Analysis

Nurses may fall at revalidation’s first hurdle without CPD support

Nurses have raised concerns about their ability to meet the continuing professional development requirements of revalidation, an RCNi investigation reveals.

Almost two thirds (65%) of the 2,909 nurses who responded to our survey express concern about being able to complete 35 hours of CPD over three years, as the Nursing and Midwifery Council’s new process demands. Of those, 22% describe themselves as ‘very’ or ‘extremely concerned’.

A total of 1,096 (38%) nurses say their employer gives them no time at all to do CPD activities, while 319 (11%) say they do not manage to complete any CPD hours over the course of a year. Notably, 81% express a clear need for protected time to carry out CPD.

In contrast, three quarters (78%) of those surveyed say they can always access mandatory training at their organisation, revealing that the accrual of CPD hours for revalidation is perceived as more difficult.

RCN head of policy Howard Catton says the findings make it clear there are still a ‘significant’ number of employers who could do more to support staff. ‘The thing that jumps out is that nurses are looking for more support from their employers in terms of CPD,’ says Mr Catton.

Almost one in three nurses (30%) say they have been refused time to carry out CPD or have encountered resistance to this from their line manager. Those who fail to meet the CPD requirements risk removal from the register.

Nurses revealed the biggest barriers to CPD in our survey, with lack of funding seen as a significant obstacle

Mr Catton says that while this is ‘a challenging time’ for the NHS financially, it is in employers’ interests to support CPD. ‘If their staff are not revalidating and come off the nursing register, that creates a shortage for them in a difficult period,’ he says.

‘I would call on and encourage employers to look at whether they are doing as much as they possibly can to support their staff through revalidation, because there are clear benefits for them.’

Staff are absolutely right to call for protected time to carry out CPD

Acknowledging that the process is ultimately an ‘individual responsibility’, Mr Catton says many employers recognise that supporting staff is a way to drive service improvement. ‘If nurses are reflecting on their practice and thinking about how they can deliver care differently as part of the organisation’s quality improvement processes, revalidation fits with that as well.’

He points out that supporting staff to undertake CPD does not have to mean committing money to training budgets or sending staff on courses. ‘It is about providing opportunities for staff to come together and talk about the care they are delivering,’ he says.

Lack of time for CPD appears to be a big issue for nurses across healthcare settings and is an issue that the new RCNi campaign 1hour2Empower, launched this week, seeks to address and publicise. The survey also reveals that 657 nurses have had to use their annual leave to carry out CPD, while 25 others have even taken sick leave for the same purpose.

Unite professional officer for health sector regulation Jane Beach says employers must commit to giving their staff CPD time. ‘These findings are really shocking,’ she says. ‘Staff are absolutely right to call for protected time to carry out CPD.

‘There are many opportunities for free CPD that employers don’t have to fund, so the least they could do is free up staff to be able to undertake it.

‘It is in their interest to have staff who are up to date and fit to practise – releasing staff is a price employers have to pay for having quality staff. It has to be a partnership approach – both parties benefit.’

Nearly 70% of the nurses surveyed are at band 5 or 6, and almost half are employed in acute trusts. The rest are employed in a range of healthcare settings including general practice, nursing homes, hospices, community trusts, universities and agencies.

They report the main barriers to CPD as:

Insufficient backfill.

Lack of protected time.

Training not being prioritised or available.

A lack of funding.

A lack of enthusiasm from managers or failure to understand staff training needs.

‘My line manager will not agree to time off for CPD activities due to our being short-staffed,’ says one band 5 mental health nurse. Similarly, a band 6 nurse practitioner was told clinical work had to come first: ‘Even though I had evidence to show that I could achieve both and the CPD would enhance clinical performance.’

Lack of funding is seen as a significant obstacle – one band 6 clinical nurse says she has spent £800 in the past three years. ‘I have had no formal training other than mandatory online training in five years. I paid for my own minor illness training and then could not get a mentor to gain accreditation.’

An NMC spokesperson says while responsibility for meeting requirements for registration rests with the individual, organisations ‘have a responsibility to support staff to undertake CPD’.

‘This will ensure that employers have a highly skilled and well-trained workforce, able to deliver the highest quality of care possible for patients.’

However, she also notes that anecdotal evidence shows many people are meeting the required levels of CPD.

‘The feedback we have had from the pilot organisations and through our revalidation events is that many people do more than the 35 hours of CPD required,’ she says.

She adds that it has ‘always been the case’ for nursing staff to undertake 35 hours of CPD over three years to renew their registration. ‘This is something that nurses, midwives and employers will be used to arranging as part of managing their teams.’

An NHS Employers spokesperson says employers have ‘an important role to play’ in ensuring staff feel confident and supported to go through the revalidation process. ‘We know that employers are working hard to do this,’ she says. ‘While responsibility for revalidation is at an individual level, we want staff to have the right information they need to meet the essential criteria.’

Patients Association chief executive Katherine Murphy says it is ‘very worrying’ there is a reported lack of enthusiasm among some managers for CPD.

‘If senior staff and decision makers see the safety of their patients as a key priority, they should be encouraging protected time,’ she says.

‘If staff are struggling to access 12 hours of CPD a year, that tells a bigger story – we are not recruiting, retaining and training enough nurses’.

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