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New powers for NMC to speed up FTP cases agreed by health secretary

The Nursing and Midwifery Council is to get new powers designed to speed up the fitness to practise process in the wake of the Mid Staffordshire scandal, it has been announced.

Prime minster David Cameron promised to reform the NMC when he responded to the publication of the Francis report into care failings at the Mid Staffordshire Foundation Trust in February. He demanded to know why at that point no nurses from the trust had been struck off.

Only one registrant who worked at the West Midlands trust has since been removed from the register while 11 out of 15 cases where the NMC found there was a case to answer are still ongoing, four years after the scandal first broke.

Mr Cameron asked the Law Commission to review the NMC’s “outdated and inflexible” decision making processes. However, there were concerns any recommendations could take up to four years to implement.

In a letter to Labour MP John Healey, seen by Nursing Times, health secretary Jeremy Hunt confirms the changes will be bought forward.

“In light of the recommendations in the Francis inquiry, the government felt that it was advisable to proceed quickly,” he wrote.

The changes are now expected to come into force in a year’s time. They will mean investigating committees, who examine initial allegations to decide if there is a case to answer, will be replaced with case examiners employed directly by the NMC while the regulator will also be able to review these initial decisions.

The changes will bring the NMC’s procedures in line with other professional regulators such as the General Medical Council.

Royal College of Nursing chief executive and general secretary Peter Carter said in principle the new powers were a “positive move” but more detail was needed about how the proposals would work in practice.

Nursing Times understands a case will be reviewed by two case examiners to ensure decisions are consistent. A decision has not yet been made on whether one of the case examiners must be a registrant. However, that is the model used by the GMC and Nursing Times understands the NMC believes there are advantages to this system.

NMC chief executive and registrar Jackie Smith welcomed the move.

She said: “We at the NMC are ten years behind in how we can investigate concerns about the fitness to practise of nurses and midwives because of our outdated legal framework. The prime minister is delivering on his promise of reform, made when the Francis report was published.” 

Readers' comments (25)

  • So who will pay for this- us?
    If the public want protecting maybe they should pay as we are not having any say in how we regulate ourselves as a supposed profession.

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  • is the GMC Model satisfactory?

    is there an increase in fees for this change?

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  • nursing training should concentrate on more skills for nurses not fast way to strike off

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  • Of course the process should be speeded up. It is cruel to keep someone waiting for a hearing for up to 6 years as has happened in the past.
    I remain concerned about the number of nurses who are referred to the NMC because the care that a patient has had has not had satisfactory when the problem has been a system failure and the nurse has been doing their best but is short staffed on the unit and has been refused help.
    I sat on the NMC panels and the nurse was always to blame, never those who reached their targets and emptied their unit in a shorter time.
    Nurses must learn to speak up when they are short staffed and record that they have done so and refuse to have yet more patients admitted to the ward when they do not have the staff or the skills to provide the care.
    When can we have Corporate manslaughter applied to the Trust Boards please? This might make them listen and start putting and funding good and safe patient care ahead of their bonuses.

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  • michael stone

    The requirement is to filter out, very quickly, complaints that are really simply down to things like 'confusion', etc, so that those never get anywhere near lengthy NMC investigations.

    However, as everyone on the professional side often becomes hugly 'defensive' as soon as 'complaint' is heard, which means that nobody properly discusses it at the local level, to work out if the cause was 'pretty-much just confusion and crossed wires', so these complaints tend to escalate and become very drawn-out.

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  • Will this stop the NMC colluding with miscreant Trusts againsts well supported nurse whistle blowers via the use of win-today-pay-later lawyers who return to re-vamp and re-present original pre-disciplinary allegation case material already consigned to the bin or is there now to be a new "Thomas Cromwell School of Clinical Prosecution" approach to fastlane strike-offs implemented?

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  • Anonymous | 24-May-2013 2:02 pm and 2:59 pm is absolutely right.

    Until we have a really "just" culture seriously influenced by "human factors" in which blame is not the first instinct of employersthen stream lining the NMC procedures will not make the step change needed.

