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NMC criticised for 'deficient' handling of Morecambe Bay cases

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The Nursing and Midwifery Council has been criticised for its “deficient” handling of the case against two Morecambe Bay midwives who were cleared of misconduct after a baby’s death.

The Professional Standards Authority was considering whether to challenge the NMC’s decision to clear the midwives at the High Court, amid concerns that it may not have been “sufficient to protect the public”.

It was examining the decision by the NMC fitness to practise panels relating to midwives Gretta Dixon and Catherine McCullough, who were both cleared in March.

In a statement issued today, the PSA attacked the nursing watchdog’s decision not to present relevant evidence to a fitness to practise panel and said its decisions were “deficient”. However, the PSA added it was barred by law from challenging the outcome.

”We have found that the NMC’s investigation and its panel’s decisions were deficient but not insufficient in law”

Harry Cayton

Nursing Times’ sister title Health Service Journal previously reported that the PSA was reviewing the handling of the case after evidence was not shared with the panel, which decided to clear both women over alleged misconduct linked to the death of baby Joshua Titcombe in 2008.

Joshua’s father, James Titcombe said the NMC’s handling of the case and the PSA’s inability to challenge the decision made it clear a major overhaul of the professional regulatory system was needed and the government should intervene.

Contemporaneous evidence made when Joshua was alive, as well as medical opinions and transcripts of a 2011 inquest, were not submitted to the NMC fitness to practise panel. In its conclusions about Gretta Dixon the panel wrongly said no other evidence was available apart from Ms Dixon’s own patient notes.

“It’s clear that a major overhaul of the professional regulatory system is urgently needed”

James Titcombe

The PSA said today the NMC decision not to supply evidence to the panel was “deficient but not wrong in law”.

It said that while the withheld evidence “may have been of relevance to resolving” issues in the case, its omission “was not so material that it could be said to be wrong in law”.

PSA chief executive Harry Cayton said: “We have carefully considered these cases, it is regrettable that all the evidence the NMC held was not put before the panel. We have found that the NMC’s investigation and its panel’s decisions were deficient but not insufficient in law. We will be writing to the NMC to raise our concerns.”

Mr Titcombe, a former patient safety adviser to the Care Quality Commission who campaigned to expose failings at the University Hospitals of Morecambe Foundation Trust, said families affected by poor care were still waiting for action and it was time for the government to step in.

“It’s hard to see how anyone involved can find closure or be assured that lessons have really been learned if everyone turns a blind eye to this problem”

James Titcombe

He said: “The findings of the Morecambe Bay inquiry [chaired by Billed Kirkup] were stark and revealed serious concerns about missing records, covering up the truth and repeatedly failing to learn.

“This is the reason why recommendation 19 of the Kirkup report was for the professional regulators to undertake their own detailed investigations into the conduct of individuals.

“It’s clear that a major overhaul of the professional regulatory system is urgently needed.

“It’s hard to see how anyone involved can find closure or be assured that lessons have really been learned if everyone turns a blind eye to this problem. If necessary, the government need to intervene to oversee an appropriate process that adequately addresses recommendation 19.”

jackie smith

jackie smith

Jackie Smith

NMC chief executive Jackie Smith has already admitted the fitness to practise process is “not as it should be” and was not designed to resolve complaints but identify only whether a nurse or midwife was safe to work.

In a statement today, Ms Smith did not address the criticism from the PSA and claimed the NMC had not been provided with its view. HSJ specifically asked the NMC if it accepted its handling of the cases was deficient.

She said the PSA reviews all NMC decisions but did not comment on the fact the authority had decided to convene a panel to consider this case because of specific concerns it had.

Ms Smith said the NMC had received a notification letter on Friday that the PSA review had been completed and would not be referred to the High Court.

She added: “I have met with some of the families affected by the tragic events at Morecambe Bay and apologised for the time it has taken to conclude these cases, which have taken longer than any of us would have wanted. However, this has been a complex investigation involving multiple agencies and individuals. We are committed to concluding the remaining cases as quickly as possible.”

  • 2 Comments

Readers' comments (2)

  • michael stone

    My brain must be having a bad day, today:

    'The PSA said today the NMC decision not to supply evidence to the panel was “deficient but not wrong in law”.

    It said that while the withheld evidence “may have been of relevance to resolving” issues in the case, its omission “was not so material that it could be said to be wrong in law”.'

    Surely the panel should decide what evidence is of relevance - if you only tell people (this panel) part of a story, you are 'pushing it in a particular direction'.

    Although I am not familiar with the particular machinations of this NMC stuff - and I think that if I tried to become familiar with it, I might 'lose the will to live' before I'd really got my head around it.

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  • Civil rights were eroded significantly in practise even during Blair's time and they continue to be eroded. Plenty of talk, very little walk.

    Court panels and judges do not necessarily get presented with all of the evidence and it is perfectly lawful. A ridiculously small amount of time is available for a judge, for example, to read any of the evidence that is made available to the courts. Clearly this allows undue influence from institutions and the court system is shambolic. Even-handedness can be favoured in preference to justice.

    And of course you cannot be removed from the NMC register if you are a nurse practising, again quite lawfully, without being on the register in the first place.

    The misuse of the Data Protection Act is another pitfall. To anyone involved in situations which develop into complaints, I would urge you to give the institutions defending peoples' rights, WRITTEN CONSENT to use any data you have supplied.

    With luck things may then go on behind the scenes to make improvements because they are very unlikely to be admitted and addressed where it can be seen publicly.

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