The Nursing and Midwifery Council is exploring the introduction of “personal experience statements” to enable people to communicate the impact of substandard care on their life and wellbeing in a radical move that could see the body “treading new ground for a regulator”.
The regulator confirmed to Nursing Times it was looking at how such statements – similar to “impact statements” for victims of criminal offences – could be used as part of its new approach to fitness to practice.
“Not withstanding some of the difficulties of doing it I believe if we can it will make a huge difference”
“One of things we have been exploring is how we can work differently with people so that we can help them to share their experience of care and the impact that the experience has had on them and how we can include this as part of the process of investigating or looking into what happened and then ultimately in coming to an outcome, a decision about whether or not the nurse should remain on the register or not,” explained NMC head of public support Jessie Cunnett.
Speaking at conference organised by law firm Leigh Day on the experiences of people with learning disabilities and autism of the justice system, she said the new statements could be an exciting step forward for the regulator.
She stressed they would not be exactly the same as victim impact statements, which are written or oral statements usually presented to a criminal court at the sentencing of a defendant.
“It isn’t quite the same and won’t work quite the same – because we are not the same as a criminal setting - but it is like that and we are exploring how we can introduce something along similar lines that makes sure that the impact of the events have some weight and some value when we’re thinking about the outcome,” said Ms Cunnett.
She said the NMC had already discussed the concept with a “large range of people” including people with learning disabilities and autism.
“We understand that it’s a quite a complicated thing to do and there are different opinions,” she said.
“We are just in the process of drawing together all of the findings from different conversations that we had and they included conversations with people who are lawyers and decision-makers as well as organisations representing different types of people,” she added.
Ms Cunnett said she was “really excited” to see a report on the outcome of these initial discussions and looking forward to the next steps.
“The process is supposed to be about assessing future risk and not punishing for past mistakes”
The NMC confirmed to Nursing Times it had staged a series of focus groups to explore the idea of personal experience statements and help draw up more detailed proposals.
The next stage would be to gather feedback on these more fully developed proposals from various groups including the public, nurses and midwives, registrants who had been through FtP processes, NMC staff and leaders, union and legal representatives and patient organisations.
Ms Cunnett suggested that if the concept was eventually approved and adopted the NMC would be leading the way among regulators for health and care professionals.
“If we can manage to do something like that as an organisation we would be treading new ground for a regulator and not withstanding some of the difficulties of doing it I believe if we can it will make a huge difference,” she said.
Campaign group NMCWatch, which has been pushing for reform to FtP, told Nursing Times it was aware of the concept.
Personal experiences statements had the potential to “give the panel further context to the allegations”, said a spokeswoman.
However, she said the NMC would need to proceed with caution to ensure the use of such statements was fair.
“We must not forget that the process is supposed to be about assessing future risk and not punishing for past mistakes – according to the NMC – and so this would need to be presented with caution otherwise the emotion of the case may over-ride the ability to assess the true risk that individual nurse or midwife may or may not pose,” she said.
She said currently nurses and midwives were often criticised in FtP hearings for not having considered the full impact of their actions or shown enough remorse and there was a risk statements would tip the balance against them.
The government recently published its plans to reform legislation governing how regulators like the NMC operate and said it wanted to see more support for professionals.
“It’s so important that we truly understand the impact of their individual situation”
The NMCWatch spokeswoman said it “would only be fair” to allow a nurse or midwife to present their own statement setting out the impact of misconduct allegations on them.
She said key questions included exactly when and how personal experience statements would be used, if and when they would be made available to the nurse or midwife in question so they could formulate a response, and who would decide if statements were relevant or required.
NMC chief executive and registrar Andrea Sutcliffe told Nursing Times the NMC was striving to become “a more human and caring professional regulator” particularly when it came to FtP.
“People are at the heart of the NMC’s values and behaviours, which is why when someone has been affected by poor care, it’s so important that we truly understand the impact of their individual situation and consider what it would be like to be in their shoes,” she said.
“To help embed this further in our work, we are currently exploring how the use of personal experience statements could be used as we continue to develop our new approach to fitness to practise in the months ahead,” she added.
She confirmed the NMC had not yet decided whether personal experience statements would definitely be part of its FtP reforms.
“We have not yet made a final decision about the use of personal experience statements and will take all views into careful consideration in agreeing the way forward,” said Ms Sutcliffe.