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A new name and a new purpose

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Jonathan Asbridge.

President, NMC

Nurses are unlikely to have woken up on 1 April to discover that, in a Kafkaesque metamorphosis, the UKCC had turned into a totally different life-form. However, the Nursing and Midwifery Council (NMC) will be different from the UKCC from day one and, over the longer term, those differences will be significant and will become apparent.

Nurses are unlikely to have woken up on 1 April to discover that, in a Kafkaesque metamorphosis, the UKCC had turned into a totally different life-form. However, the Nursing and Midwifery Council (NMC) will be different from the UKCC from day one and, over the longer term, those differences will be significant and will become apparent.

A new purpose
The NMC is a new organisation with a new purpose. It sees itself as independent, performance-driven, public-focused, innovative, cost-effective and open. We will have failed if, in time, our major stakeholders don't share that view of the organisation.

In some respects the NMC will be little different from the UKCC; it will still maintain the register, give advice, set standards and deal with allegations of misconduct. But the new council will not only have additional responsibilities, it will also go about its business in new ways and in a new style. For many nurses, it will be the 'how' that appears different rather than the 'what'. I want to look at both aspects in turn, starting with the 'how'.

Light-touch regulation
Most people are ambivalent about regulation; they see it both as a burden and an essential tool in protecting the public. The NMC wants regulation to be as burden-free as possible while, at the same time, ensuring that practitioners are fit for practice. That means a light-touch regulatory regime.

Employers, for example, already have processes in place for managing competence issues. The NMC will aim to work with them to ensure that only the most intractable cases are reported to the council under the new fitness-to-practise procedures, which are likely to be in place in two to three years' time.

There is no point in the council duplicating what employers already do effectively. Similarly, duplicating processes which higher education institutions already manage effectively would also be pointless. So we won't.

Performance standards
We will have a strong focus on our performance. Fulfilling our functions is not enough; we have to do so as efficiently and as cost-effectively as possible. We will measure key aspects of our performance and publish the results on our website, warts and all. Our aim is to maintain and improve our standards over time.

A vital area in which the council is seeking significant improvement is access to the organisation. Too many people cannot get through on the telephone. The UKCC put in train a programme of improvement and we will build on that to ensure better access to the NMC; this is a top priority.

A new register
Turning to the 'what' aspect of the changeover, the two most complex areas to be addressed are establishing a new register and developing and introducing new fitness-to-practise - formerly professional conduct - rules and procedures.

The former affects everyone on the register, the latter affects only a few. Practitioners can be assured, though, that the council will consult them about both, and we will make those consultations as simple, interesting and engaging as possible.

Establishing a new register is not simply a matter of looking at the current register, deciding we need fewer or more parts and dreaming up what they might be. There are significant sensitivities and dependencies.

For example, a parallel but related issue that the UKCC has passed to the new council is the matter of the branches of nursing. The UKCC identified six possible options, including retaining the current branch system. A decision on that has to precede a decision to change significantly the nursing categories on the register.

There are also historic country-specific issues and the position of enrolled nurses on the register. The council may decide to sort all these issues out in one go or it may decide to change the register gradually over time.

Fitness to practise
On fitness-to-practise issues, the order sets out many potential changes, some of which the council has to institute and others which it is free to decide not to. It is likely that nurses will have a view about lack of competence and how the council can deal with allegations in a way which won't submerge the organisation in masses of paper and ratchet up the costs.

Determined, modern and effective
Nurses may not see regulation as exciting, but this is an exciting time for regulation. Registrants have a new regulatory body that is determined to be modern and effective and involve registrants in change. In the end, however, it is nurses themselves, together with our other stakeholders, who will judge whether the NMC achieves those aims.

- Contacting the NMC: Nursing and Midwifery Council, 23 Portland Place, London W1B 1PZ. Website: www.nmc-uk.org.

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