On Wednesday, March 20, 2024, a delegation  from the Nursing and Midwifery Council (N&MC) of Ghana, the University of Huddersfield, UK, and TechnoFerry International Limited, UK, embarked on a significant visit to the Nursing and Midwifery Council (NMC) UK. The delegation included Mrs. Philomina A.N. Woolley, Acting Registrar; Mr. Ampem Darko Oklodu-Abbey Esq, Deputy Director (Operations) and Head of Intelligence and Discipline Unit; and Mr. Dennis Addai, Senior IT Officer (all at the N&MC of Ghana). Accompanying them were Dr. Bibha Simkhada, Senior Lecturer in Adult Nursing and Deputy Director of Graduate Education, University of Huddersfield, UK; as well as Mr. Hari Krishna Neupane, IT Consultant; and Mr. Manish Parajuli, Project Manager (both representing TechnoFerry International Limited, UK).

The primary objective of this visit to the NMC UK was to glean insights and expertise in implementing the innovative revalidation policy for nurses and midwives. The delegation sought to understand firsthand how the UK has effectively spearheaded this initiative, which has significantly contributed to enhancing health outcomes and fostering professional development among nurses and midwives. This visit was a pivotal component of an ongoing collaborative project aimed at “strengthening the N&MC of Ghana's capacity to oversee and regulate the professional registration of nurses and midwives to ensure high-quality care”. Supported by funding from the UK Department of Health and Social Care through the Tropical Health and Education Trust (THET), this project is part of the Global Health Workforce Programme. By leveraging the experiences, strategies, and best practices of leaders like the NMC UK, the delegation aims to tailor its approach to suit the distinctive needs and challenges of the healthcare system in Ghana.

Upon arrival, the delegation was warmly received by Natasha Dare, Head of Regulatory Policy, NMC UK, who graciously facilitated the meeting in the absence of Peter Pinto de Sa, Assistant Director, Office of the Chair and Chief Executive, NMC UK. The visit commenced with an illuminating presentation on revalidation, setting the stage for discussions and the exchange of practical recommendations on the introduction of a context-specific policy in Ghana. Additionally, the IT team had the opportunity to delve into the technological intricacies of policy implementation. In addition, Natasha Dare kindly agreed to serve on the Steering Committee for the execution of this project.

Although not present during the visit, other key members of the project include Precious Adade Duodu, Senior Lecturer in Adult Nursing and International Lead for the Department of Nursing; Professor Padam Simkhada, Professor of Global Health and Associate Dean International (both at the University of Huddersfield, UK); and Dr. Susan Jones, Lecturer and Professional Lead for Nursing, University of Liverpool, UK.

In conclusion, the visit to the NMC UK was instrumental in providing invaluable insights and expertise that will inform the development and implementation of revalidation policies for nurses and midwives in Ghana. Through collaboration and knowledge exchange, both countries are poised to strengthen regulatory frameworks, enhance professional standards, and ultimately, improve healthcare delivery for the benefit of all.

The Nursing and Midwifery Council (N&MC) of Ghana, in partnership with the University of Huddersfield, UK, proudly announces their participation in the in-country launch of the Global Health Workforce Programme (GHWP) on 21st February 2024, hosted at the Ministry of Health, Accra, Ghana. GHWP aims to bolster health partnerships to fortify the health workforce in Ghana, forging resilient health systems post-pandemic and advancing towards universal health coverage. The programme is funded by the UK Department of Health and Social Care, via Tropical Health and Education Trust (THET).

The collaboration between N&MC and the University of Huddersfield secured a substantial grant from GHWP, dedicated to "strengthen the ability of the Nursing and Midwifery Council of Ghana to oversee and regulate the professional register of nurses and midwives to ensure high-quality care". This current project, building upon three previous collaborative projects, underscores a steadfast commitment to evidence-based practices and continuous improvement.

Derived from the Health Professions Regulatory Bodies Act 2013 (Act 857), N&MC's mission is to "secure in the public interest, the highest standards of training and practice of nursing and midwifery in Ghana". Additionally, with a vision to "optimize the use of ICT solutions in line with the 4th Industrial Revolution for improved nursing and midwifery regulation", N&MC embarks on a strategic plan spanning from 2021 to 2025. This comprehensive strategy prioritizes total ICT digitization and automation, service enhancement, effective stakeholder engagement, and operational decentralization.

