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Admitting fault may allow nurses to avoid NMC hearing

Nurses facing fitness to practise proceedings can now avoid a full hearing if they admit they are at fault, following the introduction of two new measures by the Nursing and Midwifery Council.

Under one of the changes to the system, which came into force today, a nurse can admit that their fitness to practise is impaired and accept a sanction, such as suspension, proposed by the NMC. 

Allegations will have to be admitted in full and details of cases dealt with under the process will be recorded and published in the same way as all other NMC panel determinations.

The regulator believes the move will bring significant benefits, including avoiding unnecessary full hearings and resolving cases quicker – and therefore helping it reduce its historical backlog of cases.

The process is called “consensual panel determination” by the NMC, although it is known in legal circles as “consensual disposal”. It is already used by the General Medical Council.  

The decision to introduce it was agreed by the NMC council in November and was supported by 80% of respondents to a formal consultation held between May and August 2012.

Serious allegations will still have to be dealt with through an NMC public hearing.

Jackie Smith, NMC chief executive and registrar, said the new process would allow the regulator to “fairly and swiftly” manage cases where a nurse or midwife accepted the charges against them.

“This process will encourage nurses and midwives whose fitness to practise is impaired to acknowledge this at an early stage,” she said. “This will reduce the need for witnesses to attend hearings and reduce the length of hearings, enabling us to concentrate our resources on cases where there are significant matters in dispute.

“Consensual panel determination will help us to reduce the overall time it takes to progress a case, enabling us to meet one of our most important objectives of hearing fitness to practise cases in a fair and timely manner,” she added.

The NMC has also introduced a second mechanism for nurses and midwives subject to fitness to practise proceedings that allows them to voluntarily remove their names from the register.

Under the change, a nurse or midwife who admits their fitness to practise is impaired and who does not intend to continue practicing can apply to be permanently removed from the register without a full public hearing.

The NMC has decided voluntary removal will only be allowed in circumstances where there is no public interest in holding a full hearing and where patients are best protected by a clinician’s immediate removal from the register. 

It is likely to be available to those who accept they are no longer fit to practise due to a serious or long-term health condition or are near retirement age. If an application is allowed, the status “voluntarily removed” will appear next to the name of the nurse or midwife in the online version of the NMC register.

Ms Smith added: “Voluntary removal ensures that we can take swift action to safeguard patients and the public and will allow fitness to practise cases to progress more efficiently and cost-effectively.”

Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “Voluntary removal in addition to the introduction of consensual panel determinations will provide more flexibility and allow the NMC to give greater attention to their most serious cases.

“The NMC needs to be as efficient as possible if it is to justify increased registration fees,” he said. “We hope these changes will allow certain cases, where there is no public interest in a full tribunal, to be resolved more quickly.”

Readers' comments (36)

  • is this just to save money? why can't nurses just resign? what has nearing retirement age got to do with it?

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  • Another money-saver from the NMC.
    When will they start to actually support our profession?

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  • won't this push some innocent nurses into admitting guilt against false allegations just to avoid further difficulties?

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  • What do the unions/occy health/lawyers have to say about nurses nearing retirement age or having long-term health conditions being asked to accept they are no longer fit to practice. This is very worrying indeed. Is this just a form of constructive dismissal, what rights will they have? Will they still be entitled to all their pension? what about their reputation and recognition for their years of service?

    Many older nurses and those with long-term health conditions are very competent, caring, energetic and safe.

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  • Different treatment by process if you are approaching retirement age sounds like an ageist policy and therefore potentially in breach of the 2010 Equality Act.

    NMC heading for a procedural nightmare? Surely not?

    It would be interesting to see how many practitioners would actually fall on their sword (that is what they are effectively doing) if there is a reasonable chance that they would actually not receive a sanction. Sounds like people will be gambling on the outcome of an investigation and panel deliberations. We have professionals on these panels for a reason - its about mitigation and reviewing the human factor where things go awry. This sounds like a tool where people can volunteer to commit registration suicide to reduce the amount of work undertaken by the NMC rather than what suits the Registrant regardless of guilt or innocence.

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  • George Kuchanny

    The important part of this article is “This process will encourage nurses and midwives whose fitness to practise is impaired to acknowledge this at an early stage,” - From my perspective this is a very good thing. Those of us who deny error having made one should be dealt with more harshly than those who admit and learn. Full stop. I agree with other comments where someone who is completely free of error might admit to one. Please please do not. As for the so called ageist component, I do not think that it is frankly. Retirement on ill health grounds is available to those of us who think our competence is impaired by advancing personal health issues (by the way I am very long in the tooth myself!). The real issue here is those who are incompetent and WILL NOT admit it even though they are putting people at risk.

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  • I can't get my head around this.

    Are they saying that, for instance, a nurse makes a drug error - she is coming up to retirement age so the NMC will push her into believing she is too old, therefore obviously past her best and therefore incompetent? She is then forced to voluntarily remove her name off the register which would obviously then lead to her being forced to retire/resign.

    If a younger nurse makes the same error they will be subject to a full enquiry with all the legal and union support we all deserve - regardless of age.

    Nurses are expected to work until they are 65, which is not our choice, are we all to be discriminated against now as well and being made to feel useless.

    Isn't this just a case of 'go before we push you out'.

    Who were the 80% of respondents? How many of them were nurses with long term health conditions or coming up to retirement age?

