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NMC code will oblige nurses to report 'near misses'

Nurses are to be required by their code of conduct to report “near misses” that could have led to patient harm and will also be required to tell patients when errors have occurred, however minor.

The measures were announced last week as part of the government’s response to the Francis report.

The Nursing and Midwifery Council will work with other regulators to agree a consistent duty to be candid with patients when mistakes occur, whether serious or not.

The regulators will also issue guidance making it clear that clinicians have a responsibility to report “near misses” that could have led to death or serious injury, as well as actual harm. The government said the move was inspired by normal practice in the airline industry.

The NMC will make clear that obstructing colleagues in being candid will be a breach of their professional codes.

Jackie Smith, NMC chief executive and registrar, said: “We will work with other regulators and prepare guidance on candour around near misses.

Jackie Smith

Jackie Smith

“We will also make clear that a professional obstructing candour or raising concerns can be a fitness to practise issue,” she added.

The government also announced a new criminal offence for wilful neglect so that managers or clinicians found “responsible for the very worst failures in care are held accountable”.


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Readers' comments (14)

  • Will this include short staffing, unsafe staffing levels, lack of training and poor management support that all, in some way, lead to poor patient care.

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  • There is no such thing as a "near miss". Plenty of near hits though.

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  • Who will come and apologise to patients, visitors and staff when a patient comes to harm or has a delay in treatment because there are not enough staff on duty to look after them properly?
    What will happen to all the incident reports that we will be putting into management?
    What action will be taken when patient safety is compromised because of staff shortages? - whether it's nursing or medical staff, we are not the only people working in the health industry - what happens when a scan, pharmacy drug or blood test is delayed leading to harm?

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  • Sounds like this could lead to more complaints, from people trying to claim compensation !!! whether a valid claim or not !

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  • I think it a reasonable for a patient to presume that if there was a near miss in which their safety had been put at risk that they'd at least be told about it. If I were a patient, I'd want to know.

    Just report absolutely everything: short-staffing, near-misses, doctors not seeing patients, violence, abuse etc etc. Report and pass it on to your manager - if you've reported it, they can't deny knowing!

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  • Is this solely down to nurses or are other health professionals obliged to do the same. This needs addressing and should be discussed across the board with other health professionals. The reporting of incidents (I agree) are very important and helps the service nurses and other health professional provide to improve. I have filled in numerous Datix forms regarding serious and non-serious incidents, a problem with the reporting is that I do not get feedback and I am unsure whether anything gets learned either for the person reporting the incident to understand processes that may have been involved or the staff who have been reported.

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  • Is short staffing going to be addressed once and for all, does anyone actually understand how this affects our patients or even care any more?
    Who do we report this to? our managers, unions, governing bodies?
    If I report late medication due to short staffing what can I expect to happen?

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  • Anonymous | 26-Nov-2013 10:49 am

    The problem is that there is currently chronic under-reporting. Nurses (and they write here regularly) constantly list how much work they do, how many breaks they miss and hours many hours they work for free. They are doing much damage by being complicit in this system. Whilst they moan, they think that acting on behalf of patients and themselves begins and ends with completing an incident form. Any nurses who do more, usually do so in isolation. If your colleagues and you ALL phoned and emailed your manager, completed incident forms after EVERY incident or situation causing concern, demanded meetings (which are minuted) with management and involved ALL the unions, then I think you would expect more to happen. However, that won't happen, because, if you are making your views known to management, then you will most likely be unsupported by colleagues. Unless and until nurses get motivated and organised to demand change, then we can expect no improvement.

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  • When we report near misses and incidents too often,we get told not to put in so many incident reports as management get fed up with dealing with them.

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  • Do the governing bodies know how many incident reports are put in by the staff? do they get sent a copy? do they know how short staffed we are?

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  • I can't believe the number of people who perpetuate the "we're rubbish, we've no staff, we can't cope" stuff that the media put out. This is exactly what the public utilities and nationalised industries were saying in the lead up to privatisation.

    Everyone should challenge themselves every day to look in the mirror and ask themself "Did I do absolutely everything to the best of my ability today?" How many of us will be able to say yes everyday?

    For too long, too many people have accepted just enough as the standard to aspire to. Now it has been discovered that just enough actually isn't enough in a lot of cases, and now people are having to make more effort to increase the quality - and that doesn't sit well with a lot of people.

    The "Angels" reputation that the profession had bestowed upon it during the latter part of the last century is in severe danger of being lost. Cameron and his crew may have said "we are all in it together" we know they have their own private lifeboat, but we - the NHS as a whole really are all in it together, so instead of bickering about who does what, why can't people just knuckle down and do their best all the time, every day and see if that makes a difference.

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  • Whilst I don't like the constant moaning amongst nurses, it is because I know just how hard they work and how they give their best daily, yet they seem to be incapable of standing up for themselves.

    However, if anyone feels able to state that nurses are not working in extremely challenging and difficult situations and doing their best, then I can only conclude that they are not a nurse or not having to work very hard. If they were, they would know the true depths of their ignorance and perhaps desist from such silly comments.

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  • As a Nurse. I regretfully do not hold the NMC in, well anything really? Organisationally the recent NMC ethos has been trying really hard to be seen as something as opposed to doing anything? In the light of recent scandals in care provision (we all know which), the NMC is finally stomping it's small feet and slipping out of its oversized regulatory shoes! The approach is simple: blame the Nurses for not caring. We, the NMC only care about the public. Perhaps that is because they NMC do not directly get public money. It will get interesting though. Nurses are falling off the register. What is more it would appear that Nurses don't want to be nurses anymore? Less people want to be Nurses. The beauty of altruism has been erroded by misguided and politically popular bureaucracy. No Nurses - no worries. The NMC will look after the public.
    Now, despite my pathetic and academically defunct rant. Nurses should go with this. In fact, I would spend my 'free time' and even non existent breaks and unpaid voluntary overtime reporting the Near Misses. As a Nurse it is my moral duty to report 'everything' that could have happened, should have happened, will happen and most importantly has happened. Registration with the NMC is vital for public protection and ensuring professional standards. However £100 per year so that one can tell the future as well?
    I would love to justify a Nurses explanation as to why a patient was not receiving direct care? The Nurse(Any Grade) was documenting, reporting and archiving the episodes of care that - would, should, could, will, did not and did happen?
    Episodes of care should be countersigned by patient or representative or another HCW. Recent events have clearly shown that records are falsified.
    Well done NMC, the paperwork is great. Practicality? Ask yourself?

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  • Anonymous | 28-Nov-2013 8:19 pm

    Hear hear, i couldn't have put it better myself.

    Do those smug twits in the NMC have any brains at all? And if not, why not?

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