Analysis

‘Nurses risk failing to revalidate without protected CPD time’

RCN warns that pressures on funding and staffing mean nurses have no time for continuing professional development at work

RCN warns that pressures on funding and staffing mean nurses have no time for continuing professional development at work

  • Employers are denying staff time to complete CPD, says an RCN report
  • No protections exist to provide the time nurses need for CPD
  • Not completing CPD could mean failure to revalidate with the NMC

Picture: iStock

Nurses risk failing to learn about the latest developments in patient care because staffing pressures mean they have no time for continuing professional development (CPD).

This warning comes in a new report from the RCN that highlights the challenges nurses face in meeting their CPD requirements.

The report was launched at RCN congress, where the spectre of short staffing loomed large in debates that included whether nurses should work outside their area of practice and fringe events on small nursing homes struggling to survive.

Yet the implications of nursing staff missing out on CPD go beyond patients potentially being denied improvements in care, the report says.

35 hours

Nurses must complete 35 hours of CPD training every 3 years to revalidate and remain on the NMC register

The RCN warns that nurses risk failing to revalidate with the Nursing and Midwifery Council (NMC) if they miss vital CPD.

NMC regulations on the issue are clear – nurses must complete 35 hours of CPD every three years to remain on the register.


Janet Davies: The importance of
CPD must be recognised. 
Picture: John Houlihan

Despite this requirement, no protections are given for the time they need to undertake it.

This, combined with increasing demand and a staff shortage in the NHS, means employers are denying staff time to complete CPD, the report says.

Essential to a nurse’s work

The college describes members in England being granted leave to undertake CPD and then having it cancelled for reasons including winter pressures, staff shortages, increased patient loads and staff sickness.

The RCN points to a UK-wide struggle for nurses to achieve even mandatory CPD training as evidence that nurses across the UK are having difficulty accessing wider professional development.

Mandatory training is classified as CPD deemed essential to a nurse’s work, such as blood transfusion or hand hygiene training, and as such does not usually count towards the NMC’s 35-hour requirement.

Unpublished information from an RCN survey in 2017 of more than 435,000 registered nurses, of whom 7,608 responded, showed a failure to complete mandatory training by 35.2% of nurses in Wales, 27.8% in Scotland, 24.7% in Northern Ireland and 14.8% in England.

‘Policymakers and employers must find a way to fund and guarantee this time‘

Janet Davies, RCN general secretary

34%

In 2016, 34% of nurses told the NMC they completed ten or fewer hours of CPD training a year

Source: Nursing Standard survey

A third of nurses (34%) told the NMC during the revalidation process in 2016 that they achieved ten or fewer hours of CPD training each year.

RCN general secretary Janet Davies argues that considering nurses must undertake CPD to remain on the register, its importance should now be recognised and protected.

‘Policymakers and employers must find a way to fund and guarantee this time,’ she says. ‘Nurses must not be allowed to fall foul of the regulator’s requirement.’

What to do if a CPD request is denied

RCN head of professional learning and development Anne Corrin offers this advice:

  • Check with your line manager to see why the request has been denied and to see if a compromise can be found
  • Check your request aligns with organisational priorities - ensure you have developed a good business case for your request
  • Keep accurate records of when you request time for CPD, why it is important, how it will contribute to your personal development and how it will improve patient care at your workplace, to support future discussions with your line manager
  • Raise it with your RCN learning representative, who will advise and support you on how to succeed in future requests, both at individual level and at an organisational level
  • If there is no RCN learning representative at your workplace, approach the RCN to discuss organising the appointment of a learning rep or get in touch with RCN Direct for further advice

Find out more about becoming an RCN learning representative

Time to learn and develop


Danny Mortimer: The government
should restore CPD funding.
Picture: NHSE

NHS Employers chief executive Danny Mortimer has also indicated his support for recognising the importance of nurses’ CPD.

‘CPD courses are not just nice to have – employers are clear that they are essential,’ he says.

Mr Mortimer says that if staffing pressures are eased in the short term, allowing nurses to undertake CPD, then more nurses would also choose to stay in the profession.

‘If we start to bridge the gap in vacancies and reinvest funds back in CPD and workforce development we will see a positive impact on staff retention,’ he says.

‘We repeat our call for the government to restore CPD funding.’

A report issued by the Commons health and social care committee in January went so far as to call for ringfenced CPD funding for nurses and specific CPD funding for those working in the community. The MPs called for a clear audit trail to ensure funding gets to its intended destination, something they will follow up with Health Education England (HEE) early next year.

‘We repeat our call for the government to restore CPD funding’

Danny Mortimer, chief executive of NHS Employers

The call is set against a background of significant challenges for CPD funding in England.

HEE’s workforce development budget, which the RCN claims is ‘largely used for CPD for nurses’, has been cut by 60% over the past two years.

In 2015-16 it was £205 million, this year it stands at £83.49 million.

