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Concern over new NMC powers to issue public warnings

  • 13 Comments

Concerns have been raised that plans by the Nursing and Midwifery Council to introduce a new system of public warnings for registrants who have breached professional standards may result in “gratuitous” use of the sanction.

The regulator wants to have the option of using the new sanction when there are serious concerns about an individual’s past conduct, but they are thought to no longer present a risk to the public – meaning there is “no case to answer”.

“It is not a slap on the hand. It is declarable to future employers, to agencies, and can have a reputational impact”

Gail Adams

Instead of taking the person through to a full fitness to practise hearing in front of a panel the NMC has proposed that a case examiner, who carries out an assessment following investigation, will instead issue a warning.

Under the NMC’s plans, the warning will be public and stay on the registrant’s record for 12 months.

The proposal is part of major changes being brought in by the NMC to speed up its handling of fitness to practise cases.

The vast majority of people responding to an NMC consultation, which was published last week, supported the changes put forward, but around one in five disagreed with the regulator’s approach to publishing warnings.

At an NMC meeting last week, some members of the council questioned why 21% of the 41 organisations and 17% of 91 individuals taking part in the consultation did not agree with the approach.

NMC director of fitness to practise Sarah Page told the meeting there was “perhaps a fear of warnings being used gratuitously”, and also because the sanction would be published.

Currently, if an FtP panel finds there is “no case to answer”, due to the individual no longer posing a risk to patients, there is no public mark on their registration.

“It does seem rather odd that in cases that might have previously gone through to a full hearing and ended up with no case to answer, that they then still get a warning”

Louise Silverton

“The introduction of warnings is a new sanction and we need to strike the right balance between the public protection element against the registrants’ own interests,” she said.

“A warning will be used in a case where, because of the registrants’ insight and demonstration of understanding of the issue, we are able to close the case. Whereas currently we would take them to a full hearing,” she said.

“A warning will enable us as a regulator to mark the seriousness, while not restricting the practice of the registrant,” she added.

She said the challenge was to ensure what the NMC published was “sufficient to mark our role as regulator, but doesn’t go too far”.

Ms Page said the NMC believed the balance could be struck by only publishing the warning and a summary of the reasons behind it for a period of a year.

Gail Adams

Gail Adams

Gail Adams

Later at the meeting, representatives from nursing and midwifery unions also voiced their concerns about the same issue.

“The issue of warnings is a very serious matter. It is not a slap on the hand. It is declarable to future employers, to agencies, and can have a reputational impact,” said Unison’s head of nursing Gail Adams.

“It is also very difficult in a small summary to convey information that is proportionate and doesn’t set hares running, that in any way unnecessarily undermines the reputation of the registrant, but at the same it fulfils public protection,” she added.

Registrants should have to provide their consent before a warning could be issued, said Ms Adams.

Royal College of Midwives’ director of midwifery Louise Silverton added: “Our main concern is that warnings will only really take place when changes have been made and there’s been some remediation and learning [by the registrant].

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Louise Silverton

“It does seem rather odd that, in cases that might have previously gone through to a full hearing and ended up with no case to answer, they then still get a warning when they feel they have put everything to right,” she said.

The council agreed in principle to all the changes it had proposed to improve FtP processes. It includes allowing case examiners to issue warnings, give advice and recommend undertakings – when registrants who are a low-level risk to patients agree to return to work as long as they comply with certain measures or restrictions.

In January, the Department of Health published findings from its own consultation on the FtP changes and confirmed it would go ahead with plans to alter legislation.

