Safeguarding the public through emerging policy

1. Safeguarding the public through emerging policy Roger ThompsonDirector of Nursing and Midwifery Policy and Standards 15 April 2011

2. Highlights • Safeguarding adults • Guidance on raising and escalating concerns • Revalidation • Student indexing • Additional material to support the code • Midwifery • Unregulated practice • Advanced practice • Investigating systemic failure

3. Safeguarding adults • We are encouraging nurses and midwives to reflect critically on personal and team practice and to prioritise safeguarding activities • Our online safeguarding hub is your gateway to share best practice, resources, training tools, policies and guidelines • Our suite of films won the top prize at this year's International Visual Communications Association awards.

4. Guidance for raising and escalating concerns • Our new guidance on raising and escalating concerns is for all nurses, midwives and pre-registration students • It establishes the principles for best practice and the processes they should follow when raising and escalating concerns

5. Guidance for nurses and midwives • Act in a timely manner to safeguard the public • Seek independent, confidential advice • Present concerns in a constructive way • Where possible follow employer’s policy or local safeguarding policies • Ensure appropriate steps taken to protect patient confidentiality • Keep accurate records of actions and responses

6. Guidance for managers • Investigate promptly and objectively • Keep the employee who raised the concern advised of progress • Ensure action is monitored and recorded • Follow your employer’s policy or local authority safeguarding policy • Ensure patient confidentiality protected • Seek advice or support if unsure

7. Purpose of revalidation • To enable the NMC to confirm that: • nurses and midwives continue to be fit to practise • their skills and knowledge are up to date and specific to their current area and scope of practice • To promote a culture of continuous improvement in practice for nurses and midwives

8. Revalidation will deliver • A standard and guidance that: • build upon Prep • set the requirements for revalidation within the framework of the code • An enhanced renewal of registration process • An enhanced CPD validation process focused on: • the outcomes of learning activities • their impact on practice

9. Revalidation will deliver (cont.) • A risk-based audit process based on sound evidence • Processes for feedback, resubmission of evidence and removal from the register when the standard is not met • A cost-efficient infrastructure to: • support the revalidation system • enable nurses and midwives to record CPD activities and renew their registration online

10. Revalidation next steps • Agreement to NMC proposals from NMC Council • Development and engagement – Spring-Summer 2011 • Consolidate evidence base (e.g. expert knowledge; domestic/international research; findings from other regulators; secondary sources; statistical input) • Engage with external stakeholders • Write revalidation standard and guidance

11. Revalidation next steps (cont) • Options appraisal and sign-off – Autumn-Winter 2011-12 • Define and assess options • Agree and sign off preferred option • Consultation and pilot – Spring 2012

12. Issues and challenges • Ensure application to different areas of practice and multiple settings • Build upon local good practice • Determine the types of evidence that can be submitted to confirm the continuing fitness to practise of nurses and midwives • Keep it simple, risk-based and proportionate

13. Student indexing: background Students who have been discontinued from programmes for reasons of misconduct or serious concern have commenced a programme at another AEI without disclosing this information

14. Aims • An index of all students undertaking pre-registration nursing and midwifery approved programmes available from September 2011 • Improved access to students on NMC approved programmes to enable us to: • provide tailored advice • invite to come to events and to respond to consultations / surveys

15. Additional material to support the code - Aims and objectives • To produce material to support nurse and midwifery leaders and those active in military operations in applying the code in their practice • To collate examples of effective practice that address the ethical and practice dilemmas they face

16. Midwifery Activity • Review of the Midwives rules and standards • Midwives exemptions • Stakeholder engagement

17. Health care support workers • 2010 the NMC commissioned NNRU - King’s College, London to research the regulation of healthcare support workers The report highlighted • risks to public protection from an unregulated healthcare support workforce • identified the challenges in developing evidence to support regulation • Reinforced the NMC's role in leading the debate

18. Current work • Focus on delegation; work to start in July 2011

19. Practice beyond initial registration • Freedom to practise • Public protection • Clinical careers • Awarding bodies

20. Regulate or not…? • Added value vs burden of regulation • Proliferation of job titles • Inconsistencies in training and experience

21. Current position • The Coalition Government’s respones to PM's Commission • Further regulatory action needs to be based on evidence; it would have to be appropriate and proportionate • Any proposal will have to address the issues of fitness to practise and how this relates to other parts of the register • Revalidation will play a major part

22. Investigating systemic failureJoining up regulation • Regulating individuals • Regulating providers • Bridging the gap

23. Current position • Working collaboratively with systems regulators (CQC, Monitor and others) in exchanging information and sharing good practice • Exchange of information with other professional regulators (GMC, HPC) • Establishing a critical standards intervention model

24. Thank you