No specific allocation

When contacted by Nursing Standard, a spokesperson for HEE downplayed the role of its workforce development budget in CPD, saying it was for a ‘broad range of investment’.

‘HEE does not have, and never has had, a specific allocation for general CPD for the NHS workforce,’ the spokesperson said.

‘Our workforce development fund covers a broad range of investment based on local NHS priorities.


Rita Devlin: Concerned about
continued falls in funding.

Funding for nurses’ CPD is also under pressure in Northern Ireland, where the country’s Department of Health has cut its nursing and midwifery education budget year on year. It was £9.5 million in 2010-11 and fell to £8.34 million in 2016-17.

A political stalemate in Northern Ireland means no education budget for nurses has been released for 2018.

RCN Northern Ireland head of professional development Rita Devlin says the college is concerned about the continued falls in funding, and the situation is also challenging for nurses in the private sector.

‘CPD for nurses working in the independent sector is more ad hoc, as there is no central budget and they are reliant on employers funding educational programmes and releasing staff to attend these programmes,’ she says.

In the rest of the UK, the main issue with accessing CPD appears to be staffing levels.

Even in Wales, which now has a safe staffing law, nurses are being denied access to CPD.

RCN Wales employment relations associate director Helen Whyley says despite nurses’ access to CPD being incorporated in safe staffing calculations, in practice nurses are still having study leave frozen due to staff shortages.

‘The system is failing staff on the ground,’ she says.

Ms Whyley hopes the launch in October this year of the Welsh government’s Health Education and Improvement Wales body, which will be responsible for development of the health workforce in the country, will bring a focus on CPD for nurses.

‘HEE does not have, and never has had, a specific allocation for general CPD for the NHS workforce’

Health Education England spokesperson

NHS Wales chief nursing officer Jean White says she was not aware of instances of nurses missing out on CPD due to staffing pressures, but is not surprised it is an issue.

36%

of nurses said lack of time meant they had to leave necessary patient care undone.

Source: Staffing for Safe and Effective Care (RCN)

‘It is one of those perennial problems when you have a poor winter, financial pressures and staff shortages. Education and training is often the thing that gets trimmed, so I would not be surprised at all if that has happened in some circumstances.’

Speaking at the CNO annual showcase conference in Cardiff in May, Ms White echoed comments by other senior figures in nursing that it is ultimately the individual’s own responsibility to fufil their revalidation requirement.


Ellen Hudson: Nurses need
protected time for CPD.

RCN Scotland associate director Ellen Hudson says many nurses are being forced to undertake CPD in their own time.

‘We know that workload and staffing challenges have a negative impact on access to CPD and that nursing staff are often left with no option but to use annual leave to complete their CPD,’ she says.

‘This short-sighted approach puts nursing staff and their patients at risk.’

Ms Hudson called for the Scottish Government and employers to ensure nurses have protected time for CPD.

The RCN wants to gain an understanding of the disparities across the four UK nations to inform its future strategy. To do this, it is calling for all bodies in healthcare education funding and workforce development in the UK to publish data on total funding allocations for CPD, training completed and workforce needs.

One possible future strategy is to follow the model of CPD for doctors, the RCN report suggests.

Matching nurses’ CPD with doctors’

In the UK, doctors have study leave for CPD protected and guaranteed, and the RCN is now calling for a similar programme for nurses.

While the British Medical Association would not confirm whether it would support such a move by the RCN, a spokesperson said CPD protections are vital for doctors.

‘Without such protection, many doctors would be left unable to take part in educational opportunities that are necessary to meet curricular, professional development or regulatory requirements.’

‘CPD is ultimately a nurse’s own responsibility’

A senior figure in one of the UK’s biggest healthcare trusts says CPD hours for nurses should be protected but ultimately it is the individual nurse’s responsibility to fufil their professional development obligations.

Barry Quinn, a senior member of the Barts Health NHS Trust corporate nursing team in London, described CPD as ‘a core part of our profession’.

Dr Quinn helps to oversee thousands of nurses across four sites at the UK’s second-largest trust, where CPD is a high priority. It is discussed with every nurse during annual appraisals, with a focus on which courses would be right for them and their practice.

But Dr Quinn, who is also consultant editor of RCNi’s Nursing Management journal, says that while managers have an important role to play in helping nurses gain access to CPD, each individual nurse must take responsibility for their professional development.

‘You can point the finger at the trust and the pressures but you also have to take it upon yourself,’ he says.

‘No one has ever knocked at my door and asked me if I wanted to do training.’

Best way to show you value someone

From a management perspective, Dr Quinn stresses the importance of CPD to the nursing profession and staff retention and warns senior figures against ‘breaking promises’.

Dr Quinn says he knows of some trusts in the UK where the turnover for newly qualified nurses has been more than 50% over two years, with a lack of access to CPD being a key reason for staff leaving.

He says: ‘The best way to show you value someone is to invest in their professional development.’


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