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Legislation changes to speed up fitness to practise confirmed by Department of Health

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The government is to press ahead with legislative changes that will speed up the Nursing and Midwifery Council’s handling of fitness to practise cases, after a consultation showed support for the reforms.

The Department of Health has now published its response to a consultation on the changes, which was launched last year and attracted 1,421 respondents.

It said the changes would give the NMC new powers that were broadly in line with the reforms that it had made for other healthcare regulators, such as the General Dental Council and General Medical Council.

The legislation changes will allow the NMC to make decisions earlier on in the process for certain FtP cases, meaning it will only need to hold costly hearings for the most serious cases.

It will mean the NMC can issue warnings or give advice to registrants when their past conduct has caused concern but they are currently fit to practise, or when there has been only a minor breach of professional standards.

The changes will also allow the NMC to agree undertakings, which are formal binding agreements between the regulator and the registrant, that would set some conditions of practice for a period of time – such as training or working under supervision.

This would occur where the registrant posed a low-level risk to patients and there was, therefore, a “case to answer”. Warnings will be published by the NMC – for 12 months – as will details of undertakings, but the advice issued will not be made public.

“The introduction of undertakings allows regulators to apply a more proportionate and flexible approach”

Government response to consultation

Just over half of respondents to the consultation agreed to these proposals. But the DH noted that “a number” of respondents – including the Professional Standards Authority, which oversees the NMC – said that where there was a “case to answer”, a full panel hearing should take place to ensure transparency and public confidence.

“However, the Department [of Health] believes that the introduction of undertakings allows regulators to apply a more proportionate and flexible approach to regulation whilst upholding public confidence and transparency as details of the undertakings are published,” said the government in its response.

Meanwhile, a number of other proposed changes relating to FtP will also go ahead, according to the government’s response to the consultation.

These include merging the NMC’s different types of FtP committees, removing the requirement to hold hearings in the country of the registrant’s registered address, and introducing a power for the courts to replace interim conditions of practice or interim suspensions with one another when they receive applications to extend or terminate such orders.

In addition to FtP reforms, the DH’s consultation also looked at legislation changes affecting midwifery supervision. Despite opposition to the proposed removal of statutory supervision for midwives, and also the removal of the legal requirement for the NMC’s midwifery committee, the DH said it would press ahead with these plans as well.

The FtP changes are expected to result in around £60m of savings for the NMC over the next decade, according to the DH. However, it is not expected that the NMC will pass this on to registrants by reducing annual fees.

The NMC said it planned to use any savings by investing in its other programmes of work – including education, setting standards, and revalidation – or to offset rising annual costs from ongoing increasing numbers of FtP referrals.

In a statement, health minister Phillip Dunne said: “We want the NHS to be the safest healthcare service in the world – by giving the NMC direct responsibility for regulating midwives, and making the NMC’s assessment of midwives’ and nurses’ fitness to practise more efficient, these changes will help to make midwifery and nursing as safe as it can be.”

NMC chief executive and registrar Jackie Smith said: “I have long maintained that our current legal framework is out of date and in need of significant reform and I am pleased that the government has recognised this. 

”We have worked closely with the Department of Health on these important changes which will enable us to become a more efficient and effective regulator, better able to protect the public,” she said.

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Readers' comments (1)

  • The Department of Health intends to move forward with the proposal to give the NMC the power to issue a warning to a registrant that will be published for 12 months.
    I took part in this NMC consultation and did put my argument forward why I felt issuing a warning in the public domain without a hearing is breaching the conventional Human Rights Act (1998) article 6(1) (right to a fair hearing). Nearly 45% of NMC referrals are submitted by employers and in some cases, this has been due to the registrant whistleblowing against that organisation........ If this is the case, the probability of the employer submitting full supporting contemporaneous documents will be highly unlikely .............
    The action of a PUBLIC WARNING is completely disproportionate and incompatible with article 6 ............... If the registrant disagrees with this PUBLIC WARNING, then what appeal process has the NMC / Department of Health implemented?
    Registrants are able to appeal NMC/CCC full hearing decisions at the High Courts of Administration BUT if a CAUTION is served, the registrant will have to appeal under Judicial Review.......... SO........ what provisions are in place if a PUBLIC WARNING,is unfairly served?
    The consultation report alleges it wants to surrender more powers to the NMC (that the GMC already have).........BUT.........
    - The GMC receive nearly 10,000 (ten thousand) complaints anally against Doctors that results in an average of 200 (two hundred) being sanctioned, impaired or struck off.
    - The NMC receive nearly 5,000 (five thousand) complaints anally against registrants that results in an average of 1,300 (One thousand three hundred) being sanctioned, impaired or struck off.
    All of the above has been alleged as being proportionate, transparent, efficient and fair!!! .... REALLY?

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