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Worry grows as second senior nurse leaves NMC

Concerns have been raised about a lack of nursing leadership at the top of the Nursing and Midwifery Council after it emerged another senior nurse had quit the troubled regulator.

Nursing Times has learnt that NMC director of standards and registration Roger Thompson has resigned.

A learning disability nurse by background, Mr Thompson had been with the NMC and one of its predecessors, the English National Board for nursing, midwifery and health visiting, since 1995.

The NMC declined to give a reason for his departure, which preceded that of former chief executive and registrar Dickon Weir-Hughes, whose resignation was announced on 12 January.

Their departure leaves director of education Rita Newland as the only member of the NMC’s executive team with a nursing background.

Director of fitness to practise Jackie Smith has been appointed interim chief executive, while assistant director of policy and standards Katerina Kolyva is acting up in Mr Thompson’s role. Neither have been on the nursing register.

Royal College of Nursing head of policy Howard Catton told Nursing Times it was “crucial” there was “strong professional nursing leadership” as part of the NMC’s senior team.

Unison head of Nursing Gail Adams said: “There is an insufficient number of nurses at the NMC at a senior level…registrants will be concerned whether they have an understanding of the issues.”

She also criticised the regulator for not formally disclosing Mr Thompson’s resignation on 2 December.

Ms Adams said Unison had a good relationship with the interim leaders but would want to see a nurse in the director of standards and registration post, and a more representative board with either the chair or chief executive a registrant.

A spokeswoman said the NMC would be reviewing its “arrangements” for the standards and registration post later in the year.

As revealed by Nursing Times last week, the NMC has been placed under review by the Council for Healthcare Regulatory Excellence. Its review is expected to focus on the NMC’s failure to clear a backlog of fitness to practise cases.

An NMC spokesman said its project work had been halted and was “under review”.

This includes its review of the third part of the register for health visitors and other specialist community staff.

Ms Adams said it was right for the NMC to “park” some projects and focus on improving fitness to practise delivery in the short term.

An audit of the NMC in November by the CHRE found there were still “areas of significant weaknesses” in its handling of cases.

Alison While, associate dean at the Florence Nightingale School of Nursing and Midwifery at King’s College London, said she hoped the review would help the NMC to reflect on what its “core mission” should be.

She said there was a risk that extending its role, for example by regulating healthcare assistants, could distract the NMC from its main role of licensing nurses and midwives.

However, others expressed concern about the delay to the review of the third part of the register.

Unite lead professional officer for health visiting Obi Amadi told Nursing Times it was “disappointing”, as it was an important part of plans to expand the health visiting and school nurse workforce.

In a speech last autumn, Professor Weir-Hughes said the third part of the register was a “shambles” and in urgent need of reform.

He was also an outspoken supporter of the mandatory regulation of HCAs, a policy not supported by the CHRE or the government. The NMC “clarified” its position on HCA regulation in a letter to Nursing Times this month, noting that its council had not formally agreed to pursue it as a policy.

Senior nurses from organisations that work closely with the NMC told Nursing Times they had not been surprised to learn of Professor Weir-Hughes’ departure, as they had been aware of tensions within the NMC, one of which was HCA regulation.

Chair of health services research at Southampton University Peter Griffiths said the NMC’s interest in HCA regulation had been unwelcome in “certain circles”.

“They may have left themselves open to some criticism,” he said. But he added that he thought wherever “nursing work was being carried out”, including that by HCAs, it should be considered a “matter for the NMC”.

Readers' comments (32)

  • The NMC needs representation from the shop floor - nurses who have to cope with the reality of nursing today not who live in cloud cuckoo land.

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  • you can't have our leaders at the NMC just walking out without giving any reasons. we have paid to employ them!

    I feel sorry for the HCAs and all the controversies surrounding their position. how can anybody in a ward team work well in such an unstable environment and with so many uncertainties?

    Instead of having a third part to the register why can't the nmc have separate branch dedicated wholly to standardising the training and registering all those wishing to work as nursing support workers on the wards so that they can have a safe and properly regulated profession of their own instead of being treated as underlings.

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  • This is very worrying,already there are too many non-nursing or medical people in high brow positions,determining what health care needs.
    If all nurses refused to pay their registation fees till suitable mangement are in place,that would cause more need for a shake up than any strike action ever could.
    What would they do suspend us all??????
    Some of our precious pay gives these people their high salaries,they leave at a drop of a hat and none of us no why.
    The NMC is my representative,sets standards i have to work by,i want to know whats going on.
    Tell you what i'll do the job,my background is purely nursing,frontline nursing cant make more of a mess than whats happened already!!
    Hey that would be novel a nurse runnning the NURSING and MIDWIFERY council,mmm thinking out the box here.

