there in your learning that need to be addressed? Why would this make a difference?
- Have you been involved in any significant events and what did you learn from this? What has changed as a result or what needs to change?
- Have you had or obtained any feedback from colleagues and or patients? What did this show and how do you feel? (There are some 360 degree feedback tools you can use. For example: https://www.fourteenfish.com/ )
Following the meeting the discussion should be summarised and provided in a written and/or online format. You may want to establish an interim review of certain objectives that have been discussed. You may find the following link on our website useful wessexlmcs.com/appraisalformsforstaff together with People Performance Management Toolkit (22.12.22).pdf (nhsemployers.org) pages 32-35 focus on annual appraisal reviews – please note- the appraisal process is not about performance management.
It is important to clarify that appraisals are not disciplinary processes or a disciplinary discussion. There are other, separate processes for addressing serious issues of conduct or capability, which should be followed and used appropriately. In addition, appraisal is not a discussion you ‘save things up for’, with some nurses waiting all year to approach employers with concerns or ask for support. An open-door culture in general practices creates the environment that is vital to safe and effective care. Whether feedback contains praise or constructive criticism, it only has value if it is given in a timely manner. Essentially there should be no surprises in any appraisal discussion. Appraisal tips for practice nurses | Nursing in Practice
The Purpose of Revalidation
In April 2016 it became a legal requirement for all nurses to go through a revalidation process every three years to maintain their registration and ‘fitness to practice’.
Revalidation encourages the individual to “reflect on the role of the Code in your practice and demonstrate that you are ‘living’ the standards set out within it.” You must also ensure that you pay your annual registration fee.
The Revalidation Process
As outlined by the NMC, the process is divided into providing information and evidence on:
- Practice hours worked- You must have practised for a minimum number of hours over the three-year period since your registration was last renewed or you joined the register.
- Continuing Professional Development – You must have undertaken 35 hours of continuing professional development (CPD) relevant to your scope of practice in the three-year period since your registration was last renewed, or you joined the register. Of those 35 hours of CPD, at least 20 must have included participatory learning.
- Practice-related feedback – You must have obtained five pieces of practice-related feedback in the three-year period since your registration was last renewed or you joined the register.
- Written reflective accounts – You must have prepared five written reflective accounts in the three-year period since your registration was last renewed or you joined the register.
- Reflective discussion – You must have had a reflective discussion with another NMC registrant, covering your five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code.
- Professional indemnity arrangement – You must declare that you have, or will have when practising, appropriate cover under an indemnity arrangement.
- Health and character – You must provide a health and character declaration.
- Confirmation – We will ask you to declare that you have demonstrated to an appropriate confirmer that you have met the revalidation requirements.
You can begin to process your application 60 days before your revalidation date.
Your up-to-date registration details are recorded on the NMC database that can be searched by employers and members of the public.
More resources and templates to aid with revalidation can be found here.