The Nursing and Midwifery Council must work more closely with bodies that regulate healthcare organisations and improve efforts to ensure employers were held to account as well as individuals when care failings occurred, it was claimed last night during a debate on nursing regulation.
The current head of the NMC and the former boss of the Royal College of Nursing were both asked during the debate whether professional regulators were too “distinct” from systems regulators such as the Care Quality Commission, given the contribution of workplace pressures to errors in care.
“We need to be identifying those areas where we should be acting”
Responding, NMC chief executive and registrar Jackie Smith said there should be “closer alignment” between regulators across the UK to improve patient safety.
However, the NMC should do this without duplicating other regulators’ work and creating an unnecessary burden on healthcare organisations, she said.
“We need to be identifying those areas where we should be acting and areas where we shouldn’t. But I think we also need to be very clear we don’t need to tread on their territory and do the work of the CQC or [others] because that’s not right either,” she said during the event at London South Bank University.
“We need to be smart about where we need to be and that does require us to be innovative and creative,” she told the audience.
“Regulation falls far too much on the conduct of the individual registrant”
Former RCN chief executive and general secretary Dr Peter Carter went further and said the NMC should be given more authority to set standards for organisations and not just registrants.
He said that, while individuals should be held responsible if there were no mitigating circumstances surrounding an error, not enough was done to “contextualise” how mistakes happen.
“We take nurses that have appeared before the NMC that have manipulated the four-hour NHS waiting target – which they should not do. But what about the pressure when people feel absolutely bullied into doing those kinds of things,” he asked.
“And, while I think nurses have to be prepared to stand up to those sorts of things, what I don’t see are the organisations being held to account to the same level as individuals are,” he said.
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Earlier on in the debate, Dr Carter said the standards for organisations that the NMC should set should include those covering working hours, staffing ratios and clinical standards.
“The NMC has a very difficult job in providing public protection, but it lacks the authority to protect the workforce that in turn would do so much to safeguard patient care,” he said.
“The emphasis in respect of regulation falls far too much on the conduct of the individual registrant, as opposed to having an equal focus on employers,” he added.