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RCN questions necessity new wilful neglect offence for NHS staff

Nurses and other clinicians found guilty of “wilful neglect” of patients could face prison, under measures due to be published next week by the government, the prime minister has said.

However, the Royal College of Nursing has questioned the necessity of the new law and argued that action should instead be focused on legally enforceable staffing levels.

Wilful neglect will be made a criminal offence and be modelled on one punishable by up to five years in prison under the Mental Capacity Act, according to reports.

The policy is being trailed in the national media today ahead of major government announcements on health and the NHS next week.

It will be officially unveiled next week when ministers publish their full response to the Francis report on care failings at Mid Staffordshire Foundation Trust and a series of other high profile reviews that have taken place this year.

A sanction for wilful neglect was one of the recommendations made by Professor Don Berwick in his review of NHS patient safety, the findings of which were published in August.

The involvement of No 10 reveals the importance with which the government response to Francis and the other reviews is being taken.

Commenting on the new law on wilful neglect, David Cameron said: “The NHS is full of brilliant doctors, nurses and other health workers who dedicate their lives to caring for our loved ones.

“But Mid-Staffordshire hospital showed that sometimes the standard of care is not good enough. That is why we have taken a number of different steps that will improve patient care and improve how we spot bad practice.”

He added: “Never again will we allow substandard care, cruelty or neglect to go unnoticed”.

“This is not about a hospital worker who makes a mistake, but specific cases where a patient has been neglected or ill-treated. This offence will make clear that neglect is unacceptable and those who do so will feel the full force of the law.”

In response, Peter Carter, chief executive and general secretary of the RCN, said he would “never excuse those who wilfully neglect patients”.

But he argued that “remedies already exist to tackle staff who are guilty of harming patients and we would question whether a new law is actually required”.

“When things go wrong, as well as looking at the actions of an individual clinician, we also need to look at the whole system that surrounds a care failing. Too often, frontline staff are trying to deliver care against a backdrop of intense pressure and woefully inadequate staffing levels,” he said. 

“If the government are willing to look at introducing new legislation to protect patients, then the area they should be concentrating on is ensuring legally enforceable safe staffing levels. This measure would have the single biggest impact in improving care across the NHS,” he added.

Documents obtained by Nursing Times reveal that the government is planning to tell trusts to act on staffing levels in its response to Francis report, but it will not support a minimum staffing ratio.


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Readers' comments (35)

  • I'm curious about what criteria will define 'wilful neglect'.

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  • Tell you what Dave. You first!! For wilful and malicious destruction of the National Health Service and creating conditions whereby our patients are daily exposed to danger with only the dedicated and courageous staff you are so keen to threaten standing between them and disaster. You and your bunch of criminal henchmen make me sick!!

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  • I welcome this proposal: I think the thought of five years behind bars, permanent removal from the NMC register or GMC or whatever, will concentrate the minds of those who may be inclined to do harm to patients through penny-pinching, shockingly-bad management, withholding treatment etc., etc. I think this is long overdue!

    As per usual, Peter Carter and his Stepford tribe just don't get it, their response does not surprise me one little bit.

    These proposals should be welcomed by any hard working nurse as you've nothing to fear from this, but those who collect the large salaries, who make decisions that put people at risk without ever having to meet a patient face-to-face I hope it makes you think twice!

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  • What action will be taken against those who have cut beds, cut staffing, cut budgets, ration treatment, ignore vulnerable groups and wilfully neglect the wellbeing of staff.
    Are doctors and nurses the only people who are involved in patient care?

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  • I think this is focused on some of the examples where nursing staff abused vulnerable patients like those in Winterbourne.

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  • Every other media outlet that covered this story explicitly mentioned hospital managers, but NT - which now seems to be one of the official mouthpieces of the RCN - has chosen to omit this particular noun for effect.

    'All NHS staff, including hospital managers, could face five years in jail if they are found guilty of the most extreme types of poor care' Telegraph, November 16, 2013.

    I really welcome these proposals as I think for too long now, some Consultants, hospital managers and senior nurses have been allowed to get away with making some absolutely shocking decisions that have put patients at serious risk of harm safe in the knowledge that they'd never be held to account for their actions.

    Hopefully just the thought of prison will be enough to make those decision makers think twice, but everyone else has to make sure that they document and report concerns about staffing, decisions to move patients and unsafe practices etc., via IR1s (or whatever your Trust uses). If everyone does it then individuals can't be singled out and bullied.

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  • People keep saying here, "the thought of prison".
    How about the thought of prison for doing their job keeps people from wanting to become carers, ever!
    I see malicious and ambulance chasing lawyers all over this legislation with trivial claims.
    And no nurse would ever want to be a manager now.

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  • Nurse Managers will have nothing to fear from these proposals. They will further close ranks and cover their tracks. Remember, they have been doing it for years and are very clever at it. Those ordinary nurses doing a good job actually have a great deal to fear, particularly if they raise concerns. Managers can make it look like your fault. Why can't people understand this? Just ask yourselves why only nurses are singled out for blame and focus of sanctions when all that is wrong in healthcare systems and institutions is complex and multifaceted. It is 'lack of compassion' in the Nursing profession that is exclusively given as the reason.
    These proposals do nothing to address the culture of fear and bullying within healthcare. Don't get me wrong, I would love to see those responsible for neglect go to jail, but they won't, because other things need to change before they can be caught and held to account. Jan Harry, and the lack of complete consequences for her actions and inactions at Mid Staffs, being a case in point. Don't kid yourselves. No managers will go to jail as a result of these proposals and patients will not be better protected. You, on the other hand, had better watch your back.