Recognizing the paramount importance of reflective practice, N&MC has integrated a reflection component into the pre-registration nursing and midwifery curricula, emphasizing the significance

of continuous learning and development. Despite digital license renewal, opportunities persist for system enhancements to ensure ongoing competence and professionalism among registered nurses and midwives. Thus, the introduction of revalidation in 2026, the focus of this current project, anticipates a transformative shift in Ghana's healthcare landscape.

Mrs. Philomina A.N. Woolley, Acting Registrar of N&MC, emphasized the significance of this initiative during an interview with Ghana Television (GTV), highlighting its potential to elevate standards and enhance patient care. She stated that, "in time past, we have been doing relicensing ... but we realize that the clients that we take care of still complain about the attitude of nurses [and midwives]. And so, what best can we do to improve the healthcare that we give to our clientele? [That’s why] we are bringing in the University of Huddersfield to help us do [what] we call revalidation".

Revalidation, a periodic assessment of professionals' competence and performance, aims to enrich the quality and safety of practice by promoting continuous learning, reflection, and improvement. This transformative initiative heralds a significant stride towards improving care delivery and fostering professional development in Ghana's nursing and midwifery sectors. Mrs. Woolley expressed confidence that "when this is rolled out, a lot of the cry of the public will decrease to the barest minimum."

Precious Adade Duodu, Senior Lecturer in Adult Nursing and International Lead for the Department of Nursing, University of Huddersfield, highlighted the project's intended outcomes, including the development of a robust, user-friendly, and intuitive database as well as foster capacity building for nurses and midwives. He emphasized the importance of reflection in daily practice, peer feedback, and the ultimate improvement of patient outcomes in Ghana. Speaking to Ghana Television (GTV), he said that “one of the key things that’s going to improve our practice

is to continually reflect on what we do on daily basis. That will help us to learn, relearn and unlearn and to incorporate new knowledge and ideas into our own practise. So, Registrar talked about one aspect of it, which is to improve patient outcomes. But also on the other side, it helps the nurses and the midwives themselves to ensure personal and professional growth, because daily you’ll be learning by incorporating that [feedback and reflection] into your practise”. He continued that “it also prevents professional isolation because you're going to engage in some sort of peer feedback with your colleagues, as well as patients and family members that will ultimately improve patient outcomes here in Ghana”.

In line with the strategy of effective stakeholder engagement, N&MC convened a stakeholder consultative meeting on Tuesday 20th February 2024 at the Head Office in Accra to deliberate on this initiative. It is significant to highlight that the decision to implement revalidation arose from recommendations derived from the three prior projects, each deeply rooted in stakeholder consultation. To achieve this objective, the N&MC, following the deliberations of the consultative meeting, aims to integrate additional steps into the licensing process, including:

1. Documentation of CPD implementation through written reflections.

2. Practice-related feedback from colleagues, patients, carers, and families.

3. Reflective discussions with line managers to validate CPD completion and practice improvement efforts.

4. Self-declaration of good health and character at the point of revalidation.

These measures aim to shift the relicensing process from a mere tick-box exercise to a meaningful professional development opportunity.

The anticipated outcomes of this one-year GHWP project include the implementation of a robust electronic database, supported by user-friendly and safe management information systems (MIS).

Capacity building initiatives will ensure smooth operation, with extensive training and piloting preceding full policy implementation. Mrs Woolley rounded up her interview highlighting that “we are also going to have capacity training for our MIS team, so that they will have the capacity to develop these internet [technological] aspects. The University of Huddersfield is also going to help us to build the capacity of the nursing and midwifery staff that we have”.

The IT Consultant on the project, Mr Hari Krishna Neupane of TechnoFerry International Limited, UK who recently visited Ghana expressed enthusiasm for supporting the N&MC IT team to build a secure, user-friendly, and intuitive database for the revalidation policy. The project has already commenced, with needs assessment and capacity building activities underway.

In conclusion, the introduction of the revalidation initiative represents a significant milestone in Ghana's journey towards healthcare excellence. By embracing continuous learning and professional development, N&MC reaffirms its commitment to securing the highest standards of nursing and midwifery practice, ultimately enhancing the quality of care for all Ghanaian citizens while promoting professional development among nurses and midwives, who form the largest proportion of the health workforce.