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Regulator signals its ‘commitment’ to new fairer culture on fitness to practise


Leaders at the Nursing and Midwifery Council have agreed to introduce a raft of changes in the way it resolves concerns about nurses’ and midwives’ fitness to practise.

Among them are plans for fewer fitness to practise hearings, more openness and transparency, and moves not to automatically strike people off for certain types of misconduct.

The changes signal its commitment to “moving away from a blame culture towards a just culture in health and social care”, said the regulator.

“These plans set a new direction for the NMC and will help to bring about a just culture”

Matthew McClelland

The move follows a major consultation that concluded in June. The NMC has published the findings alongside a new fitness to practise strategy, which was approved by its council on Wednesday.

Overall, it said the consultation showed broad support for the NMC’s attempt to move away from a “culture of blame and denial” to a system that put more emphasis on learning from mistakes.

The NMC said its focus would now be on reducing risks to patients and service users in the future by “encouraging openness and learning, not on punishing nurses and midwives for past mistakes”.

“Our plans put the voices of patients and families at the heart of what we do”

Matthew McClelland

Changes to the process will make sure the regulator treats patients and families with compassion and respect, and properly listens to and resolves their concerns about nurses and midwives, it said.

There will be better information and support for patients and families, and a rolling programme of training and development for NMC employees, it added.

These specific changes follow severe criticism of the way the regulator dealt with families from Morecambe Bay and those affected by the care scandal at Gosport War Memorial Hospital.

The NMC has also pledged to work more closely with employers so that as many issues as possible can be “resolved quickly and effectively at a local level”.

Greater consideration will be given to the context in which incidents occur in recognition of the complex issues and pressures nurses and midwives face every day.

When concerns are raised with the regulator, registrants will be encouraged to be open about what happened and to talk to the NMC as early as possible about what they have done to put things right.

If more action is needed, the regulator will seek to agree with the nurse or midwife what steps they need to take before they are fit to practise safely and professionally, it said.

As previously reported, in many cases, the NMC has said a full public hearing may not be needed, which will reduce the burden on everyone involved, especially patients and families having to relive distressing experiences.

Full reasons for the NMC’s decisions will be published, so there is transparency about what steps have been taken to manage public protection risks and why, highlighted the regulator.

Matthew McClelland, director of fitness to practise, said: “These plans set a new direction for the NMC and will help to bring about a just culture in the health and care sector.

“It’s clear we needed to change and improve our approach to help keep people safe and support nurses and midwives to practise safely and professionally,” he said.

He added: “Our plans put the voices of patients and families at the heart of what we do and place a much greater emphasis on openness and learning to help reduce risk for the future.”


Readers' comments (3)

  • Nice timing : (

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  • About time, too many nurses have suffered from NMC FTP cases and been treated like criminals.

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  • Will current cases that have dates planned be reviewed to reduce the necessity of lengthy hearings - 7 to 10 day hearings just because the registrant is denying charges is ludicrous,, particularly when there was never any patient harm and it is an issue of proving or disproving honesty. Cases need to be based on fact and not a witch hunt CSI type attitude of assumption that all registrants are wrong doers and there must be proof somewhere!!

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