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  • Nick Davies | 17-Nov-2013 7:20 am

    "I see malicious and ambulance chasing lawyers all over this legislation with trivial claims."

    Exactly, and people need to wise up about that.

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  • We are all already accountable to parliament and the law. We are already vulnerable to being struck off the registers permanently,...well maybe in a yearor two when the NMC has cleared its backlog and not resorting to pragmatic cautions.
    When a govt of PR millionaires introduces a fear based move like this without the necessary changes to enable the problems to be resolved either concommitently or at least in short succession, then the situation will result in further institutionalised bullying and harrassment. You cannot ask, demand or exact something from someone when you are preventing or obstructing their way to managing or resolving the problem.
    Again this translates as another way of holding power over.
    It does however enable an open door for privatising the whole system with the apparent lure of private corporations able to apparently throw money at the problems in a PR glossy hype.

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  • Nick Davies | 17-Nov-2013 7:20 am

    "And no nurse would ever want to be a manager now" good, most nurse managers are crap anyway.

    Let's hope many people reconsider their positions wherever they work. Let's hope it makes a few of the new "I'm only doing nursing cos it's a free degree" gang think twice about starting the course.

    Think of all the scandals in all of the elderly care homes, LD institutions and what has gone on in our hospitals - I think it's time that there was an 'ultimate sanction' if you like, in place to concentrate the minds of those who cut corners, who put profit before patients, who understaff their team etc that they're not going to be allowed to get away with it! Just my opinion.

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  • 11.01:
    There already exists your 'ultimate sanction' strategy. Not new.
    Nurse degrees are not free
    People getting away with it....getting away with Daily Mail hyperbole is the real crime here!!

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  • Anonymous | 17-Nov-2013 11:01 am

    "I think it's time that there was an 'ultimate sanction' if you like, in place to concentrate the minds of those who cut corners, who put profit before patients, who understaff their team etc that they're not going to be allowed to get away with it!"

    Then you had better start with the entire government!

    Those in positions of power have been watching their backs for years and are extremely proficient. There will be no 'ultimate sanction' for them. There is relevant legislation in existence which has the potential to impose massive consequences for those whose actions have caused these scandals. No one uses them now. They will continue to be "..allowed to get away with it." That isn't opinion. That is fact.

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  • tinkerbell

    Two companies who have given £1.5m to the Tory party now have £1.5billion in nhs contracts. How convenient for them.

    Of course wilful neglect should be a crime, didn't know that it wasn't already, someone should have spotted that loophole earlier. How convenient.

    Bribery and corruption and selling off the nhs to your mates should also be a crime but we can't let a small detail like justice and fairness for ALL get in the way of an ideology. How convenient.

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  • Anonymous | 17-Nov-2013 11:39 am

    Of course all of that may be true, but I think - as far as government is concerned - Mid-Staffs was a turning point

    The RCN were heavily criticised in Francis's report, as like others, they were there, they knew what was going on and did nothing to stop it. No wonder the RCN have concerns, I bet Dr Peter Carter's hoop is putting as we speak haha!

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  • Anonymous | 17-Nov-2013 7:45 am

    Agree !

    Those among the "nurse" management hierarchy who persist in enforcing low staffing levels and a poor skill mix need exposing !

    Most "nurse managers" disgust me, they are incompetent and do not care about the well being of patients or "junior" nurses .

    The argument for serious industrial action grows stronger by the day !

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  • Only a fool would not agree that wilful harm/neglect of patients/clients shouldn't be punished.

    But can't the concept of "corporate manslaughter" be extended to "corporate harm" and include incompetent, bullying nurse managers who preside over unworkable systems which staff at the sharp end have to cope with?

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  • Anonymous | 17-Nov-2013 12:34 pm

    "Of course all of that may be true, but I think - as far as government is concerned - Mid-Staffs was a turning point."

    Really? In what way? By failing to introduce any measure to ensure adequate staffing levels and skill mixes in healthcare settings? By blythely ignoring most of the recommendations of the Francis Report and aiming the blame and consequences for any problems within the NHS squarely at the staff on the frontline? It is obvious though, they have succeeded in pulling the wool over the eyes of many. They must be delighted.

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  • tinkerbell

    'They have besmirched the name of Britain. They have made us ashamed of the things of which formerly we were proud. They have offended against every principle of decency and there is only one way in which they can even begin to restore their tarnished reputation and that is to get out! Get out! Get out.' Nye Bevan 1956

    Nothing much has changed then.

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  • RCN please show us your teeth. You have questioned the necessity of this law have you? Back your members, support the staff that cope daily with poor staffing levels and too much work. Speak up for the people who pay the union dues. Managers will in no way be held account for wilful neglect. This law will only serve to demoralise further a beleaguered peoples, will not improve patient care and will only promote the " watch your own back culture".

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