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NMC asks for views on changes to fitness to practise process

The Nursing and Midwifery Council has unveiled plans to give the body new powers including the ability to re-open closed fitness to practise cases.

The proposals, set out in a consultation document launched on 17 April, are part of government-backed efforts to strengthen the regulator’s role.

The NMC is seeking key changes including the introduction of “case examiners” to decide if there is a case to answer when a nurse or midwife’s fitness to practise is called into question. These decisions are currently made by a panel of registrants and lay members drawn from a pool of about 100 people.

“One of the key issues with the current approach is that it can be difficult to achieve and demonstrate consistent, quality decision-making among panel members,” said the consultation document. “This is despite regular training and guidance.”

“The introduction of case examiners and the changes to the composition of registration appeal panels would enable us to speed up key processes that impact on registrants”

Jackie Smith

Under the new system, a joint decision would be made by a pair of case examiners – one registrant and one lay member.

Case examiners are already used by the General Medical Council, while the General Optical Council is in the process of introducing the role.

Another key change would mean the NMC would gain the power to review “no case to answer” decisions in the early stages of fitness to practise investigations, as revealed earlier this month by Nursing Times.

Currently the regulator cannot re-visit a decision to close a case at this stage. The proposals would allow the NMC’s registrar to review cases – usually within a year – if there was reason to believe the decision not to proceed was flawed or if new evidence came to light.

The plans would also allow the NMC to request and check key registration information, as well as introducing changes to the make-up of registration appeal panels.

NMC council members would no longer play any part in these panels, in order to “maintain a clear separation of the duties between the operational and governance functions of the NMC to ensure impartiality”.

The NMC said the changes would help make the regulator more effective and efficient, speeding up some of its processes and improving its ability to safeguard the public.

“The introduction of case examiners and the changes to the composition of registration appeal panels would enable us to speed up key processes that impact on registrants,” said NMC chief executive and registrar Jackie Smith.

Jackie Smith

Jackie Smith

“These proposals would also allow is to review ‘no case to answer’ decisions made early on in the fitness to practise process. This change is important to ensure the protection of the public and would bring us in line with other healthcare regulators.”

The consultation is being carried out in parallel with a Department of Health consultation on the legal changes needed to bring the new rules into effect.

Responses to both consultations must be submitted by 12 June. If the changes are agreed, the new NMC rules are expected to come into effect in late 2014 or early 2015.

Readers' comments (3)

  • Under the new system, a joint decision would be made by a pair of case examiners – one registrant and one lay member.

    Would this mean another hike in fees to fund this, I wonder?

    Unsuitable or offensive?

  • should be a voluntary job with modest and realistic expenses otherwise there are vested interests.

    Unsuitable or offensive?

  • This can be seen as another marketing growth technique.
    If the issue is closed and there have been no subsequent practice concerns expressed nor any pattern of behavioural malpractice established, what is the point of reopening unless of course the event is particularly relevant or significant of likely further "harm".
    But who determines "relevance" and "significance? ..and moreover who defines and thus determines what constitutes "harm", the NMC of course.
    Does having an "attitudinal" problem constitute "harm"?
    The NMC have demonstrated their enthusiasm for examining trivia, even issues that the referring employer thought too trivial to discipline at the time or even to mention in their referral.
    This development increases the opportunity for NMC involvement and once into the jaws of the NMC there is little opportunity to escape either in the short or even medium term.
    Your referral, whatever the merits of your case is a permanent record and the only certainty is that a promisingly successful career is effectively over.
    The process is guaranteed a source of absolute agony which for a minor case will last at least three years at the conclusion of which the NMC will decide whether to continue or conclude its involvement depending upon its view of your performance.

    Unsuitable or offensive?

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