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  • Agree with ALL the above.

    If there is yet further fee hikes to the NMC then I am going to walk.

    With the vast majority of positions on NHS Jobs advertised at bottom band 5, it will soon be unsustainable to keep this body of parasites in clover.

    I would get more respect and sleep sounder at night if I was working in Marks and Spencer, as many of my colleagues already do.

    I would NEVER advise anyone to enter nursing. It just isn't worth it.

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  • tinkerbell

    most people who have lost a loved one don't want to point the finger of blame or sue, they just want an honest answer. No amount of money can bring back someone you love. It is vitally important that we have a duty of candour.

    Honesty heals, lies hurt.

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  • michael stone

    tinkerbell | 25-May-2013 1:26 pm

    Yes - and the 'defensive barrier' you often get, makes you 'see a conspiracy', which is why so many things turn in to time-consuming complaints !

    I'm not sure how to get to 'open and honest first responses' from NHS staff, but unless we get pretty-much to that, this issue about complaints will never be resolved, in my view. It does involve the 'perhaps there isn't really any blame' thinking that Roger Kline touched on, but that isn't how it works at present - the solution involves 'trusting others to be decent', which is a challenge.

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  • DH Agent - as if ! | 25-May-2013 1:49 pm

    you seem to have pretty low impression of nhs staff or is it nurses in general?

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  • This is a two-way street.

    Where to point the finger of blame is the very first instinct of most people who perceive they have been wronged, regardless of situation. Until that is addressed and staff are not routinely hung out to dry, then you can forget about a duty of candour. It isn't just the NHS that needs to address this. The public needs to deal with its own behaviour. The problem is societal, as is the solution.

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  • tinkerbell

    well until it is addressed we shall never move forward, what would you prefer? Soceity is you and me.

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  • michael stone

    Anonymous | 25-May-2013 2:01 pm

    I have got a low opinion of the way the NHS often responds to 'concerns' especially, and to 'complaints' to a lesser extent - I also dislike a lot of the guidance given to NHS staff.

    That does not amount to a low opinion of NHS staff, or of nurses.

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  • tinkerbell | 26-May-2013 12:17 pm

    "Society is you and me."

    I agree. It is also ALL other people.....and therein lies the problem. After decades of working with an increasingly finger-pointing public and too many times seeing good staff being 'blamed' for things that are not their fault, there has to be an acknowledgement that all sides must play their part.

    An open and honest culture does not exist outside of the NHS, so expecting it to exist within the NHS (particularly in the face of increasing daily 'challenges' for staff), is sadly unrealistic. The most lies I hear in any given day are from the mouths of my patients!

    The Francis Report has, unintentionally, done nothing other than provoke the government into implementing a series of daft and harmful initiatives which put nurses front and centre in the blame firing line. No wonder they are defensive. They are working in an unfair system where too often the innocent get hung out to dry and the guilty get off without blemish. And the public are quite happy to jump on the bandwagon.

    The problem with the NHS is societal, as is the solution.

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  • "The problem with the NHS is societal, as is the solution."

    definitely so!

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  • Mike Stone
    Never mind Mike, next year or two when you complain about the NHS you'll get a free TiVo box for 12 months. Enjoy!

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  • DH Agent - as if ! | 26-May-2013 1:06 pm

    "I have got a low opinion of the way the NHS often responds to 'concerns' especially, and to 'complaints' to a lesser extent - I also dislike a lot of the guidance given to NHS staff.

    what do you mean precisely by this vague and woolly opinion? can you site any precise examples or experiences of this?

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  • Anonymous | 28-May-2013 7:06 am

    Good grief!! "Can of worms" and "opening" come to mind. Don't you read these threads? This discussion is now going to take an immensely tedious turn for the worse. I'm off. BTW, the word is "cite" and remember that you asked for this and have only yourself to blame!

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  • DH Agent - as if ! | 26-May-2013 1:06 pm

    DH in the NHS and the British Government is the designation for the Department of Health. It is therefore highly presumptuous to comment under the title of DH Agent!

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