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NMC insists plans for more private FtP cases not 'done deal' as consultation launches


The Nursing and Midwifery Council has launched a consultation on its controversial plans to deal with the majority of fitness to practise cases in private, claiming the change would encourage nurses and midwives to speak up about problems at an earlier stage in the process.

The proposals, which would mean fewer public hearings are held, have attracted criticism in recent weeks following their unveiling in draft council papers from the regulator.

“This isn’t a done deal, we’re eager to hear not only from professionals and employers but importantly from members of the public”

Jackie Smith

However, critics of the idea have claimed the proposed changes by the NMC will remove a deterrent against poor conduct, reduce public scrutiny and result in less transparency by the regulator.

Last week, the NMC defended its plans at its latest council meeting, as reported by Nursing Times. But, as it launched its consultation exercise today, the regulator insisted the plans were not a “done deal” and encouraged nurses and the public to share their views.

It highlighted that the changes, if approved, would mean cases were only dealt with privately when there was no dispute about the complaint and what sanction should be applied.

Those affected by failings in care would only be called to give evidence at public hearings where “absolutely necessary”, said the regulator in its consultation document – titled Ensuring patient safety, enabling professionalism: a new strategic direction for fitness to practise.

The NMC restated that it planned to continue to publish the outcome of cases – and as part of the changes also wanted to start publishing details where registrants voluntarily remove themselves from the register.

It said it wanted to introduce the changes to reduce the amount of time taken to deal with a case, to support nurses and midwives to be open about their mistakes and to move away from its current “distressing” fitness to practise process.

“Where nurses and midwives speak up early and learn from their mistakes we want to see fewer hearings”

Jackie Smith

More widely, the regulator wants to see employers dealing with complaints first. It has proposed only becoming involved with a case if it has already been investigated by bosses, according to the consultation document.

Today the regulator’s chief executive and registrar, Jackie Smith, said: “Where nurses and midwives speak up early and learn from their mistakes we want to see fewer hearings and cases resolved much more quickly.

“We want to move away from a process which is often adversarial, cumbersome and distressing to one which supports a learning culture where nurses and midwives can be open about what happened,” she said.

“Our proposals aren’t about excluding anyone, rather we want to reduce the impact on all those involved whilst putting patient safety at the heart of what we do,” said Ms Smith.

“This isn’t a done deal, we’re eager to hear not only from professionals and employers but importantly from members of the public about our proposed new approach,” she added.

The consultation on the changes is open until 30 May.


Readers' comments (2)

  • I understand the analogy behind the NMC proposals but need to question the following:

    (a) - ECHR Article 6 is an ABSOLUTE RIGHT to have a fair hearing. BUT many without legal representation do not attend CCC or Interim Order hearings............So can I presume that the ones who do not attend these public hearings will be offered full transcripts without having to request them?

    (b) - What are the annual statistics of registrants being "struck off", "impaired" or "sanctioned" on those who attend and those who do not attend hearings? A comparison would be appreciated

    (c) - Majority of referred registrants will refuse to attend a full CCC hearing based upon the pretence that a private paper hearing will deal with their evidence in a fair manner via the "Investigatory Committee" hearing. So how will NMC/CCC private hearings differ from "Investigatory Committee" hearings?

    (d) - Unfortunately, the panel can cherry pick evidence based upon witness statements and testimonies (who can be demonstrably untruthful and not of honest opinion), but disregard overwhelming supporting contemporaneous will this be avoided?

    (e) - The NMC or their counsel / barrister/ and CCC court can rely upon witness statements as "used" evidence and disregard "used/unused" contemporaneous evidence which can support the registrant..........SO will the NMC surrender all contemporaneous evidence to the CCC/ private hearings? And will an INDEX be provided which can hopefully be reflected upon the full transcripts of the private hearings?

    (f) -  Can the registrant submit their supporting and additional evidence under NMC rule 31 as "used evidence" to ensure a fair balanced hearing?......OR........ Will the NMC and CCC/ private hearing panel use what they feel is appropriate?




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  • Cathryn Watters response: registrants aren't in the best place to make decisions about what to do next when faced with correspondence from the NMC. They want the whole situation to go away quickly and are not necessarily in the right frame of mind to make decisions. Not all have legal representation. Therefore what will be put in place to safeguard the registrant? Can letters be reviewed in order to ensure they are clear and can they be directed to somewhere for additional advice such as NMC Watch if they need more support? My fear is that this is fine if you have a registrant who understands fully the implications of their decisions, is able to communicate well and is able to advocate for themselves but the majority do not fall in that bracket.

    Cathryn Watters response: When the correspondence goes out the registrant stating their hearing can be held in private we would hope to see the full options given to them including the right to go to full hearing.

    Cathryn Watters response: Statistics of attendance and non-attendance would be interesting to look at particularly from recent changes utilising Consensual Panel Determinations. How many registrants do not attend or participate in the process - have they been asked why so that lessons can be learnt?

    Cathryn Watters response: As per my previous statement most will opt to take the "lesser option" and  have it heard in private as can't cope with drawn out process. This may make them vulnerable to agreeing the charges without fully understanding the implications. Again how will you safeguard them in this instance? Some will choose for private as they can't afford to travel to attend full hearing and be away from home for ++ days or off work for unknown period of time. They may choose private because it is easier rather than the best option for them. 

    Cathryn Watters response: Many of us have found that not all the information is included in the bundles sent to registrant. In order to be fully transparent everything that the panel and NMC lawyers / teams get the registrant should get as well. There is no way of the registrant knowing they have received the full bundle unless they appeal and do FOI / DP request which many wont so this sets them at a disadvantage. Don't forget many have not done the accusations suggested but have no proof so show it, this doesn't mean they should agree the charges just because they can't prove otherwise!

    Cathryn Watters response: there needs to be  a non biased person who ensures all information given is transparent and accurate. Something seen as not important to the NMC counsel as does not strengthen their case may be disregarded but may actually be of use to the registrant to defend theirs.

    Cathryn Watters response: Justice Kerr, Lusinga V NMC stated the importance of the Indicative Sanction Guidance being more nuanced to ensure levels of conduct are appropriately sanctioned. this was mirrored in Watters V's NMC(2017) where Justice Cheema Grubb stated that once again the sanction guidance fell short of what was required and that the panel failed to weight appropriately. What guarantee do we have that this wont occur again if no legal representative is there to ensure proper consideration of points of law? Will there still be a legal advisor at these private hearings? The ISG now available on the NMC website is less indepth than previous - surely this is not the whole guidance given to panels and if not why is it not available to be seen by the registrant?

    Cathryn Watters response: My only other comment would be that private hearings were removed from the process a few years ago where is was obviously felt that this was not appropriate so why now are they being suggested at being returned - what has changed?
    BY Cathryn Watters, I have asked a friend to submit this for me as unable to sign on to NT website at present.

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