The Nursing and Midwifery Council is “determined to do better”, says its chief executive after an annual report found the regulator was still failing to meet many key standards.
The Professional Standards Authority, which oversees the performance of the NMC, has highlighted ongoing issues in areas such as the way it manages fitness to practise cases and registration.
It found he NMC was meeting three out of five key standards for registration but only four of the 10 for fitness to practise, with concerns about the time taken to progress cases, decision-making and data security,
“I would say to registrants ‘you can have confidence in us’, but we’re not complacent and are absolutely determined to do better”
The regulator also failed to further improve customer service during 2013-14 with the proportion of unanswered calls increasing from 9% to 11%.
However, for the first time in a long while, the PSA said it had seen improvements in all of the NMC’s core functions. In particular, it noted significant improvement in the way it engaged with nurses and midwives about its work.
“We are pleased to note that is has achieved improvements across each of its regulatory functions, even though a number of the standards of good regulation were not met,” stated the PSA’s review of the NMC’s performance in 2013-14.
NMC chief executive and registrar Jackie Smith said the report showed the organisation had “come a long way” since a strategic review highlighted numerous failings two years ago.
“This was never going to be a quick fix,” she said. “Basically the organisation was on its knees, it didn’t understand its core purpose and had fundamental problems top to bottom.
“Here we are two years later and this report talks about the fact we have improved across the board,” she told Nursing Times.
“I would say to registrants ‘you can have confidence in us’,” she added. “But we’re not complacent and are absolutely determined to do better.”
Ms Smith acknowledged the need to improve “customer service” after the PSA found more than 26,000 calls to the regulator went unanswered from April to September 2013, with callers spending an “unreasonable” amount of time in a queue.
“If you’re going to have an interaction with the NMC, then we want to make it as slick as possible,” said Ms Smith.
“We want to improve that connection with anyone who comes into contact with us. But it is quite a big piece of work,” she added.
Regarding efforts to improve work around fitness to practise cases, she said the NMC’s “hopes had been dashed” by the government’s recent decision not to push ahead with legislation that would have allowed the regulator more flexibility.
However, she said there was “an absolute focus” on achieving the key performance target of ensuring that 90% of cases went from the adjudication stage to the first day of a hearing within six months by the end of this year.
“We must achieve it and I am confident we will achieve it,” she said.
The regulator recently announced it had reduced the average times for fitness to practise investigations by 54%. The average time taken for a case to be investigated dropped from more than one and a half years – 19.7 months – in 2011 to nine months in April 2014.
Ms Smith was also adamant the NMC was ready to take on the challenge of introducing a major new revalidation system by the end of 2015, despite the other challenges it faces.
“If we were proposing something which was radical, completely innovative and a burden to the NHS and independent sector then I would probably say we were biting off more than we can chew,” she said. “But what we’re proposing is building on what’s already out there and I am 100% behind the fact we can deliver it.”
In its report, the PSA continued to express concern about the revalidation model the NMC has chosen, arguing the regulator could not be sure it would protect the public.
“They just don’t like our proposals,” said Ms Smith. “Their issue is that a one-size fits all revalidation model is not proportionate or risk based.
“But my challenge back is that… what we are proposing is a whole heap more than doing nothing. It is absolutely adding a check and balance and absolutely adding value,” she told Nursing Times.
The PSA has criticised the NMC’s proposed model for not taking into account of the fact that different groups of nurses and midwives might pose different levels of risk.
However, Ms Smith revealed the NMC was looking at its approach to risk.
“We do have data at our disposal through the fitness to practise annual report and information about lapsed registration, which enables us to think about evaluating the risk,” she said.
“We are very alive to the risk issue and will have more to say about that in the next few weeks.”
Key findings from the PSA’s annual performance review of the NMC include:
- The NMC is meeting four out of five key standards for education and training and three out of five key standards for registration
- The regulator failed to further improve customer service during 2013-14 with the proportion of unanswered calls increasing from 9% in 2012-13 to 11% between April and September 2013
- It is only meeting four of the 10 standards for fitness to practise with concerns about the time it takes to progress cases, customer service to those involved, decision-making and data security
- For the first time in about six years there has been a significant improvement in “stakeholder engagement” as shown by feedback from nurses, midwives and other nursing organisations