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Government launches consultation on giving nursing regulator 'greater freedom'


The Nursing and Midwifery Council could be given much greater freedom to set its own its procedures without the need for legislative changes, under a new UK-wide consultation.

The Department of Health has today launched a consultation asking for views on potential reforms affecting the nine regulatory bodies that oversee fitness to practise, education and other standards.

“Our current legislation is woefully outdated”

Jackie Smith

The consultation – titled Promoting professionalism, reforming regulation – will run until 23 January and covers topics such as “efficient regulation”, “responsive regulation”, and “protecting the public”.

The move, welcomed by the NMC, could specifically lead to greater freedoms for regulators to speed up reform without the need for lengthy parliamentary process as well as greater efficiency.

It asks respondents whether they agree that all regulators should be given a “full range of powers for resolving fitness to practise cases” – in line with those already available to the General Medical Council for doctors – and “greater flexibility to set their own operating procedures”.

In addition, the consultation calls for views on whether each regulator should set out proposals on how they will “ensure they produce and sustain fit to practise and fit for purpose professionals”.

In a move likely to be prove popular with registrants, it also asks whether any savings made through the reforms should be “invested upstream to support professionalism” or be “passed back as fee reductions”, or both.

“The UK’s model of professional regulation for healthcare professionals has become complex and outdated”

Department of Health

Meanwhile, it requests views on closer working arrangements between the different regulators and hints at wanting to merge some of the smaller ones.

A document accompanying the consultation stated that the regulation of health professionals “needs to be faster, simpler, better and less costly”.

“The regulation of healthcare professionals must change in order to protect patients, to support the transformation of our healthcare services and to meet future challenges,” said the document.

“While the healthcare regulators are generally effective in protecting the public from serious harm, there has been criticism, not least from the regulators themselves, that the system is slow, expensive, complicated, reactive, overly adversarial and confusing for patients, professionals and employers,” it said.

“This complexity makes it difficult for the regulators to operate as effectively and efficiently as they would wish,” it said. “It also makes it difficult for patients to know when and how to raise concerns about the care provided by a healthcare professional.”

The document added: “Better and more responsive healthcare professional regulation is a shared ambition for both the regulators and all four UK governments.”

As part of a section on variation between the regulators, the document noted that the NMC spent around £58m on fitness to practise cases in 2015-16 – representing 76% of its total spending.

When broken down, this equates to an average of £10,727 spent on each case and at a cost of £84 per registrant per year.

The move by the government follows suggestions this time last year that ministers were keen to press on with reforms, including rationalisation of regulators, in the wake of the Brexit vote.

Meanwhile, a number of fitness to practise changes specifically affecting nurses and midwives finally came into force earlier this year, based on recommendations made in the Francis and Kirkup reports.

The changes, that came into force in April and July, included removing the legal requirement for midwives to have a supervisor, and gave the NMC more powers to speed up fitness to practise cases.

In a statement issued today, the NMC said it welcomed the government’s new consultation on proposals to reform health professional regulation.

NMC chief executive and registrar Jackie Smith said: “I’ve made no secret of the urgent need for regulatory reform. Our current legislation is woefully outdated; it is a barrier to us becoming the modern and dynamic regulator we want to be.

“At the moment, we are entirely reliant on the government for adapting our legislation in response to changing external circumstances – a process that can often take years to achieve,” she said.

jackie smith

jackie smith

Jackie Smith

“We need a much more flexible approach to regulation, enabling us to meet the demands and expectations of a rapidly changing health and care landscape while continuing to ensure openness and transparency,” stated Ms Smith.

She added: “This consultation is a welcome step in the right direction but government must ensure that they press ahead with the changes that are so desperately needed to ensure that we have legislation which will enable us to properly protect the public in the years to come.”

Examples of questions asked in the government consultation:

  • Do you agree that all regulatory bodies should be given a full range of powers for resolving fitness to practise cases?
  • Do you agree that the regulatory bodies should be given greater flexibility to set their own operating procedures?
  • Do you think that the views of employers should be better reflected on the councils of the regulatory bodies, and how might this be achieved?
  • Should each regulatory body be asked to set out proposals about how they will ensure they produce and sustain fit to practise and fit for purpose professionals?
  • Should potential savings generated through the reforms be passed back as fee reductions, be invested upstream to support professionalism, or both? Are there other areas where potential savings should be reinvested?
  • What are your views on the use of prohibition orders as an alternative to statutory regulation for some groups of professionals?
  • Do you agree that the regulators should work more closely together? Why?
  • Do you agree that there should be fewer regulatory bodies?

Readers' comments (5)

  • Now the NMC will be able to wreck more nurses lives and careers
    Now barristers will be able to cram even more nurses money into bulging wallets
    Now nurses will have even more difficulty defending themselves
    Now nurses will have to bow even lower to this dreadful organisation
    This country does not deserve a nursing profession

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  • Perhaps if they're going to be more efficient and spend less money on lengthy, repetitive and futile investigations, we could get a reduction in our annual fee? I'm still not entirely sure what this money pays for: long, inefficient, drawn out investigations, and substantial pay rises for the NMC chief executive it seems. NMC certainly doesn't have the best interests of the country's nurses at heart.

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  • My answers to the sample questions:
    No. We have the law for full powers.
    N. They should be subject to the law.
    N. Employers are not disinterested.
    Y. This is a no-brainer.
    Pass savings back; it's money we were forced to pay so we can work.
    No to prohibition orders. Statutory reg'n is impartial.
    Regulators should not work more closely.
    There should be no more or any fewer regulatory bodies.

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  • The NMC doesn't exist to have the best interests of nurses at heart, it exists to protect the public. If this is the case(and it is) why are nurses forced to pay annually to protect the public from themselves? It makes no sense to me.

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  • NMC to have more power?

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