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NMC fails to rule out fee rise in quest to clear FtP backlog

The head of the Nursing and Midwifery Council has promised to go “back to basics” to tackle the mounting backlog of fitness to practise cases – but warned it could take up to three years and a fee rise could not be ruled out.

Speaking following the launch of the interim report of the Council for Healthcare Regulatory Excellence’s strategic review of the regulator, NMC acting chief executive Jackie Smith said they would be pausing or stopping all non-essential work to focus on tackling the backlog of around 4,000 cases.

She accepted the report’s findings that projects such as campaigning for the regulation of healthcare assistants had “distracted the NMC from its core functions”.

“The report reflects the fact that the NMC had lost its way and perhaps focused on non-core priorities. The NMC has a problem; that problem is fitness to practise and until we sort it out we should not be focusing on activity that deflects us from that functions… We need to get back to basics,” she said.

The review was ordered by the Department of Health in January following the departure of chief executive and registrar Professor Dickon Weir-Hughes, a registered nurse. He had been an outspoken campaigner for HCA regulation.

The NMC has also stopped plans for a student index, designed to keep track of individuals who have moved between universities, and halted its critical standards intervention programme, which was set up in the wake of high profile nursing care scandals to look for systemic failure in organisations. It is also looking at reducing the amount of guidance and advice it issues.

However, Ms Smith was unable to guarantee there would not need to be a hike in registration fees to cover the costs of bringing the FtP backlog under control, something she estimated could take “between two and three years”.

“Fitness to practise requires a significant amount of money. We are reviewing our resources practically on a daily basis and will be taking a financial strategy to our council in June… The strategy will have to look at fees.”

The CHRE’s interim report was critical of the relationships between the NMC’s chief executive and his team, council members and NMC staff, some of whom reported they were reluctant to approach the chief executive with concerns. The report also criticised former chair Tony Hazell, who resigned three weeks ago, for failing to provide necessary leadership.

The report recommended the posts of chair and chief executive be filled on a permanent basis “swiftly”. But it said there was no need for either of them to be registrants, which is likely to fuel fears about the loss of professionally led regulation. Both Unison and the Royal College of Nursing have previously signalled their concerns over the issue.

However, the report also recommended that the NMC consider splitting the role of chief executive and registrar into two.

CHRE chief executive Harry Cayton said there was “no reason” the posts should not be held by a nurse or midwife, but it was “not necessary” to do the job.

He said: “Professionally led regulation has been dying for some time. It’s about shared regulation between the professions and the public. I’m certainly not suggesting that there shouldn’t be 50% of the council from the nursing profession.”

In addition the report recommended that the NMC’s 14 member ruling council be reduced in size.

Unison head of nursing Gail Adams said the NMC needed to be in a “strong position” to ensure it was “fit to carry out the vital role of self regulation for nursing”.

“The interim management team have done a good job but the appointment of a permanent CEO and chair will give the NMC stability and impetus to help make progress,” she said.

She added that Unison “recognised the hard work” done by NMC staff but said there had previously been a “lack of effective focused leadership at the very top”, which in turn had “undermined their ability to deliver the essentials of regulation”.

“The CHRE make some strong criticisms and we want the NMC to improve its transparency. It should be the norm there as it is in other organisations, for decisions to be deliberated and decided upon in public.

“To date they have carried out many of their deliberations behind closed doors and, while the public may have been able to read about outcomes, they have not been able to question those decisions.”

Readers' comments (41)

  • tinkerbell

    it seems we have to pay for everyones elses incompetency, whether that be the bankers, this misguided government and now the NMC. We're just the low hanging fruit, pop your purse open.

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  • will it be subsidized or an interest free loan offered?

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  • Yeah more money to be paid out......i need to win the lottery

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  • Its far too expensive already. When I qualified in 1985, we were told that that we pay £65 to register, and then that is it for life! What a big, fat lie that was.

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  • Fit for purpose? Or just fit to raise as much money as possible from us??

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  • Yes when I qualified in 1964 I paid what I was told was a lump sum to register Not £75 every year Where did this come from?. I was working on bank after retiring but got so little bank work because of cutbacks it was daft to be paying £75 to stay on register .I quit ! best thing i ever did No stress anymore.

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  • When i qualified in 1998 it was £37 every three years , if i recall correctly.

    Now £75 every year.

    They should pay us to stay on the register, if it keeps increasing ppl will leave

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  • all those who paid a one off lump sum to register as an SRN for life with the GNC should get a full refund for all the subsequent fees paid tri-annually and annually to the UKCC and the NMC! They should also have the right to retain their original qualification of SRN for life as our predecessors did!

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  • The NMC have been talking about this for a few years now seems like they've found an excuse to now. Didn't they spend a fortune recently upgrading to swanky new offices?. It wouldn't be so bad if we still got the little booklets like the ones we used to get periodically from the U.K.C.C. at least you thought you were getting something for your money. All we seem to get from the N.M.C. is begging letters saying how overworked and poor they are. 3 years 7 months and counting to retirement day.