  • 13 Comments

Readers' comments (13)

  • This will only promote knee jerk reactions in the public, galvanised by the Press, who as we all know, use headlines and controversy, especially villification of those held high in public regard. It is not for the public to know the minutae about professional misconduct, as few understand the contributing factors that lead to poor practice - most will simply jump on the bandwagon of fingerpointing, social media will multiply the publicity, and the unfortunate nurse, who may well have failed due to ill health reasons, has the added trauma and professional ruination of national publicity. Yes, some are liabilities - we all know this. But a public hanging by publicity is relegating the seriousness of issue to a mere gladiator fest. What happened to PROFESSIONALISM that the NMC seeks to uphold - what about a nurse whose mental health has deemed him or her unable to maintain standards, but who will recover to attain that in time, with support, time off, extra training perhaps....no, let us cast their right to confidentiality to the public. I would be horrified and enraged should my health records be publicised. There is no justification for this. It will only serve to reduce the already crisis level of nurses, by the threat of this, or stop those who have erred and who genuinely want to improve, even from trying.

    I rest my case. Are nurses not entitled to confidentiality - professional and health - or are we now so uncaring that we want this? Remember - who will look after you when you are frail, in need - ohh, just don`t get ill - it`s non negotiable, as there will be a demand supply dangerous issue....

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  • I find this to be extremely counterproductive as the comment above suggested a public hanging of the nurse serves no purpose. A nurse who fails might as well return their pin number now. There are mitigating circumstance why errors occur and with this new NMC LAW this will not be reflected publicly. As stated above the mental health of the nurse needs to be considered or protected. However, the NMC do not care about that because they don't care about nurses anyway.

    "Under the NMC’s plans, the warning will be public and stay on the registrant’s record for 12 months".

    Who would want this stain on their registration anyone who employs you would not do so because this will be seen as a restriction. Is the NMC going to inform all employers that the nurse is safe to practice and do so in writing to all trusts and agencies?

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  • Anonymous 4 April 6:32 PM
    Professionalism & NMC just don't fit together.
    The NMC has no interest in a nurses well being. A group of nurses & midwives have been able to cut publication in a blog on a daily basis and this must be their way of slithering their slimy way back into the pubic eye.
    The NMC should start being transparent and acting with integrity, getting its house in order before smearing nurses all over the daily gutter press

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  • Doremouse

    Anonymous 4 April 6:32 PM
    Professionalism & NMC just don't fit together.
    The NMC has no interest in a nurses well being. A group of nurses & midwives have been able to cut publication in a blog on a daily basis and this must be their way of slithering their slimy way back into the pubic eye.
    The NMC should start being transparent and acting with integrity, getting its house in order before smearing nurses all over the daily gutter press

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  • In care homes trained nurses can legitimately work without being registered with the NMC.

    If they misbehave the NMC cannot suspend or remove them from the register because they are not on it in the first place. That's very unfair on those who are registered.

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  • Doremouse

    The above comment is totally wrong. NURSES as opposed to senior care assistants MUST be registered. A residential home does not have to have a registered nurse on duty. The district nurse visits to administer a variety of meds , do dressings etc.

    Re the pic of 2 nurses for this article Have you noticed one of the RNs is wearing a watch and a ring , she has scissors & other stuff in her pocket that could be a danger and she is wearing badges. Health & Safety & cross infection policies gone

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  • The above comment is totally wrong. NURSES as opposed to senior care assistants MUST be registered. A residential home does not have to have a registered nurse on duty. The district nurse visits to administer a variety of meds , do dressings etc.

    Re the pic of 2 nurses for this article Have you noticed one of the RNs is wearing a watch and a ring , she has scissors & other stuff in her pocket that could be a danger and she is wearing badges. Health & Safety & cross infection policies gone

    Unsuitable or offensive? Report this comment

  • Why not put nurses in stocks and have passers by throw rotten veg at them?

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  • I went through an investigation at the hands of the NMC and can say first hand how soul destroying a process it is. Despite there being no case to answer, this still stays on my record for two years - where is the fairness in that? The NMC wouldn't know fairness if it sat up and bit them.

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  • The NMC wants to cut the long waiting list for hearings. A public warning is not the answer if there is no case to answer. The public should be warned if there is a case to answer. Publicly punishing a nurse is not the way forward. Oh by the way I am waiting to hearing they have increased our fees to cover the administration of the new initiative......taking away our paltry 1% pay rise.

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