The impact of a nurse’s actions on “public confidence” should be a factor considered in fitness to practise cases in future, under proposals likely to be passed by parliament.
The proposals are contained in a private members’ bill put forward by Conservative MP for Stafford Jeremy Lefroy, which has won the support of the coalition government and Labour.
“The bill will help create clarity about the responsibility of the regulators for upholding public confidence in regulation”
Mr Lefroy’s bill – named the Health and Social Care (Safety and Quality) Bill – aims to establish new rules requiring professional regulators to consider public confidence in fitness to practise decisions.
The move is intended to provide a mechanism for the Nursing and Midwifery Council to sanction nurses who may be technically fit to practise but whose actions have damaged public confidence, including nurse managers who retain their registration but no longer work on the frontline regularly.
It follows the cases of Jan Harry, a former director of nursing at Mid Staffordshire NHS Foundation Trust, who had sought to use as a defence that she was not directly involved in care that had led to patient harm.
Meanwhile, her successor, Helen Moss, was never sent to a fitness to practise hearing by an NMC investigation committee and the reguator had no power to overrule it.
In addition, the NHS could be required to achieve “zero avoidable harm” if the government-backed bill makes it onto the statute books.
It would also place a duty on organisations to share information and use a common patient identifier, such as the patient’s NHS number, across health and social care.
The government whips’ office has now taken control of the timetable for the bill, which has already had its first and second reading.
With the support of the coalition, it is likely to move to committee stage in December.
Mr Lefroy told Nursing Times’ sister title Health Service Journal: “This bill is all about patients, we have had enough bills about structure. This is about writing the principle of putting patients first into law.”
If successful, the bill could lead to the creation of new regulations to prevent health and social care providers from causing avoidable harm to patients.
According to Mr Lefroy, instances of such harm could include leaving patients without adequate food or drink, patients being left unsupported in accident and emergency for long periods, poor records resulting in drug errors, and neglect as a result of understaffing.
The bill excludes harm that could not be “reasonably avoided” to take account of clinical risk.
In a speech to parliament earlier this month, Mr Lefroy cited a study by the London School of Hygiene and Tropical Medicine, which identified 12,000 avoidable deaths in the NHS per year.
“How many lives would be saved if all providers had the same standards as the best in class? That is why it is so important to address avoidable harm through legislation,” he told MPs.
He accepted that legislation alone, without improvements in culture and leadership, would not solve the problems of avoidable harm, but added: “It is my belief and hope that it will make a recurrence much less likely.
“My constituents in Stafford will then know that all they have gone through over so many years will not have been in vain,” he said.
The British Medical Association said it supported the clause on avoidable harm, but said it was “very concerned” about changes to professional regulation.
“[This] could lead to regulatory committees and panels punishing professionals who pose no threat to the public, solely on the basis that failure to do so might incur the disapproval of the public,” it said.
Harry Cayton, chief executive of the Professional Standards Authority which oversees the work of professional regulators, said the bill was a “partial step forward” after proposals from the Law Commission for reform of healthcare regulation were not included in the Queen’s Speech.
He added: “We think the new definitions included in the bill will help create clarity about the responsibility of the regulators for upholding public confidence in regulation as well as protecting the public.”
Health minister George Freeman said: “We fully support this bill. Mid Staffs was a turning point for the NHS, and Jeremy Lefroy’s proposed measures are a major step forward in making the NHS safer.”