Central Manchester University Hospitals NHS Foundation Trust (CMFT) is a leading health provider in Manchester, providing secondary and community services to the local population and a wider range of specialist services to the North West population. It treats over one million patients each year.
CMFT employs approximately 3,700 registered general nurses, 380 registered midwives and 165 registered health visitors.
First thoughts about revalidation
CMFT has long been conscious of the fact that the NMC Code is not always embedded in everyday practice. They see revalidation as an opportunity to change this, and felt the revalidation pilot provided the chance to influence the implementation of revalidation and ensure this new process was effectively underpinned by the Code.
Processes and procedures
CMFT identified two revalidation leads within the organisation, a Deputy Director of Nursing and the Head of Professional Development, Andrea Boland. They also established a steering group to provide strategic direction and to ensure revalidation is aligned to established systems and processes within the Trust. Reporting into the steering group is a Revalidation Champion Group, made up of senior nurses and midwives representing their respective divisions. Their role is to support both registrants and confirmers in their divisions, to ensure everyone is clear about their roles and responsibilities and to encourage everyone to register with NMC Online.
CMFT were keen to embed revalidation into the appraisal process, and the existing line management structure was used to identify reflective discussion partners and confirmers. Where individuals are not directly line managed by another NMC registrant, they are encouraged to have their reflective discussion with another NMC registrant who they are professionally accountable to.
CMFT were initially unaware that their Electronic Staff Record (ESR) could record the revalidation date. This information is readily available to all NHS Trusts in England and CMFT now include the revalidation date in all registration reports to ensure all professionally registered staff have a valid registration.
Support for staff
CMFT facilitated a number of revalidation workshops for nurses and midwives. These sessions provided an overview of the revalidation model, highlighted key dates and provided an opportunity for people to start putting their portfolios together. The Trust also facilitated a number of workshops for confirmers and reflective discussion partners, which focussed on their roles and responsibilities.
The Trust developed an evidence pack to support registrants in collecting their evidence. This evidence pack includes all NMC forms and templates, which are aligned to the Code and CMFT values. It also includes completed examples of forms and templates, so staff are clear not only about what evidence they need to collect but also about the level of detail they need to provide.
A standard certificate of learning was created for use at all education events in the Trust. This certificate captures the number of individual and participatory hours of Continuing Professional Development (CPD), and on the back there is a reflective tool to encourage staff to capture their learning at the time that it happens.
CMFT have developed a revalidation intranet site which houses all the necessary tools to support registrants to revalidate with confidence. Given the comprehensive range of free resources available from the NMC website, along with the resources they have developed in-house, the Trust currently have no plans to purchase an online e-portfolio.
Nurses and midwives are being supported to access evidence of their practice hours from the E Roster portal. They are also able to provide evidence of CPD by accessing records of attendance at training days via the Oracle Learning Management (OLM) system.
Lessons learnt so far
The revalidation workshops were key when it came to reducing anxiety and demystifying the revalidation process. Most registrants were anxious about producing the right types of evidence, particularly when it came to feedback. It was therefore helpful to refocus registrant's minds on the purpose of feedback – the importance of learning from and reflecting on it – rather than thinking only about how to evidence it.
There was also some apprehension from nurses and midwives about sharing their reflections with another person. As practitioners they were used to reflecting, but rarely wrote that reflection down and almost never shared it with another member of staff. It was important to discuss the importance of reflecting openly and honestly, and to reassure people that it is ok to reflect on negative as well as positive experiences.
CMFT will continue to embed revalidation into their appraisal processes, and they will continue to facilitate revalidation workshops for all nursing and midwifery staff. They have captured their positive experiences of revalidation so far in a DVD called 'Revalidating with Confidence in CMFT'.