Recommendation 194

Nurses annual learning portfolios

Accepted in principle
As part of a mandatory annual performance appraisal, each Nurse, regardless of workplace setting, should be required to demonstrate in their annual learning portfolio an up-to-date knowledge of nursing practice and its implementation. Alongside developmental requirements, this should contain documented evidence of recognised training undertaken, including wider relevant learning.  It should also demonstrate commitment, compassion and caring for patients, evidence by feedback from patients and families on the care provided by the nurse. This portfolio and each annual appraisal should be made available to the Nursing and Midwifery Council, if requested, as part of a nurse’s revalidation process. At the end of each annual assessment, the appraisal and portfolio should be signed by the nurse as being an accurate and true reflection and be countersigned by their appraising manager as being such

We consider that the aim of the recommendation, which is to have a role that is accountable for providing assurance to the Nursing and Midwifery Council that nurses can show they are keeping themselves up-to-date and fit to practise, is best achieved through the introduction of nursing revalidation.

The inquiry also recommended that independent of the development of nurse revalidation, the Nursing and Midwifery Council could establish minimum standards for appraisal and support, which could be overseen by responsible officers appointed and accountable to the Nursing and Midwifery Council.

The Nursing and Midwifery Council has committed to introducing a proportionate and effective model of revalidation, which is affordable and value for money, to enhance public protection.  Subject to public consultation, the proposed model would require evidence that the nurse or midwife is fit to practise.   Under the current proposals, the Nursing and Midwifery Council Code and standards would be reviewed and revised to ensure they would be compatible with revalidation, and guidance for revalidation would also be developed.

In addition, before the introduction of revalidation by the Nursing and Midwifery Council, NHS Employers will:

  • support NHS organisations in ensuring they have a clear link between the values in the NHS Constitution and their own local values
  • support NHS organisations in developing and improving values based appraisal and performance management having taken steps to improve performance appraisals for the 1.1 million staff on Agenda for Change as set out in recommendation 7
  • encourage NHS organisations to make the necessary links with the work the Nursing and Midwifery Council is leading on revalidation as they develop new local performance and appraisal arrangements

High performing staff can improve outcomes for patients. The government strongly encourages employers to use the full flexibilities in existing pay contracts so that pay progression is linked to quality of care, not time served.  NHS Employers will support this by working with the service on new model performance frameworks, which will place greater emphasis on the quality of care, including the important NHS values of compassion, dignity and respect.


In February 2013, the Nursing and Midwifery Council began a UK-wide programme of engagement on revalidation and has held two national consultations. The first ran from January to March 2014 and focused on the proposed model of revalidation. The second, which ran from May to August 2014, included a draft revised Code intended to address the issues raised by the Francis reports into failings at Mid Staffordshire NHS Foundation Trust. These include, for example, putting patients first (including a greater emphasis on providing the fundamentals of care, hydration and nutrition); dealing with complaints; raising concerns (‘whistle-blowing’); the professional ‘duty of candour’; and leadership, delegation and teamworking.

The Nursing and Midwifery Council will test the resulting revalidation model in a pilot during 2015 and full implementation of the model is planned to commence by the end of 2015. The Nursing and Midwifery Council has established an oversight board that will drive forward the planning and confirm that the UK is sufficiently ready for implementation.

With Health Education England, NHS Employers has developed a mapping tool to allow local organisations to map their values to those in the NHS Constitution. NHS Employers has also produced guidance for employers linking pay progression, appraisal and performance management. This includes a number of resources to support employers including good practice case studies and a model policy. Further resources including case studies and podcasts will continue to be developed during the year.