Safeguarding the public through emerging policy
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Safeguarding the public through emerging policy. Roger Thompson Director of Nursing and Midwifery Policy and Standards 15 April 2011. Highlights. Safeguarding adults Guidance on raising and escalating concerns Revalidation Student indexing Additional material to support the code

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Safeguarding the public through emerging policy

Safeguarding the public through emerging policy

Roger ThompsonDirector of Nursing and Midwifery Policy and Standards 15 April 2011



  • 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

Safeguarding adults

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.

Guidance for raising and escalating concerns

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

Guidance for nurses and midwives

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

Guidance for managers

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

Purpose of revalidation

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

Revalidation will deliver

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

Revalidation will deliver cont

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

Revalidation next steps

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

Revalidation next steps cont

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

Issues and challenges

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

Student indexing background

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

Safeguarding the public through emerging policy


  • 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

Additional material to support the code aims and objectives

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

Midwifery activity

Midwifery Activity

  • Review of the Midwives rules and standards

  • Midwives exemptions

  • Stakeholder engagement

Health care support workers

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

Current work

Current work

  • Focus on delegation; work to start in July 2011

Practice beyond initial registration

Practice beyond initial registration

  • Freedom to practise

  • Public protection

  • Clinical careers

  • Awarding bodies

Regulate or not

Regulate or not…?

  • Added value vs burden of regulation

  • Proliferation of job titles

  • Inconsistencies in training and experience

Current position

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

Investigating systemic failure joining up regulation

Investigating systemic failureJoining up regulation

  • Regulating individuals

  • Regulating providers

  • Bridging the gap

Current position1

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

Thank you

Thank you

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