Revalidation: Midwives working outside of maternity care

As a registrant with the Nursing and Midwifery Council all nurses, midwives in the UK and registered nursing associates in England are required to maintain their registration with the NMC, through the process of revalidation. 

Revalidation encourages updating knowledge and developing new skills, helps to maintain and enhance individual practice and supports career progression. Through revalidation, nurses, midwives and nursing associates provide evidence of their continued ability to practise safely and effectively. The NMC Code is central to the revalidation process as a focus for professional reflection. 

If you are a midwife, working in services other than maternity care, you need to consider how you are going to revalidate with the NMC. Visit the NMC website to find more guidance on revalidation. 

To fulfil the requirements of revalidation, the midwife (and manager/employer) needs to consider: 

• the underlying registration
• scope of practice and 
• continuing professional development (CPD). 

The NMC Code in section 22 is clear that all registrants must "keep your knowledge and skills up to date, taking part in appropriate and regular learning and professional development activities that aim to maintain and develop your competence and improve your performance" (22.3).

In Practising as a midwife in the UK the NMC acknowledges that a midwife’s scope of practice may change depending on the nature of their roles and the learning they have undertaken. A midwife's scope of practice might be taken to mean "the range of things that the midwife has the skills, knowledge and proficiency to do’ and not to be confused with 'protected function' which means ‘something that only midwives can legally do’. 

The current Standards of Proficiency for Midwives are based on best evidence and emphasise the role and scope of today’s midwife. They include pre-pregnancy, future reproductive health and more about the midwife’s role in complications and additional care needs:

• “Midwives work across the continuum from pre-pregnancy, pregnancy, labour and birth, postpartum, and the early weeks of newborn infants’ life. This includes women’s future reproductive health, well-being, and decisions…”
• “Midwives respect and enable the human rights of women and children, and their priority is to ensure that care always focuses on the needs, views, preferences, and decisions of the woman and the needs of the newborn infant”.
• “Midwives provide safe, respectful, empowering, and equitable care irrespective of social context and setting, including wider reproductive health services. In all settings, the midwife is responsible for creating a safe, respectful, kind, nurturing, and empowering environment.” 

The definition of midwifery in the Standards of proficiency for midwives says: “Core characteristics include optimising normal biological, psychological, social, and cultural processes of reproduction and early life; timely prevention and management of complications; consultation with and referral to other services; respect for women’s individual circumstances and views; and working in partnership with women to strengthen women’s own capabilities to care for themselves and their families.” 

As well as the specific standards about reproduction such as 1.3, 3.4, 3.11, 6.21, 6.52.1, there is also the midwife’s role when care is complicated and there are additional care needs for women, their newborns and families (Domain 4).  

Domain 5 also focuses on standards for midwives around CPD and supporting and supervising others, including students and colleagues. 

There are also key themes throughout the standards about: 

• optimising the normal processes of reproduction and early life
• anticipating, preventing, and responding to complications and additional care needs
• ensuring that women, partners and families have all the information needed to fully inform their decisions
• public health, health promotion, and health protection. 

While midwives’ careers may develop in practice, education, research, management, leadership, and policy settings amongst others, revalidation links back to the Code and related standards.  

In the NMC’s recommended CPD log, it asks: ‘Please identify the part or parts of the Code relevant to your CPD’ and ‘Link to Standards of Proficiency.’ The suggested template for practice hours asks about work setting, scope of practice (referencing both the Code and the Standards of proficiency) whether direct clinical care, education, research, management, leadership, policy, commissioning, consultancy quality assurance or inspection and a brief description of your work.

This all means that midwives working in services other than maternity, for example, in fertility care, should be able to demonstrate via revalidation that they are continuing to meet the NMC standards to remain on the midwifery part of the register.

The easiest way for anyone who is on the midwifery part of the register to ensure currency with midwifery is to continue to practice in maternity settings or to maintain links with maternity care. In the context of fertility care, this could go some way to addressing the ‘gap’ between fertility services, early pregnancy and maternity care, as identified in the recent RCN publication Transition from Fertility to Maternity Care.

The challenge for midwives who work in different health care settings than maternity services, is to identify where the skills and knowledge they have learned as a midwife translate into their current scope of practice.

The NMC publishes and regularly updates standards of proficiency for everyone on the register. These requirements outline the knowledge, understanding and skills that students must have to apply to join the register and to practice safely and effectively. It is important for midwives to become familiar with the most recent standards, identify which ones relate to your scope of practice and identify your training needs. This will help you to advance your practice and also means that you will be equipped to supervise and assess students if this is part of your role.

It is important that you speak to your employers about your revalidation, so that they can support you in developing your scope of practice and enhancing your knowledge and skills through your CPD.

If you need any further help with this, please log into MyRCN for support from our Member Support Services.