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  • The NMC has been in trouble since the abolition of the ENB and the other UK counterparts and the change from UKCC to NMC so this is not new. AS FOR PUTTING the Director of fitness to practise Jackie Smith in charge - how come? It is her section that is being criticised for not performing on the backlog of cases. It i s disgraceful as some of these nurses will need to be stopped from nursing as found unfit and so the NHS will not be paying them on suspension but some will be able to return as either found fit to practise and can rejoin the workforce or need retraining of some sort. By the way, we do not work on a shop floor. We are professional nurses. Using terms like this makes nursing sound like a production line or ordinary business. YES, we need experienced nursing professionals at the NMC. YES, it would be good to know why the top nursing brass have left but presumably there may be legal or personal reasons why they have gone which can't be revealed. YES it would be good to know. Is it rattle throwing or disagreements working on behalf of nursing as a profession? Want to be treated like professionals then we need to write and speak like them to gain respect which is at an all time low (not to mention low paid and low profile.) Likewise, why pay and treat nursing support staff as second class workforce? Why not train them properly towards a fully recognised nurse and just not learning a task and doing it in isolation? This harps back to the task allocation format of nursing in the old days! I think we should have a two tier level of nursing again but then those who want to upgrade to a first level trained nurse can do so not like the previous SEN level, those that don't can remain as second level but all levels of nurses will be trained in a more holistic and standard way and actually act on nursing assessment. Let's face it we have so many less than adequate nurses who are meant to be trained so why not give everyone a decent training and pick out the good ones and get rid of the less than good? There would still be room for nursing assistants who could assist with the hands on and other ward tasks.

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  • cheryl mundur | 24-Jan-2012 11:54 am

    I agree. if you have never trained and worked in nursing and on the front line with patients how can you possibly know what the needs are, except at a theoretical and analytic level, which in no way reflects the reality - and all that for far more pay than an RN! The whole health service regulation and management is totally topsy-turvy to the serious detriment of the patients it is supposed to be caring for and to the staff employed to do the caring!

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  • If they have left suddenly (2 of them!!!!!!) for personal/legal reasons just say so without disclosing of course,we'd understand that,but to say nothing is bound to make us wonder what is going on.

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  • I would also agree the NMC is an organisation for 'Nursing' how can you have people with no or minimal nursing background in charge. Yes you need experience in senior positions or management but without grass roots/shop floor experience how can you have any idea of what matter to nurses/midwives.
    As cheryl says we pay their salaries we should have and must have a say in who they are and how they work.

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  • The NMC has not behaved as it should since it was set up in a different way. This happened just before the discussions to introduce Project 2000. Believe or not this Project 2000 was a pilot and supposed to be evaluated before being the status quo for nurse education.
    However, it never was - thanks to the UKCC/NMC and nursing practice has gone significantly downhill ever since.
    There seems to be absolutely no champion for value based nursing education and practice - the RCN changed its direction during the Chairship of Eirlys Warrington and became focussed on trade union activities. Other than few knee jerk publications on professional issues after other organisations and government have raised concerns, it really is not the lead for nursing anymore - in fact no UK organisation is.
    I have absolutely no respect for the NMC, its activities or its people as they have totally wasted my fees.
    I intend to ask for my money back as I have just paid it!!

    I would like to respond to the person above who said that "already there are too many non-nursing or medical people in high brow positions,determining what health care needs."
    Sadly the Nursing Profession has not behaved like a true profession and recognised the role of the observer - the public - in their experience of nursing practice. Until Nursing does that - it's voice will be become weaker and weaker.
    I greatly value the role of 'non-nurses' and 'medical' and "high-brow' and the public in their perceptions of good care. Without these views how on earth would I know that I was trying to meet their needs appropriately and with compassion?

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  • i agree with anon 12.40 re the value of non-nursing etc but i dint think they should be in charge

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  • Nurse told what to do by arrogant Prime Ministers, dubious Health Ministers; being led by rancorous toffee nosed medics; now the registering body is being taken over by traffic wardens; whatever next?

    Someone needs to syringe the doughnuts out of the ears of these people and get some sense into the organ they keep hidden under their highbrow facist skulls.

