A leading midwife has said the Nursing and midwifery Council owes midwives and nurses, as well as families, an apology over the way it handled fitness to practise cases linked to the Morecambe Bay maternity scandal.
The suggestion was made by Helen Shallow at a meeting of the NMC’s governing body where members expressed their “shock”, “sadness” and “shame” at the failures identified recently in the Professional Standards Authority’s Lessons Learned report.
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It concluded the regulator’s response had been “inadequate” and “frequently incompetent”. Key failings identified by the PSA included the fact that the NMC did not listen to families or treat them with respect. The regulator was also criticised for a lack of openness and honesty.
New NMC council chair Philip Graf opened the meeting on Wednesday with an apology, which was echoed by chief executive Jackie Smith who said the NMC had made a “tragic situation worse” for grieving families affected by the deaths of mothers and babies at Furness General Hospital.
“We didn’t listen to them, we didn’t show respect for their views and I am truly sorry for the distress we caused,” said Ms Smith, who announced prior to the publication of the PSA report that she was stepping down later in the summer.
“I also want to pay tribute to them for taking part in this review – it must have been extremely painful,” she said. “But I am grateful to them for what they did, because it has enabled us to reflect on our performance in the future.”
“Where is the apology to registrants who have undergone overly long and deeply distressing fitness to practise processes”
She admitted the way the NMC had engaged with families had been “appalling” and there had also been some “absolutely shocking” lapses in record-keeping. However, she would not be drawn on whether the regulator could have prevented harm had it acted sooner.
During the council meeting, Ms Smith was pressed on whether “inaction” by the NMC when first alerted to concerns about midwives by the police in 2012 meant “lives continued to be put at risk”.
“This has been covered in some detail by the PSA in their review. What we can be absolutely clear about is that we took too long,” she said.
She added that an independent review – the Kark Review – had been carried out to look at whether the NMC could have intervened earlier to restrict the practise of one of the midwives concerned.
“That has been disclosed and that was very clear that we carried out a risk assessment at every opportunity and the conclusion by the PSA in its review was very clear on that point,” she said.
“It also really important we hear the voice of registrants”
The NMC has written to the families involved and has offered to meet them. But the meeting heard that at least one complainant has refused to meet the NMC while Ms Smith, who is due to step down in July, remained at the organisation.
The meeting heard the regulator had suffered a “reputational hit” in the light of the Lessons Learned report that had damaged not only public trust but the confidence of nurses and midwives on the register.
Ms Shallow, academic and former head of midwifery, said midwives and nurses – including those involved in delayed and protracted misconduct investigations – also deserved an apology.
The Lessons Learned report, published in May, showed it took more than eight years between the first complaint about maternity care at Morecambe Bay being received by the NMC and the final fitness to practise hearing.
“We have heard a great deal – quite rightly – about apologies to families but I wonder if there is an apology due to registrants who pay their annual fee, who undergo rigorous revalidation to stay on the register,” said Ms Shallow, who was until recently a midwifery education and policy adviser to the NMC.
“We didn’t listen to them, we didn’t show respect for their views and I am truly sorry”
She said: “Where is the apology to registrants who have undergone overly long and deeply distressing fitness to practise processes, when ultimately there was no case to answer? Do not registrants deserve an apology as well?”
Mr Graf said the NMC recognised the fact that FtP processes often “take a long time” had an impact on everyone involved and this was one of the issues the regulator’s current review of FtP was seeking to address.
“All people who find themselves unnecessarily or unfairly distressed in these situations deserve an apology,” he told the meeting on Wednesday.
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Council members also emphasised the need to listen to nurses and midwives about what needs to change.
“I am saddened for registrants who will have real concerns about this report and question, I’m sure, our arrangements for fitness to practise once again,” said registrant member Ruth Walker, executive nurse director at Cardiff and Vale University Health Board.
She said it was crucial to listen to patients and the public, but added: “It also really important we hear the voice of registrants – those going through a process and those not going through a process.”
The Lessons Learned review found aspects of the FtP process, including its adversarial nature and the amount of time it takes as well as the fact nurses and midwives “inevitably feel that they are being held to account and their livelihoods are at stake and this encourages a defensive approach”.
The NMC has extended the deadline for responses to its consultation on FtP to ensure those who wish to contribute in the light of the review findings can do so.
NMC officials promised more detail on the NMC’s response to the Lessons Learned review at the next NMC council meeting in July, including plans to review and update its complaints policies and update guidance for staff to ensure the organisation was “as open as transparent as we can be”.