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Revalidation case study: Ray Walker at Mersey Care NHS Trust

Ray Walker, Executive Director of Nursing, Mersey Care NHS Trust

Ray Walker, Executive Director of Nursing, Mersey Care NHS Trust, took part in one of the NMC's revalidation pilots in Spring 2015. Here he speaks about his experiences and offers advice to all nursing staff who will be applying for revalidation for the first time in 2016. 

“Mersey Care NHS Trust provides specialist mental health services, addiction services and learning disability care in the North West and beyond. We provide specialist inpatient and community mental health, learning disabilities, addiction management and acquired brain injury services for the people of Liverpool, Sefton and Kirkby in Merseyside. We also provide secure mental health services for the North West of England, West Midlands and Wales.

“We employ just under 1,000 registrants. These are largely mental health nurses, but we also have learning disability and adult registered nurses. From our 1,000 registrants, 67 were eligible to take part in the NMC revalidation pilot.

“We had been interested in revalidation for a number of years, especially post the Francis Report. When the NMC began to explore how it was going to take revalidation forward, we expressed our interest and applied to be one of the pilots.

“We had previously been a pilot site for medical revalidation and we saw, as an organisation, that there was a drive to improve quality through this focus on the profession. We believed that the development of a revised NMC Code and revalidation process provided a similar opportunity to refocus on nursing as a profession and the quality agenda.

“I was fairly knowledgeable about revalidation as I sit on the NMC Strategic Revalidation Working Group, so I understood its main principles and drivers. The level of knowledge of revalidation at Mersey Care was mixed at the beginning of the pilot. Some of our registrants had taken the initiative and competed their own reading, but others were much less engaged. All of our registrants were anxious about the process and what it meant for them. However, we found this anxiety was displaced once we had talked them through the process and its requirements. In fact, our registrants welcomed the focus on nursing practice that revalidation gave them.

“In terms of resourcing, we did need to review some of our existing internal systems, such as our appraisal system, and we invested additional resources in technology. We hosted a number of sessions to support registrants through the process. These sessions took place at various times and locations to accommodate our workforce. They were very wide-ranging and covered individual issues, from understanding what revalidation meant for people on a career break, for example, to how the process of revalidation is achieved. We will continue to run these sessions on a regular basis. However, once registrants understand the process after completing it once, they will see it is fairly straightforward.

“Our registrants did experience some difficulties with revalidation, including around the role of the confirmer and the standard of reflection needed. We referred them to the NMC for information, but their guidance is evolving and will be clarified now the pilots are finished. Also, our nurses did have some technical difficulties with the online system and some registrants were uncomfortable with the IT, but we regard these as teething problems. 

“Our nurses particularly enjoyed the focus on the Code and the professional discussion about nursing alongside organisational objectives. Revalidation facilitated discussions about the role and contribution of the registered nurse. We were really pleased that was the case, as we think that giving registrants an opportunity to reflect on their practice as a driver for improving quality.

“Revalidation builds on PREP and as all registrants have been completing PREP for many years. Importantly, revalidation does not have extensive additional demands to PREP. As an organisation, we focused on trying to help nurses link their discussions with the Code. For our staff, achieving their practice hours is not as issue, although as we continue with revalidation, there may be issues based on personal circumstances.” 

“In terms of CPD requirements, our registrants understood what they could and could not use as examples of CPD. We made sure that our nurses were explicitly aware of the 20 hours of participatory learning and we didn’t identify any issues of registrants being unable to complete their CPD hours.

“During the pilot, some of our registrants held their professional development discussions during their appraisal and others held theirs outside of that meeting, depending on when in the appraisal cycle their revalidation fell. As the process continues, most of our registrants have a registered nurse as a line manager so they will be able to have their professional discussion during their appraisal meeting, although separate to their appraisal. But as the NMC guidance states the registrant can choose to have their professional discussion in whatever context they wish as the onus of revalidation is on the registrant.

“My advice to registrants starting to think about preparing for NMC revalidation would be to look at the NMC website where they will find a great deal of up to date information and resources. As the emphasis of completing revalidation is on the individual, registrants should make sure they sign up for an NMC Online account. Registrants need to be aware that their date for revalidation is not the same as their annual NMC renewal and that they can find this date online. Registrants should make sure they are up to date with their existing PREP requirements and I would also be thinking about my reflection and reflecting on the NMC Code with any training I complete."