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  • The NMC has not behaved as it should since it was set up in a different way. This happened just before the discussions to introduce Project 2000. Believe or not this Project 2000 was a pilot and supposed to be evaluated before being the status quo for nurse education.
    However, it never was - thanks to the UKCC/NMC and nursing practice has gone significantly downhill ever since.
    There seems to be absolutely no champion for value based nursing education and practice - the RCN changed its direction during the Chairship of Eirlys Warrington and became focussed on trade union activities. Other than few knee jerk publications on professional issues after other organisations and government have raised concerns, it really is not the lead for nursing anymore - in fact no UK organisation is.
    I have absolutely no respect for the NMC, its activities or its people as they have totally wasted my fees.
    I intend to ask for my money back as I have just paid it!!

    I would like to respond to the person above who said that "already there are too many non-nursing or medical people in high brow positions,determining what health care needs."
    Sadly the Nursing Profession has not behaved like a true profession and recognised the role of the observer - the public - in their experience of nursing practice. Until Nursing does that - it's voice will be become weaker and weaker.
    I greatly value the role of 'non-nurses' and 'medical' and "high-brow' and the public in their perceptions of good care. Without these views how on earth would I know that I was trying to meet their needs appropriately and with compassion?

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  • this now confirms to me that I made the right decision in not renewing my registration and paying my fee at the end of 2011. I can now use the money for something more beneficial.

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  • @anonymous 2:15 and I believe 12:40

    Debate, sharing of ideas, collaborative benchmarking and audit, muti professional and discplinary input to conceptual goals to achieve a desirable level of care, compassion in nursing is different to people who are NOT nurses providing leadership, investigation without experience of doing the job.

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  • Nursing practice and the teaching of nursing and caring has got steadily worse over the years. I still believe that nurse training and clinical skills are best taught in a School of Nursing and hands on in a ward situation.
    Let's get back to basics, caring for people and their relatives with compassion. I'm all for nurses having degrees ( I have Bsc Hons Psych) but let's look after people as we'd like our loved ones looked after. Common sense went out of the window years ago, time to bring it back. I'm and SRN paid £17 for life when I qualified in 1976, can I have all my money back please?

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  • kathleen flanagan | 24-Jan-2012 7:39 pm

    I agree, I qualified for life as an SRN and registered with the GNC and now I lapsed my registration with the NMC at the end of the year rather than resigning completely, as I am no longer practicing but one never knows what the future might hold. I received a photocopied letter with Dicky Wier's signature telling me in no uncertain terms the difference between a qualified nurse and a registered nurse. they graciously point out that I am still considered as a qualified nurse but as I am no longer on the register I am not permitted to call myself a registered nurse or use the initials RN after my name. Prior to this I received another letter from them with all their warnings of what would happen to me if I committed fraud and tried to practice, how I could not lapse my registration if I was wanted for malpractice, etc. It seems that we are all potential criminals and fraudsters until it is proved that we are not!

    In the NMC's own wording 'When a registration is lapsed, you do not 'lose' your qualification, but you are no longer entitled to call yourself a registered practitioner or cite your previous registration with your name. It is important to distinguish between your qualifications and your registration status. With a lapsed registration, you can still refer to yourself as a qualified nurse, ... as long as you do not try to give the impression that you are registered or cite your previous registration with your name."

    It then goes on at great length and in a very antagonistic manner to let you know how to re-enter the register which I am sure I will no longer wish to do as I am also registered in Europe where I would prefer to practice and where the NMC is possibly recognized but not essential. they graciously offer further assistance if you call them but you have to be 'kind enough to have your PIN number to hand' which you presumably no longer are entitled to if you are no longer on the register!

    I think the SRN hospital based nurse training i received was excellent and has always stood me in good stead throughout my long career, most of which was abroad in a university hospital which offered good CPD opportunities, excellent working conditions together with the facilities and resources to provide the highest standards of care in collegial and congenial interdisciplinary teams and I returned to the UK to put an MSc in management under my belt as well although my bent is still towards basic nursing care but also with an interest in research and evidence based care. As for management I prefer to observe those in higher places and try and lead by example from the bottom up which was emphasised on our master's course and which I consider just as important as the other way round.

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  • Steve Williams

    Anonymous | 24-Jan-2012 11:56 am AND Anonymous | 24-Jan-2012 11:56 am - tl;dr

    (see http://encyclopediadramatica.ch/TL;DR )

    if you don’t understand the reference. Try using paragraphs in you messages at least! Obviously you have never had to write and speak like a professional (RN) before.

    Oh yes, in case any one is wondering - it‘s not a degrading term - “working the floor” is an old nursing term that means the same as “working on the front-line.” It means getting “down and dirty” none of which are euphemisms for working in a factory, fighting in a war or engaging in sudorific practices that ultimately involve the exchange of bodily fluids.


    Now down to the topic in hand...


    I have no idea why two of the top people at the NMC have suddenly “bailed” with no clear explanation... it makes me think of sinking ships and those types of low-life beings that desert them (Italian Captains and rats!)

