'NMC review must hear nurses’ concerns about their regulator'

I have nothing but respect for the dedicated, hardworking staff at the Nursing and Midwifery Council. Having worked closely with them, I know firsthand their commitment to nurses, midwives and patients. But I also know that there are problems we need to resolve – something is obviously wrong with an organisation when it needs two governmental reviews in just four years.

The largest regulator of nurses and midwives in the world, the NMC covers 680,000 registrants and has an annual budget of nearly £55m. Unlike the rest of the NHS, it doesn’t face demands to find billions of pounds in savings and it won’t have to axe staff. It should be the healthiest organisation in the service, but instead it appears to be blighted by crisis and problems.

Unison believes in self-regulation. It is right that nurses, midwives and health visitors set their own standards and manage themselves, just as doctors do. This is why we are committed to working with the Council of Healthcare Regulatory Excellence and the NMC every step of the way on this latest review.

But make no bones about it, the CHRE must be able to go wherever it wants and leave no stone unturned. If we are to put things right, the review must hear loud and clear from nurses and midwives about their concerns, as well as from external organisations. Unison will be encouraging its members to make their voices heard at all stages.

‘Like others I pay my £76 each year. In return I expect a self-managing organisation that holds the respect and confidence of all. Patients and staff deserve no less’

It goes without saying that in the health service, the needs of patients must always come first. But this review must also put at its heart, the staff whom the regulator is there to serve. As a body the NMC receives no government funding – instead every registered nurse, midwife and health visitor must pay £76 each year if they want to practise. In exchange, the NMC must play a role in championing the profession’s work – education, standards and registration are just as important as fitness to practise. And action must be taken here if we are to move forward.

The fitness-to-practise process must become quicker, fairer and more transparent – not only to make sure that it can respond properly to patients’ complaints, but also to reflect the stress that is felt by all parties, including nurses and midwives during the process. If we can conclude cases quicker, and work together where registrants acknowledge mistakes we can start to move forward.

Part of the solution is how the regulator manages itself. What we need to see is real leadership that will give the organisation - from its chief executive down - a clear direction. The NMC needs to find a new way of identifying and agreeing organisational priorities, and a method to allocate its budget to reflect those priorities. Strong governance is needed so that everyone is properly held to account.

Staff also need to be appropriately managed and supported to develop and deliver the organisation’s goals - they must feel respected, valued and listened to. Unison also believes the regulator must work to engage more effectively with stakeholders, so that it can gain the trust and confidence of patients, nurses and midwives.

Unison will make sure it cooperates every step of the way to help give patients, health workers and the public the reassurance of a strong, effective regulatory body. But we are clear that this must be the last review the NMC has to undergo. Rightly, the profession will not allow any more.

Like others I pay my £76 each year. In return I expect a self-managing organisation that holds the respect and confidence of all. Patients and staff deserve no less.

Gail Adams is head of nursing at Unison

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