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  • NMC unfit to practise more like!! Yes paid one off fee when I qualified in 1981..change the name of the organisation supposedly regulating the profession & They can charge what they like then! So be prepared for a huge rise & guess what a salary freeze for the foreseeable future..wouldn't recommend nursing but then who will look after me when I'm old & crumbly hobbling around the ward?!

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  • huge rise?

    £76 p.a. is already fairly substantial sum!


    sad to think there will soon be very few or no SRNs left in practice other than those courageous enough to work beyond retirement age.

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  • Having recently appeared as a witness at an NMC hearing I was appalled at what I percieved as a very inefficient way of conducting hearings. I felt that money and time was wasted without thought. Myself and 7 others had to travel to London, be put up in an expensive hotel for two nights and spent a lot of time just sitting around in a room without really being told what was happening, in my opinion this could have been dealt with locally and without incurring all the expense which ultimately I and my nursing colleagues are paying for, whilst I fully support the need to have a governing body and this must be paid for somehow I do feel that there is also unecessary waste of our registration fees.

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  • We nurses are becoming a cash-cow for the fat cats at the NMC! We should not have to pay increasing costs for others' failings. We're hearing so much about 'Payment by results' of late.... how about turning it on the NMC? :-/

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  • I think that the NMC need to seriously consider their position, as many nurses, midwives and health visitors are not confident in their ability to prioritise what exactly their function is.
    The Fitness to Practice hearings are certainly a very important area that they SHOULD have been focusing on and then we would not have the 'backlog' that is presenting at this current moment in time.
    They seem to think that (in view of the suggestion in the raising of fees) nurses etc., will just agree to pay higher fees, at a time when the current economic situation for most of us is dire!
    They should stop wasting our hard earned money and postpone HCA regulation and deal with the mess they already have and once resolved, then take up the case for HCA regulation at a later date.
    I think that the NMC need to wake up and show some respect for the people who contribute to their wages and indeed to very existence and once they have proved that they can be trusted to carry out what they are supposed to do ...regulate the profession THEN and only Then will they deserve respect from nurses, midwives and health visitors .

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  • Ellen Watters

    £76 is a fair whack from my wage. I have asked about paying a smaller amount by monthly direct debit but was told this was not possible.. Why not.???

    It's getting ridiculous with all the other financial constraints, surely it doesn't involve too much to take say a tenner a month for 8 months..

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  • I too paid a one off fee in 1978 when I first registered and was told it would be for life. I understand that nursing has changed and so has society sadly. We have gone the way of America (as we always do) - Letigious and that is why we have to pay annually and there are fitness to practice procedures. I am not saying it is wrong but I do feel money is being wasted on expensive barristers for these proceedings. Who's pockets are we lining?
    It is time the NMC produced its accounts to all it's members so that we can see where our money is being spent. Thank goodness I retire in a couple of years. I am unhappy with the way nursing is going and would not now recommend it as a career. It was always thought of a worthwhile profession in past years but not anymore.

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  • how is a rise justified?

    although it was a very difficult decision after devoting my life to nursing, I am glad I dropped mine in October last year as I found better things to spend my money on where it was needed.

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  • P Rogers

    It might just be my age but I have a feeling of déjà vu – does anyone else recall the exact same shambles that preceded the demise of the UKCC?

    For those who don’t our last regulator managed to create a massive backlog of FTP cases (but only a couple of years worth) claimed they needed a lot more money to sort out the mess, hiked the registration fee then dissolved to be reincarnated as the NMC who were going to be oh so much more efficient… and so the cycle continues. Time for another clear out at the quango!

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  • I think its time that we all said enough is enough and refuse to pay the registration fee seeing as we're not seeing value for money. I too can recall the shambles that the UKCC left and we had to pay for that as well.

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  • If you read the interim report you will see that there has been an over 50% rise in referrals for Fitness to Practice Cases and no additional money...comments about life time registration seem to miss the point. It is in our interests as a profession to have a strong and effective regulator. The NMC had no other form of funding other than the registration fee, so no wonder Jackie Smith wouldn't commit to not raising the fee. Has the organisation been badly run? Yes. Has the NMC ever sorted out a historical mess from the UKCC ? No. Should we as a profession spend our time with anachronistic moaning ? Absolutely not. The NMC is not a trade union, nor is it a professional body there to represent nurses and nursing. It is an independent regulator and needs to be supported to do this clearly descrbed job. If this means a modest rise in the annual fee, so be it. Some nurses need to grow up a bit. If paying around £75 a year and/or a modest fee rise deters people from re-registering then there is something wrong with their priorities and maybe they don't belong in the profession anymore. I am sick of seeing nursing and the reputation of nursing sullied by a poor regulator. If they take this opportunity to sort it out once and for all then it is for all our benefits.

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