    Why our esteemed leaders and “protectors of the public” left in such a inexplicable hurry “sans raison” is not my prime concern. Nor is the fact that the head of a “failed” NMC department now going to be running the whole organisation. I can even put the fact that “The Nursing and Midwifery Council” now has very few Nurses or Midwiffs in it!

    My beef is with the fact that the NMC is in fact a QUANGO.

    Just in case you thought that “Quango” was a tropical version of that orange fizzy drink called “Tango” it actually means “quasi-autonomous non-governmental organization” which means... it is “an organization to which government has devolved power” which means... it is a "non-departmental public body" or NDPB.... which means it’s members are appointed by the government... which means YOU (the RNs) don’t get a say in who runs it - even though YOU pay their salaries!

    Ah, therein lies the rub... Alas poor Democracy - I knew him well Horatio: a fellow of infinite jest, of most excellent fancy.

    See even the Ameritards initially had it right at one point. Uncle Abe in his famous “Flame Fried Gettysburger Address with Fries and a Coke to go” speech said “government of the people, by the people” which was merely a continuation of the Westminster version of democracy anyway.

    But think on... How many institutions that govern some aspect of your life can you NOT influence?

    Okay - so the obvious biggie is the government. Well you have the right to vote if you are over 18. The same goes for your local council. In fact if you join a protest group you can get both of those to change their mind (remember Maggie’s Poll-Tax riots?)

    What about your gas, electricity or telephone provider? You can change providers. You have that right!

    The same goes for just about every other service you pay money for to enjoy. Annoyed with Unison - join the RCN (or vice-versa) - annoyed with their leadership - vote for someone else.

    Ultimately... If you have a real problem with something or someone you can take them to civil court and thereon upwards!

    When it comes to “The Nursing and Midwifery Council” what choices have you got then?

    Zippo, nada, zilch, diddley-squat, tee-pee in a hurricane, frozen milk-product in Hades, the aforementioned freezing over, Gordon Brown winning a Miss UK bikini contest, The Pope being Protestant... in fact as much chance as Gary Glitter getting a Twitter account and another #1 hit in the pop charts.

    YUP!!! You’ve got absolutely NO choice when it comes to representation on the professional board that supervises your professional regulation, standing and reputation.

    Let’s put it simply (for people like Anonymous | 24-Jan-2012 11:56 am AND Anonymous | 24-Jan-2012 11:56 am) the government (should they so wish) could actually appoint people from a real factory “shop floor” to the NMC and there is not a damned thing RNs could do about it apart from write letters to the NT - which is like urinating against a gale force!

    WEIRD isn’t it?

    Yet in other countries they have a different system. Take Ontario - Canada - for example. Their professional body (The College Of Nurses Of Ontario) holds elections from their RN membership every three years. They issue four magazines a year (included in the sub) - have a complaints procedure (against the CNO) and have online RN subscription and verification.

    Ontario actually has twice as many Registered Nurses as the UK does and virtually all of the other Canadian Provinces have the same, if not better systems in place.

    So why has the UK once again lagged so far behind other countries when it was once the vanguard of Nursing?

    I have no clear understanding - and you are a better man than I Gunga Djhinn if you can come along and explain it.

    Alas, what is really clear, is that RNs in the UK are being used, by the NMC, as “cash-cows” to fund the system.

    Perhaps - like someone in an earlier posting mentioned - the threat of a union-backed “joint" withholding of the next NMC renewal fee just might give them the shits!


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  • I suggest the whole organisation should be shut down with regulation transferred to a single health regulator. The costs of a single regulator should be very low and this would make it more straightforward for professionals to be dealt with equitably in terms of fitness to practice etc.

    We have seen nurses receive a sack/strike off first, establish guilt later when medical staff have kept posts for years despite serious wrongdoing (even if suspended on full pay).

    We have seen our fees go from the fee for life we paid at registration (which many of us paid) only to be told a year or so later that we would have to pay a 3 yearly fee, now annual! Each time the fee has risen faster than nursing salaries and few have seen benefits from the AFC reorganisation of salaries which were meant to give reward for additional skills and roles, instead the employers keep re-baselining roles so that now many roles formerly undertaken by medical staff attract a Band 5 at best.

    Our professional organisation has done nothing memorable since its establishment to improve care for patients or the profession of nursing. RIP NMC

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  • Steve Williams

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  • In which case he should have been sacked and sued for misrepresentation and misuse of the title Nurse. No wonder the NMC have been so slack on protecting the roles of Registered Nurses and Nursing titles.

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  • Steve Williams

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