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  • If a nurse makes an error then they need support, it doesn't matter what age you are. It is against the law to discriminate on the grounds of age. Nurses are expected to work until they are 65, if the NMC or anyone else doesn't believe that is safe then lower the age or place us in positions where our skills would be appreciated such as in the role of 'care maker'.
    I would like to know who these 80% of respondents were?
    Older nurses have a wealth of experience and knowledge, if they make an error then they should be treated the same way as a younger nurse, anything other is clear discrimination and is very patronising.

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  • Anonymous | 14-Jan-2013 1:35 pm

    excellent comment.

    I would like to know what the NMC, an employer, a manager, a nurse consider an error. What human being does not make errors? Everybody during the course of their career will commit errors and more so if they are working under pressure.

    there is a difference between an intentional error, an accidental error and an error due to negligence. where are the fine dividing lines?

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  • furthermore, if one commits an error which will affect the patient one reports it to the team, reports it to the treating physician and records it in the patient's notes. normally the course of action to take is decided with the doctor and unless it is detrimental to the patient and serious should not need to go any further. What is the issue with this?

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  • michael stone

    'Serious allegations will still have to be dealt with through an NMC public hearing.'

    Presumably the 'Consensual panel determination' is intended to not necessarily suspend nurses, but to simply check that the nurse has corrected his/her defective practice ? Which would tend to make sense, if it avoids prolonged NMC referrals over less seriosu matters ?

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  • @Anonymous | 14-Jan-2013 12:57 pm

    Absolutely right. As someone unfortunate enough to have gone through one of these panels, I was lucky to be a fairly resilient person. I can see someone with less confidence or coping skills opting for the easy way out.

    Its a bit like the inexperienced accepting a Police Caution thinking its a slap on the wrist. Its effectively a conviction without a sentence that appears on your CRB. I have known a couple of people who shouldn't have even had that happen to them but when offered "the easy way out" have taken it and regretted it since.

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  • tinkerbell

    “The NMC needs to be as efficient as possible if it is to justify increased registration fees'.

    Are they increasing our fees?

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  • Anonymous | 14-Jan-2013 12:57 pm

    You should not admit to things you did not do !

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  • Anonymous | 14-Jan-2013 3:38 pm

    precisely, but I foresee situations where some nurses may be put into a position where they are bullied into it just to save their jobs and careers. Hopefully I am wrong.

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  • Anonymous | 14-Jan-2013 3:12 pm

    I believe there are financial incentives for police who give somebody a slap on the wrist and the more the better. once these are on record they apparently cannot be removed. The word of the innocent against that of the authorities!

    did you hear the case some time ago of the Mum in the playground with her young kids playing quietly and her toddler crying for an ice cream on a boiling hot day. the boys were fine (not sure what age they were but they were much older than toddlers). She took the little one over the road for just a few minutes to buy ice cream. When she returned the kids were being questioned by two bobbies who had their notebooks at the ready. Although they took her details, there appeared to be no problem and she forgot this incident until several years later when she applied for a job in a crèche or nursery school and was refused because of this and although she tried to clear her records was unable to so and is no longer able to get any job involving children! I am sure this is not an isolated incident. Our country has gone totally mad - very sadly!

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  • tinkerbell | 14-Jan-2013 3:30 pm

    funny you should say that. yesterday I heard a programme on the radio about providing good service and a listener suggested wherever these are automated, such as the cash checkout in a supermarket, a reduction should be offered or at least extra bonus points on the cards.

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  • Can't remember this consultation, oh like all consultations, no discussions just informing us what will happen + for us to make some sort of input and to look like we agree to it. Bit like the fee rise consultation, that I didn't want either.
    Probably 80 people agreed out of 100 respondents, from all the registrants.
    Sounds like they want to engender a culture like in Japan, where people would just admit to anything even when innocent, end up being fine / imprisoned for things they didn't do, because the authorities are always right and that there is less stress than being lent on. Get real, dangerous people aren't going to admit they done anything wrong + might drag out proceedings as they've got nothing to lose. Innocent / more caring people are more likely to get investigated or even struck off, sometimes already due to self-reporting as theyre more conscientious. Nothing here about how to improve practice for those who want to stay in practice. The really dangerous people are those that cut resources, badly manage people + facilities, bring out poor policies, and expect same quality of care.
    I suppose its another way out + not having to pay the £100 fee from next month.

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  • All staff, at whatever level or grade, should admit to making an error. That includes HCAs, trained nurses, nurse managers, governing bodies, regulatory bodies, Trust management.

    all 'errors' made by ANYONE should be dealt with fairly, without prejudice, objectively and professionally.

    Mitigating factors must be taken into account such as staffing levels, skill mix, pressure of work, interruptions, lack of support, lack of knowledge due to nurses being forced to cope in unknown or unfamiliar situations, increased stress levels due to any of the above.

    To expect near-retirement nurses to be treated differently is unacceptable.

    The NMC need to weed out inappropriate referrals and their own incompetent staff.

    I am sure we can all quote cases when competent and caring older nurses or those with health problems have been got rid of.

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  • In renewing our license to practice (paying for something to lose), as we lose our jobs if we don't, not only it will cost us more, it will cost inland revenue as your tax deductable allowance also goes up. So don't forget your claims for last 5 years if your eligible. Loads of eligible aren't claiming and the government isn't going to remind you as they keep your money in their coffers.

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