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Exclusive: Campaign aims to support nurses before and after fitness to practise cases

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Nurses who go through fitness to practise procedures should get the equivalent of a speed awareness course for drivers to help them get back on track and prevent their loss to the profession, according to new campaign group.

Improving support before, during and after nurses and midwives appear before the Nursing and Midwifery Council is one of the key goals of the new group set up by those who have been through the experience themselves.

“We know the NMC has a difficult job but we feel we need to prepare people better”

Cathryn Watters

They told Nursing Times that the reason behind the campaign was that they wanted to “stop registrants living in fear of their regulator”.

Under the provisional name of CRISIS (Challenging Regulators In Sanctioning Individuals Safely), the group held its first meeting last week. It was attended by 10 people including eight nurses and midwives who have previously undergone – or are currently going through – FtP cases.

It has a further 25 active members online, while nearly 1,000 people have signed a petition backed by the group calling for fundamental changes to the FtP system.

One of its two leaders is cancer nurse Cathryn Watters, who successfully appealed a decision to strike her off the NMC register last year over a relatively minor irregularity in a job application.

She said one of the group’s key priorities was to support nurses and midwives currently going through FtP cases and ensure they knew what to expect and how to appeal, for example.

“Our biggest thing is about education and about teaching people what the process is like, how to get through it and give them support afterwards,” she said.

“We know the NMC has a difficult job – we’re not completely against everything that they’re doing – but we feel we need to prepare people better,” she told Nursing Times.

“The hardest thing when you are going through this is you think you are the only one,” she said. “You’re embarrassed, you’re ashamed and you don’t want anybody to know.

“To find out that, not only are you not alone, but there are hundreds of nurses going through this every year is helpful, as is seeing people like myself who have come through the other side,” she said.

“The hardest thing when you are going through this is you think you are the only one”

Cathryn Watters

Ms Watters said the aim was to campaign for positive changes that could help prevent nurses unnecessarily leaving the profession at a time of widespread staffing shortages.

While there was data on the number of nurses no longer able to practise after NMC procedures, she said it was not clear how many more left simply because they had been referred for charges that may ultimately have been thrown out or resulted in a minor sanction.

“We don’t know how many people have left as a result of simply going through it and because they just can’t face nursing anymore,” she said.

The group plans to lobby MPs to raise awareness of the impact of FtP cases amid the wider picture of staffing shortages.

Key aims set down at the first meeting include ensuring FtP risk assessments take into account registrants’ own health in order to “safeguard them as well as patients”.

The group also highlighted the need for better pastoral care for nurses and midwives “to help them learn and move forwards” after going through the FtP process.

“It seems to be that employers are using the NMC as sort of disciplinary threat”

Cathryn Watters

Ms Watters said this could include providing something like speed awareness training to help registrants ensure they were meeting professional standards and any conditions set by the NMC.

“We are just trying to make it more positive rather than negative, and more supportive rather than reactive,” she told Nursing Times.

While nurses going through FtP cases were often warned by unions not to communicate directly with the NMC, she said the experience of many suggested a more open dialogue could be helpful. However, nurses needed advice on how best to handle that.

One key theme to emerge from discussions to date was the fact many nurses who ended up before the NMC regarded themselves as whistleblowers or had raised concerns in some way, she noted.

“All of the eight at the meeting have been through some level of whistleblowing or raising concerns, and that certainly seems to be the case for other people who have contacted us,” she said.

“It seems to be that employers are using the NMC as sort of disciplinary threat or as a way of sifting out difficult employees who might be ruffling their feathers a bit or raising issues,” said Ms Watters.

She said one of the “biggest areas” discussed at the meeting was the desire to put in a system to establish what the employer had done first to investigate before referring on to the regulator.

Another key goal was to strengthen the checks made before the ultimate sanction of striking off a nurse or midwife from the register. For example, they suggested striking off decisions being reviewed by another panel or a peer review process to look at the decision in the round.

“Certainly, in the case of striking someone off, there should be more checks and balances before we get to such a massive decision as that,” she said. “There will absolutely be registrants who should no longer practise, but we need to make sure we are making the right decisions about the right people.

“I know the argument is that will make it a more lengthy and costly process, but to have the numbers of nurses struck off that we’re seeing at the moment just seems crazy,” she added.

In addition, the group is calling for a “more accessible” appeals process that is not limited to taking cases to the High Court.

“The key thing we want to achieve is for regulators to be accountable when they make mistakes,” she said. “We want them to lead by example, so as not to add to the fear associated with making mistakes that unfortunately is still so prevalent.

“Everyone makes mistakes – it is what you learn from them that is important and how it improves your practice for the future,” she said. “If we live in fear of making mistakes for fear of being referred, then this will have an impact on patient safety.”

“To have the numbers of nurses struck off that we’re seeing at the moment just seems crazy”

Cathryn Watters

Ms Watters said the group, which plans to meet three to four times a year and hopes to set up a website in future, was keen to engage with key players including the Department of Health and eventually the NMC itself.

Meanwhile, she said was confident the group could become a powerful voice to push for change. “Nurses are generally quite optimistic and the general public will listen because they listen to and respect nurses,” she said.

“The NMC is bound by a lot of legislation so we have to be realistic about what we can achieve,” she said. “But what we can do is raise awareness and get that discussion going.”

The group currently operates a closed Facebook group that nurses and midwives can apply to join. Anyone interested in getting involved can also email Ms Watters at cathrynwatters@mail.com or contact the group via her existing petition web page.

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