The Nursing and Midwifery Council has defended its proposal to deal with the majority of fitness to practise cases in private, following claims the change will decrease transparency and remove a deterrent against poor conduct.
In draft consultation documents released last week by the NMC, the regulator described its current approach of taking most cases to full hearings as “adversarial” and having a negative impact on witnesses, employers, and registrants.
In the future it wants all cases in which nurses and midwives agree with the regulator’s assessment of events to be dealt with on paper at a private meeting – which would not require registrants or witnesses to be present.
At its council meeting this week, the regulator’s director of fitness to practise Matthew McClelland was asked by council members how the NMC could reassure the public following criticism of the plans on social media.
Claims had also been made in the national media by patient safety charity Action against Medical Accidents that dealing with concerns behind closed doors meant there would be less systematic public scrutiny.
“It’s absolutely essential we carry on publishing the outcomes of our decisions at all stages in the process”
At the meeting last week, NMC council member Derek Pretty referred to claims that the NMC was removing an element of punishment by not carrying out public hearings.
“Are we ready to cope with an argument that says taking away a punishment component, which is what some people might perceive should be there, will actually take away a deterrent, and that it will become a loose and sloppy system that allows people to do whatever they want by way of saying sorry,” he said.
Another council member, Stephen Thornton, added that he believed there had been a “complete misunderstanding” about the NMC plans.
“In some way we have got to get across to people we are not in the punishment business,” he said.
NMC council member Ruth Walker, who is executive nurse director at Cardiff and Vale University Health Board, also asked how the NMC could be sure it was making the right decisions and that it could show the public it was being transparent.
Mr McClelland stressed the NMC’s legal function was to protect the public, not to punish people. “What we want to do is be very clear about that, to counter a very understandable public perception out there that that’s our role,” he said.
He told the council that the concerns about the removal of a deterrent were linked to those about transparency – and underlined the fact the NMC still planned to publish the outcomes of all cases where regulatory action had been taken.
“It’s absolutely essential we carry on publishing the outcomes of our decisions at all stages in the process where we’ve taken a regulatory outcome – precisely so people can see the types of decision we make, so that we’re open to scrutiny, but also so we’re promoting standards in the profession and confidence in the profession - as well as in what we do,” he said.
“Why would be put the registrant, complainant, patient…through the distress of coming to give evidence?
NMC chief executive and registrar Jackie Smith told Nursing Times ahead of the council discussion that she believed the regulator’s plans had been misunderstood.
“We are asking questions, as a part of the consultation, around if someone admits they have made a mistake and they demonstrate they want to learn from it, and they accept the sanction we think is appropriate – why do we need a public hearing?,” she said.
“Why would be put the registrant, complainant, patient, their families, witnesses through the distress of coming to give evidence at a hearing when the outcome is the same?,” she added.
The NMC council agreed to a consultation on the proposals, expected to be launched on 3 April, with changes due to be brought in from 2018-19.