CPA FORM 1/160215
Please refer to the Accreditation Guidance booklet when completing this application.
Please allow a minimum of 6 weeks for your application to be processed. The accreditation process commences upon receipt of full payment. Applications will not be processed unless all sections are completed; if a section is not applicable to your application please state ‘not applicable’ .
Please click the grey boxes and enter information
Name of organisation
Address
Provide full contact details of any PR company, commercial company or other representative applying for accreditation on your behalf
Contact name
Job title
Email address
Telephone number
Company website
1
What is the title of the programme?
What are you seeking accreditation for? e.g. conference, event, course, programme, resource, e-learning etc.
Have you approached/worked with other accrediting organisations?
Please indicate if you have applied for or been granted accreditation from NICE or any other institution
What is the start date of the programme?
1
For the purposes of the Quality Assurance Standards document; “Accredited Programme” refers to the; (i) event (including conferences, meetings, seminars, presentations and workshops); (ii) professional programme (including programmes provided by NHS Trusts or other training providers) and longer programmes; (iii) credit-bearing degree programme (including certificates, diplomas, undergraduate and postgraduate programmes of study); (iv) hard-copy learning and development resources (including training packs, handbooks, DVDs/USB sticks, Powerpoint presentations, articles, books); (v) e-learning (including online courses and modules); or (vi) guidelines, standards and competency frameworks (including resources for use in the workplace and for professional development)
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CPA FORM 1/160215
What is the subject area of the programme e.g. diabetes care
What is the proposed level of study ? i.e. course, first degree, masters (if applicable)
How many study hours will users be undertaking as learning activity?
Study hours are awarded for contact hours only (estimate on the basis of 7 hours = 1 day or 3 hours = half-day)
What credit points (CATs) will be awarded?
Provide details of credits provided towards any academic qualification (if applicable)
Does completion of the programme result in a qualification?
Provide details of any professional or educational qualifications that users receive on successful completion of the programme (if applicable)
Where is the programme taking place?
State all venues, including any
International locations - and state whether the programme is to be offered as online/elearning
A.1
A.2
A.3
What is the stated purpose of the programme?
Briefly describe the overarching purpose or aim of the programme
Outline the reasons for developing and
providing this course, for example identification of learning need, lack of existing alternatives, local expertise, CPD, post-purchase training etc.
Who are the target audience?
Describe the target audience with reference
(if appropriate) to prerequisite professional and/or educational qualifications and practice experience
A.4
Content of the programme
Describe the focus of the content of the programme. Please attach copies of any publicity material, and the agenda for the day/course, detailing times, speakers and content. Please note: session titles alone are not sufficient
Key learning outcome: Learning outcomes should provide resource users with a focus and inform them about
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CPA FORM 1/160215 what they can expect to achieve or gain as a result of undertaking this learning. Please describe the intended learning outcomes (i.e. specific skills, behaviours or knowledge it is anticipated the participants will acquire as a result of using the programme). Learning outcomes are best written using action verbs.
A.5
What are the three key learning outcomes for the programme?
(For example, outline/identify/discuss/evaluate/contribute/assess etc.)
1. Participants will be able to:
2. Participants will be able to:
3. Participants will be able to:
A.6
How are learning outcomes measured?
Describe what processes are in place to monitor/measure outcomes (where appropriate)
Stakeholder involvement
B.1 What relevant qualifications do stakeholders (those involved in planning and delivery) of the programme hold? Pleases complete the table below (using the example for reference) for all those (including users or user groups) who have been involved in the planning process
