There will be changes to the ways in which paramedics are audited and how they provide evidence that they are adhering to the Health and Care Professions Council (HCPC) standard. The standard requires all paramedics to continue to develop their knowledge and skills while they are registered with the HCPC (HCPC, 2012).
Newcastle University is conducting a survey regarding the evidence on the costs, outputs, outcomes, advantages and impact of the system used by the HCPC that is designed to assure the continuing fitness to practise of health and care professionals. The aim of the research is to enhance the system that should ensure fitness to practise, as well as raising awareness of continued professional development (CPD). Around 11 000 individuals on the HCPC register, approximately 3% of the total registrant body, are being selected to take part in the study, in which views are being sought on the strengths and weaknesses of the HCPC CPD and audit system.
This work comes as the General Medical Council (GMC) and Nursing and Midwifery Council (NMC) have made major changes to the way they manage CPD. Both the GMC and NMC have in the past also asked similar questions that Newcastle University are asking concerning systems that they had in place to ensure registrants could assure the public they were fit to practice. Questions concerning CPD and auditing systems come as the NHS has undergone many changes and has been subjected to a number of inquiries and reviews—for example, the failings at the Mid Staffordshire NHS Foundation Trust and the Shipman Inquiry.
Revalidation, according to Nath et al (2014), is a regulatory process that is intended to complement clinical governance, with the one strengthened by the other. For revalidation to be effective, it is dependent on an efficient appraisal scheme and systems that are in place to govern clinical processes, both of which are key to safe care.
The GMC introduced revalidation as a process by which all licensed doctors are required, on a regular basis, to demonstrate they are up to date and fit to practise in their chosen field, as well as being able to provide a good level of care (GMC, 2016). Prior to revalidation for doctors, there was no system in place for checking that they were competent and up to date. Having a licence to practise is seen as a sign that the doctor or other healthcare professional is able to show that he/she meets the professional standards that have been set by the regulator and, if appropriate, standards that are set by others—for example, the medical Royal Colleges and Faculties. Revalidation for doctors is the first nationwide system of its kind anywhere in the world.
Nurses and midwives have always had to keep their practice up to date using a system known as Post Registration Education and Practice (PREP). However, this system used to audit CPD was ineffective and in much need of reform.
The newly introduced process replaces the PREP requirements and nurses and midwives have to revalidate every 3 years to renew their registration. This will mean that they will need to do more to stay on the NMC register. Since October 2015, every nurse or midwife that applies to re-register with the NMC has to revalidate in order to be able to practice in the UK (NMC, 2015).
It has to be acknowledged that revalidation is not a panacea for all of the ills that befall the paramedic profession or indeed any health or care profession. It may not produce instant results, it will need time to mature, and the scale of what may be involved in reassuring the public that the paramedic is fit for practice should not be underestimated by the paramedic and the employer. Lessons learned from other regulators regarding their experience of revalidation should be given careful consideration by the HCPC.
Revalidation is primarily about reinforcing the trust that patients have in the paramedic. The patient will have more assurance that the paramedic treating them will have had to demonstrate (in a more robust way) on an ongoing basis that he or she is competent and fit to practice. This will be good for the profession but, above all, it will be good for the people the paramedic has the privilege to provide care to: the patient.
For those paramedics who have always ensured that they have participated in timely CPD and amassed the evidence required for this, then revalidation or whatever process the HCPC decide to introduce will be, for them, business as usual. However, it may be more of a challenge for the paramedic who has not taken CPD as seriously as they should have, in which case revalidation could provide something of a wake-up call.