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27th May 2015
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Dr Mark Porter

In conversation with Roy Lilley - this is warming up to be a really good 'conversation'!

Chair of the BMA - just how relevant is the BMA; does anyone listen to them
Is the BMA a busted flush?  The British Moaners Association or the British Machiavellian Army?

Let's find out.  Health Chat at the King's Fund 18th June Details here.

Its own weight 
News and Comment from Roy Lilley

I write something, press the button and wonder. Wonder who will read it, what response it will have.

 

Yesterday, I wrote about front-line nursing, by about lunch time my in-box melted. Blimey, are there some hacked off nurses out there! If there was a composite letter it would say; 'Thrilled to become a nurse, hate what nursing has become'. Add to that 'can't wait to retire' and 'only 26 pay-slips to go' and you'll get the flavour.

 

I've been particularly taken by surprise by the number of parents writing. They tell a familiar story; bright daughter (and some sons), huge vocational drive, studied until they went cross-eyed, proud as punch to qualify... now punch drunk and exhausted.  

 

As an outsider it looks, to me that nursing is on the edge. On the edge of what I'm not sure. Vocation looks like the glue that is holding the profession together. Mission and fulfilment are the buttresses.

 

We mistake 'work' for 'vocation'. Vocation is what makes us do the work. The work is what will stop us. Vocation is what we do when our light reaches into the heart of those around us. Work is what snuffs it out.

 

If I was unprepared for these responses I have to tell you; nothing could have prepared me for a one line email, asking me had I seen the NMC's revalidation plans? I promised to have a look. Oh gawd...

 

It is 'provisional' for use by pilot sites, scheduled to be finalised by the autumn. You'll have to have a look at the 30-odd pages. It is impossible to encapsulate the complexity of it and frankly the sheer overblown, pomposity of it. The ludicrous out-of-touch-with-reality of it. The document is here. The Nursing Times' excellent summary is here.

 

With no sense of irony the new arrangements are known as PREP and include a requirement for 351,446 nurses to do the following:

  • Obtain "at least five pieces of practice-related feedback." What patient wouldn't disguise a black truth in a cheery lie to avoid a confrontation?

  • This feedback can be directly related to individual performance or it can be about a registrant's team, unit, ward or organisation. Team and organisational performance is entirely different to individual performance. What is being measured here?

  • Record a minimum of five written reflections on the code of conduct - which has recently been updated - on continuing professional development and practice-related feedback. I think I might start a web-site where you can download reflection templates for a tenner; look for www.Reflections-R-Us.spiv.

  • Accompanied by evidence that the nurse has had a discussion with another NMC registrant about their reflections and wider professional development. I'll sign yours if you'll sign mine?

  • Provide evidence of third party confirmation that they have met all revalidation standards. The guidance states the person providing this does not have to be an NMC registrant and suggests... a line manager. The line manager will always sign this as not to do so would admit to management failings by the manager.

  • Complete at least 450 hours of practice in the three years prior to renewing their registration. Nurses in managerial, non-clinical roles off the register, then?

  • Maintain a 'portfolio of work' showing evidence of 40 hours continuing professional development. More opportunity for my web-site; download certificates of attendance to on-line nurse chat rooms.  Twenty quid seems fair?

  • Show they have indemnity insurance and provide a health and character declaration. Health, character? Self-certificated our en-bloc from the employer?

A few questions come to mind. Does the nurse get time off to do all this 'reflection'? Who provides the locum cover? Is any of this measurable, quality assured and auditable for +300k nurses? Will the NMC be employing the Red Army to provide oversight of 5,623,136 records and accompanying security, verification and bureaucracy?

 

Keeping up to speed, on top of the job, knowing what's-what is an undeniable part of being a professional. This pile of dreamed-up bureaucratic junk is laughable. These are zombie-credentials. With apologies to Bear Grylls; makes Boy Scout Badges look like a MENSA test.

 

Why not add a receipt from Tesco's as proof of a healthy shopping basket or a picture of the registrant wearing a Poppy as a measure of compassion?

 

The only thing that will save us from this bureaucracy is the NMC's own inefficiency. It will collapse under its own weight.

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HealthChat
Dr Mark Porter
Chair of the BMA
Is the BMA the force it once was?
Are they still relevant.
Where are all doctors going to come from? 
Filling up fast
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18th June 2015
King's Fund
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Lord Darzi
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