Name
For example A nurse, a user, a facilitator
Role
Chair, course leader, main assessor, tutor, facilitator, user
Relevant professional clinical qualification/experience, for example
RN, MSc Nursing, CNS wound care, lay advisor, patient representative group
B.2
B.3
Describe how key stakeholders’
(developers, presenters and target audience) views and expertise have been included in the development and ongoing quality assurance process.
This should include how the course has been planned, who has been consulted and, if appropriate, the role of a scientific or steering committee.
Please describe how patient/public partnership has contributed to the planning and will contribute to the delivery of this programme
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CPA FORM 1/160215
B.4
Describe how views and experiences of the target audience have been included in the ongoing monitoring and evaluation of the programme (not relevant if this is a new event or programme).
This should include a review of previous evaluations and any amendments which have been made in the light of these.
C.1
C.2
Explain how this application supports
RCN policy, strategy and development
Describe the relevance of the application to nurses, nursing and other health care workers in the UK, and
Europe/Internationally if applicable – see the following link http://www.rcn.org.uk/aboutus/our_mission
_and_strategic_plan/strategic_plan_2013_t o_2018
How does this application support the
RCN Principles of Nursing Practice (as detailed below)?
Describe how the values contained within the RCN Principles of Nursing Practice are applied within your application
Principle A - Nurses and nursing staff treat everyone in their care with dignity and humanity – they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally .
Principle B - Nurses and nursing staff take responsibility for the care they provide and answer for their own judgments and actions – they carry out these actions in a way that is agreed with their patients, and the families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law .
Principle C - Nurses and nursing staff manage risk, are vigilant about risk and help to keep everyone safe in the places they receive health care.
Principle D - Nurses and nursing staff provide and promote care that puts people at the centre, and involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.
Principle E - Nurses and nursing staff are at the heart of the communication process: they assess, record and report on treatment and care, handle information sensitively and confidentially, deal with complaints effectively and are conscientious in reporting the things they are concerned about.
Principle F - Nurses and nursing staff have up-to-date knowledge and skills, and use these with intelligence, insight and understanding in line with the needs of each individual in their care.
Principle G - Nurses and nursing staff work closely with their own team and with other professionals, making sure patients’ care and treatment is co-ordinated, is of a high standard and has the best possible outcome .
Principle H - Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.
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CPA FORM 1/160215
The RCN can only accredit training on branded products where the NHS Trust/employer has already purchased the product or device. For applications other than device training, if there is reference to a branded or generic product, other comparable products should also be referenced.
C.3
RCN Accreditation can only be provided post-purchase, i.e. where the NHS
Trust/employer has already purchased the branded product or device
Are you providing training on a branded product or device?
YES NO
Does the content refer to a branded drug, product or piece of equipment?
If so, have you also included reference to other comparable products?
YES
YES
NO
NO
C.4
Does this application raise any conflict of interest with regard to RCN Policy and Practice?
State any possible conflict of interest with the objectives of the RCN and how this will be managed
YES NO
The Nursing and Midwifery Council (NMC) Code of Practice requires that nurses provide unbiased information to enable patients to make informed choices.
C.5
C.6
Confirm where appropriate that the content of the application adheres to:

