PREP

Author: Rachel A Munton, RGN, RMN, RNT, CPN CERT, MA

This guidance summarises the PREP report (UKCC 1994a) with particular emphasis on the statutory requirements relating to periodic re-registration, that is those things that as a registered nurse you MUST do in order to maintain an effective registration. Detailed guidance in all of the areas outlined below can be found in the UKCC document “PREP & You” (1995a). The NMC also provides a help line to answer your PREP questions: 0171 333 6692.
The aim of the PREP requirements is the improvement in standards of patient and client care, both directly and indirectly (UKCC 1995a). Whilst the information in this fact sheet is accurate at the time of writing, it may be modified by any future directives that the UKCC issue, and it is therefore critical that you keep abreast of developments in this area.

Maintaining an effective registration
The statutory requirements relating to periodic re registration came into force from April 1st 1995. From this date, a practitioner will either be registered with the council, having met the necessary requirements, or their registration will lapse (UKCC 1996a). Nurses are expected to meet the requirements prospectively, i.e. over the three years following their first re-registration after 1995. For example, a nurse who needs to re-register in October 1997 will have until October 2000 to meet the statutory requirements. This means that all practitioners will have met the PREP requirements by April 1st 2001.

There are 4 things that you must do in order to re-register at the three yearly interval:
Complete a notification of practice form on which you will detail the registered and recorded qualifications you will be using in you current or intended practice. You will have to complete and return this form even if you are not currently employed.
Have completed 5 days or equivalent study in the preceding 3 years. These formal or informal episodes of study must have demonstrable relevance to your current role and practice, and may be categorised under 5 guided headings offered by the UKCC: patient, client and colleague support; care enhancement; practice development; reducing risk; educational development.
Have maintained personal professional profile. The primary purpose of this document is to demonstrate that you have taken action to develop and maintain professional knowledge and competence: thi si your personal record of professional education, training, work experience, skills and competencies, activities and development. There is no set format for the profile: the document must, however, be flexible enough to include a record of the minimum information the UKCC might require (1996c): for example key details of your employment, education, training, work experience, and any other significant professional and personal events of relevance to your profession practice and development, presented in a way which makes clear its contribution to your learning and practice. Care should be taken to ensure clients and events are recorded in a way which will protect confidentiality.
Whilst you may wish to review your career in total, or review many years experience, it is the three years immediately preceding re-registration that the UKCC are interested in. The UKCC (1996c) have suggested 4 key steps in compiling a profile: getting started; self appraisal; setting your goals and action plans, and putting the information together. Your profile will not be subject to external validation or approval: self verification is seen as commensurate with professional accountability. It is possible that the UKCC may ask for evidence from your portfolio in relation to the statutory requirments, but neither the UKCC nor your employer has right to access to the total document (UKCC 1996c).
Pay registration fee. The purpose of registration is to protect the public and to provide unequivocal evidence that your profession qualifications and practice meet national, statutory standards, ensuring effective, safe and accountable care. it is hoped that managers and employers will be supportive of individuals in meeting the PREP requirements, however, the ultimate responsibility rests with the nurse him/herself.

Other issues covered by the PREP Report

Preceptorship
Preceptorship refers to a period of support for nurses following initial or subsequent registration, return to practice, or progression to a new professional role (UKCC 1994a). perceptorship became recommended good practice throughout the nursing profession fromApril 1993. The perceptee is a fully qualified, accountable practitioner: perceptorship is not an extension of training, nor a probationary or qualifying period (UKCC 1993; UKCC 1995b). perceptors should be first level nurses with at least 12 months post registration experience, who will act as a guide and support both professionally and personally. The detail of implementation can be decided at local level, with reference to the UKCC guidelines (UKCC 1995b).

Return to Practice Programmes
From April 1st 2000, nurses who have taken a break from professional practice, or worked less than 100 days or 750 hours in the preceding 5 years, or are returning to an area of specialist practice having worked in another specialism for more than five years, must complete a return to practice course prior to resuming employment (UKCC 1996a). the aim of such programmes is to enable the practitioner to re-enter practice with up to date competence, current skills and confidence in order to maintain safe and effective standards of patient and client care. the length and exact content of such programmes may be decided at local level.

Specialist Practice
Specialist practitioners are described as those who will exercise higher levels of judgement, discretion and decision making in clinical care. They will be able to monitor and improve standards of care through supervision of practice, clinical audit and the development of practice through research, teaching and support of professional colleagues (UKCC 1994b). Not all practitioners need to be specialist practitioners by this definition.
Programmes of education leading to the qualification of Specialist Practitioner have been available since the academic year 1995, and all programmes will need to meet the new standards by 1998. Community mental Health Nursing is one of eight identified areas of specialist practice wihtin the community. In summary, the programmes of education must be at a minimum of degree level, offer flexible opportunities for learning, link to a system of accreditation accumulation and transfer, and compromise 50% theory, 50% practice. Further details of specialist practice and the transitional arrangements for practitioners already working as specialist practitioners are explored by the UKCC (1996) and Munton (1996).

Advanced Practice
The UKCC is committed to developing the concept of advanced practice for nurses and midwives. It is concerned with the development of future practice, pioneering and developing new roles, advancing clinical practice, research and education to enrich nursing as a whole, and services to patients, clients and health services (UKCC 1995a). it is likely that this will equate with masters or doctorate level study: further details and guidance will be developed over time.

References and Key Documents
There have been a series of 4 articles by the author published in “Mental Health Nursing” which further develop the content of his handbook insert.

Munton R. (1995) PREP: implications for mental health nurses in Mental Health Nursing May 1995 15; 3 22-23
Munton R (1995) Preceptorship and Mental health nursing in Mental Health Nursing July 1995 15; 4 8-10
Munton R (1995) Developing your personal professional profile in Mental Health Nursing November 1995 15; 6 8-10
Munton R (1996) Specialist practice in Community Mental Health Nursing in Mental Health Nursing September 1996 16; 5 6-8

UKCC (1990) the Report of the Post Registration Education and Practice Project (PREP) London, UKCC
UKCC (1993) Registrar’s letter: The Councils position concerning a period of support and preceptorship January 1993 London UKCC
UKCC (1994a) The Future of professional practice: the councils standards for education and Practice following registration: Position Statement March 1994 London UKCC
UKCC(1994b) the Councils standards for Education and Practice following Registration: Programmes of Education leading to the qualification of Specialist Practitioner Registrars letter 20/1994 December 1994 London UKCC
UKCC (1995a) PREP and You London UKCC
UKCC (1995b) Registrar’s letter 3/1995 Annexe 1: The Councils position concerning a period of support and preceptorship for nurse, midwives and health visitors entering or re-entering registered practice London UKCC
UKCC (1996a) Registrar’s letter 7/1996 March the Councils standards for Education and practice following PREP: transitional arrangements - Specialist Practitioner Title/Specialist Qualification London UKCC
UKCC (1996c) PREP and profiling in register 17 Summer 1996, 7-10 London UKCC

Rachel Munton was, at the time of writing, a nurse teacher at the Mid-Trent College of Nursing in Nottingham and was editor of the then CPNA members handbook. She is now Director of Mental Health Nursing at the Department of Health, London.