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Lack of nurses at the top leads NMC to set up advisory panel


An absence of registrants at the top tier of the Nursing and Midwifery Council has prompted it to create a panel of senior nurses and midwives to advise it. 

The NMC Senior Registrants Strategic Advisory Group will be made up of 22 senior nurses and midwives who still work at the frontline.

Details of the group’s membership are yet to be released. However, Nursing Times understands that it will comprise a mix of senior representatives from each of the four UK countries, including directors of nursing, heads of midwifery and educational leads.

“We want it to be a success and if it is, we want to keep it”

Jackie Smith

The NMC council has been restructured several times in recent years in the wake of concerns about the regulator’s performance.

It is currently has 12 members, with six members from a registrant background.

However, neither the council’s present chair Mark Addison nor the NMC’s chief executive and registrar Jackie Smith have a nursing or midwifery background. This has prompted criticism from some in the profession.

Ms Smith told Nursing Times that she rejected any suggestion that not being a registrant affected her ability to do her job. But she recognised there were “gaps in terms of engagement” between the NMC and the professions it regulated.   

Jackie Smith

Jackie Smith

“We need to get them [the advisors] in and hear what they say,” she said, adding: “We want it to be a success and if it is, we want to keep it.”

According to the group’s terms of reference – seen by Nursing Times – it is intended to provide a “regular opportunity” for the NMC council to “engage with senior registrants and share insights, information about strategic developments”.

Such developments currently include revisions to the nursing code of conduct and plans to introduce a system of regular competence checks, known as revalidation.

The group’s role will be to advise the NMC council on whether its proposals and initiatives are “fit for purpose and will enhance public protection”.

It will also be asked to disseminate information about the NMC’s regulatory and strategic developments to a wider group of registrants, and advise it on how best to engage with senior registrants on a wide range of issues.

The group’s meetings will take place on a quarterly basis, with the first one scheduled to have taken place on Monday 14 July.

Nursing Times understands that the main topic on the agenda for the first meeting was the code of conduct and, in particular, defining the “fundamental purpose” of the code.


Readers' comments (12)

  • michael stone

    This is quite 'tricky': the people 'sitting at the top' of this type of organisation, are 'pushing it' if as well as being involved with the organisation day-to-day, they are also practising as an 'operational' professional.

    At least the NMC seems to have accepted the problem (it also seems to be relevant to NHS England 'leads', who sometimes seem to be doing their NHS England 'job' part-time, while being operational clinicians the rest of the week). I was wondering about quarterly meetings (is that often enough ?) but when I consider the speed the NMC seems to work at, 4-times-a-year probably counts as very regular ?

    I was also wondering about this:

    'It will also be asked to disseminate information about the NMC’s regulatory and strategic developments to a wider group of registrants, and advise it on how best to engage with senior registrants on a wide range of issues.'

    There are some dangers, in this 'facing two ways' aspect: if the advisory panel is supposed to be putting the front-line perspective to the NMC, then suggesting to the NMC how to best 'get its messages out there' seems reasonable - but I'm not so sure about the advisory group itself 'disseminating information about the NMC’s regulatory and strategic developments to a wider group of registrants'.

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  • I have a concern.

    Is there not a potential conflict of interest here unless some due diligence is carried as to whether any of the 22 "senior" nurses and midwives lead organisations where concerns have been unsuccessfully raised by registrants about the treatment of those who raise concerns or where there are patterns of inappropriate referrals?

    In addition, just out of interest what proportion of the 22 will be from a BME background given that 20% of nurses and midwives are?

    Just asking.

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  • How will the membership be selected/appointed ? Or have they already been - as it looks as if they've had their first meeting ? I trust the process will be open and transparent !

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  • Before major changes occur to regulation, validation and employing 'senior' nurses at the top of NMC, I believe more work is required to investigate the in referrals made to the NMC. The process of these referrals for innocent nurses who have raised concerns in the workplaces. The rehabilitation of such effective nurses back in the workforce and personally I feel there needs to be an overhaul on NMC process, organisation from NMC and lenghly time of process and conclusion from NMC. I also feel there needs to be a review of the work undertaken by the chief executive and decsions made, prior to always turning the blame on good nurses out there. Let us look at managerial staff who are failing nurses and therefore failing patients care.

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  • soon all of the nmc will be lay people

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  • great, nothing seems to change...

    a severe lack of nurses who are hands on, on the frontline and patient facing, day in, day out; being told what to do by those who know better with a list of 'you must do...'

    it will be great to see these leaders work a week, in every couple of months or so, as HCAs and not just doing audits, paper-pushing and delegating it to others to do.
    Then come up with some workable solutions that befits their status of ensuring patient safety.

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  • Senior nurses/ midwives tend to be out of touch with what is happening on the ground floor, just as the NMC is. Therefore what is there to gain?

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  • I believe "told them so" is once again appropriate!

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  • Re. roger kline | 17-Jul-2014 5:21 pm

    I agree. There are a number of senior nurses in trusts and care homes who area key part of the problem & certainly unfit to be part of any solution. The failure to hold them to account seems to stem from a recognition that senior nurses control little power to change, but even if they can't change what's happening, they have a clear moral duty to speak out for patient safety. The silence is deafening...

    The current NMC has far too many non-registrants and it shows in the quality of their policy and professional guidance. A few lay Council advisors on legal, ethical & inter professional matters should surely suffice, plus a small but experienced administrative support team.

    Part of this problem stems from the failure to develop a senior clinical career structure and recognition of clinical excellence. We have nothing like the medical royal colleges, with their systems of membership and fellowship on merit. So we end up with senior academics who rarely practice and managers who don't (or are reluctant to) appreciate the workplace problems.

    Elections tend to produce self publicists and political operators. Appointments are difficult because of the lack of senior clinical recognition.

    The NMC doesn't yet seem to be going in any direction that might be helpful.

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  • I am very concerned.

    We already have the example of the Midwifery Committee, which in reality acts in an advisory capacity; and which lacks any proven ability to effect robust improvement for registrant midwives.

    How then are registrants to be satisfied that this new body will be anything but a replica of the MW Committee?

    After all shouldn't those who pay the piper be calling the tune?

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