Nursing and Midwifery Council (NMC)
The Code: Professional standards of practice and behaviour for nurses and midwives (2015)
NMC The Code: Professional standards of practice and behaviour for nurses and midwives (2015)
Confirm where appropriate that the content of the application adheres to:

Association of British Healthcare
Industries (ABHI) Code of Business
Practice (2013)
YES NO

Association of British Pharmaceutical
Industries ( ABPI) Code of Practice (2015)

Other relevant health and social care codes of practice
YES NO
Other (please state what these are):
D.1
Design and Implementation, Evaluation and Quality Assurance,
Development/Support of Nursing
Please describe, if appropriate, how your application/course/event is/has been made relevant to UK Four Country, European and
International audiences
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CPA FORM 1/160215
E.1
E.2
State what copyright ownership and authorship arrangements have been agreed
State where appropriate how permission has been obtained to use any relevant materials/resources
F.1
What evidence supports the need for this application?
Describe what evidence supports your application (e.g. key NICE guidelines, new research). Please provide key references or links to documents which support your course
F.2
State how this evidence has been used to develop your application
F.3
A suitable system of referencing has been used
YES NO
Assessment of learning
RCN accreditation refers to the learning and development content of the programme. While a learner may demonstrate desired skills at the end of training, it is not possible to assess and certify competence of any individual practitioner.
F.4
Is there any formal assessment of learning included with this programme?
If yes, provide sample material, including details of any pass/fail criteria:
YES NO
F.5
Describe how the assessment of the programme relates to the learning outcomes?
F.6
Is it clearly indicated in the programme that the RCN cannot confirm competence of any practitioner?
Please provide evidence of this.
YES NO
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CPA FORM 1/160215
G.1
Please confirm that you have considered and followed best practice in the planning, developing and implementation of your event/programme in relation to the Equality
Act (2010), anti-discriminatory legislation
(NI), diversity and human rights
YES NO
H.1
Please confirm that you have considered and followed best practice in the planning, development and implementation of your event/programme in relation to health and safety legislation and the identification and minimisation of risk and hazard to event/course participants and service users .
YES NO
I.1
I.2
Please describe the risk management process in place, and how any operational and reputational risks associated with the programme have been identified and mitigated, for example please describe how you have ensured that the content
(knowledge and skills) of your programme is in line with current best practice. You should refer to national professional standards where these exist.
Please describe your procedures should a complaint arise . This should include the name, role and contact details of the key contact person
J.1
Please describe how information from programme evaluation will be managed and used to inform future programmes .
Online/e-learning (please complete the following sections where there is an online learning component to the programme)
Standard: Programmes are fit for purpose and fit for practice
Provide URLs, usernames and passwords so that our reviewers may access the entire resource
SCORM Requirements
Meet at least minimum SCORM (Shareable Content
Object Reference Module) 1.2 standards, and the following is the expected standard:
URL:
Username:
Password:
Any other information:
YES NO
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
successful launch of the course

progress and completion of the gomo course

data to be written to the LMS

last session time

last page accessed (bookmarking)
 user’s final assessment score in the course

learner name and unique ID of learner

progress through individual sections/ topics
(not attempted, incomplete, completed) will be displayed to the user via progress indicators and stored in suspend data field

A SCORM-compliant management learning system (LMS) is a system that can accept any
SCORM compliant content and make it available to users of the LMS and deliver the content to a learner, by providing a runtime environment within which it launches the content - see the following link http://scorm.com/wpcontent/assets/cookbook/SCORM%201_2%20
Overview.htm
Operating System
Which Operating Systems are supported? Windows
XP and above should be supported as well as Apple
OS X (Snow Leopard) as a minimum.
Browser
Which browsers are supported? Eg, 7 is still standard throughout the NHS.
Accessibility/Multi-device
All learning needs to be developed so it meets W3C at a minimum double A, RNIB and BS8878 guidelines. Or, alternatives provided.
Is the learning multi-device and responsive?
If so which devices and operating systems are supported?
Testing and Loading
A specific test plan has been developed and used to confirm that:

course/learning activity is free to software bugs and broken links

course/learning activity runs without error on all supported types of computer, web browsers at the minimum supported specification.

resource needs to take a reasonable time to load on minimum system requirements (less than 10 seconds)
YES
YES
YES
YES
NO
NO
NO
NO
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Online learning guidance includes:

log-in instructions which are clear and easy to understand.

clear and explicit course learning navigation instructions

information to aid how the resource might be used as part of a blended course/learning activity

any required learner support mechanisms, such as additional items around organisation support, content support, and technical, implementation and technical support

indicative time frame

description of the facility to drop in/out/save and restart

printing permission is stated (eg, for use with other HCPs, patients)
YES
YES
YES
YES
YES
YES
YES
Online learning access and use includes:

where appropriate, an optional facility for preassessment of the learner’s existing knowledge, skills or attitudes

appropriate structuring of course/learning activity (sections are meaningful and arranged into a sequence and/or hierarchy that facilitates learning)

relevant, accurate and reliable content which is free of technical, spelling and grammatical errors.

links to a knowledge bank and supporting materials, articles etc.
YES
YES
YES
YES
Do you wish to issue RCN certificates of attendance?
How many RCN certificates do you require?
There are 100 inclusive certificates
YES NO
(Required by RCN Finance)
Finance contact name
Finance email address
Finance postal address
Finance telephone number
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
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Any reference, that needs to be quoted on the invoice
Is a purchase order number required
Purchase order number if required
YES NO
CPA FORM 1/160215
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CPA FORM 1/160215
We hereby apply for accreditation in respect of the Programme described on page 1 of this application form; subject to the Terms and Conditions of Business of the RCN Centre for Professional
Accreditation, which you have provided to us and which we have read and understood.
Please provide a scanned signed copy of this page
Signed by:
Name (please print):
Date:
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