Around 60% of referrals made to the Nursing and Midwifery Council last year did not go any further, according to the latest report on the regulator’s fitness to practise activity.
However, the NMC is still falling short of its own targets to conclude cases as swiftly as possible, revealed the regulator’s Annual Fitness to Practise Report for 2016-17, published on Monday.
“These changes better able us to identify and close cases which do not raise public protection concerns”
The report shows more than 3,500 reports of alleged misconduct, incompetency or wrongdoing by nurses and midwives failed to make it past the first stage in 2016-17.
In all, the regulator closed 60% of cases at the initial assessment stage because the nurse or midwife in question could not be identified or the concerns were not serious enough to warrant further action.
This is up from 51% the previous year and follows a drive to boost “first stage decision making”.
Over the past year, the report said the regulator has continued to strengthen and improve screening processes, including providing comprehensive training for those involved.
“These changes better able us to identify and close cases which do not raise public protection concerns at the earliest opportunity, and concentrate resources on investigating only serious cases which require regulatory action,” stated the report.
However, it also showed that the regulator was still just short of its own targets for concluding cases within a 15-month window.
“We remain committed to concluding older cases within our control”
The regulator has said it is committed to resolving at least 80% of cases within 15 months. While it was in striking distance of that goal in the first six months of the year – managing to resolve around 78% of cases within the timeframe, this slipped down to 75% by the end of the year.
“This was indicative of our push to progress older cases. We remain committed to concluding older cases within our control and reaching optimal caseloads in 2017-18,” said the report.
Overall, the NMC’s report shows the number of concerns raised about the conduct and behaviour of nurses and midwives continued to rise – but at a much slower rate compared to the past five years.
In 2016-17, the NMC received 5,476 new referrals, up 1% on the 5,415 referrals received in 2015-16.
The concerns related to just 0.8% of the total number of nurses and midwives on the NMC’s register – roughly eight referrals for every 1,000 registrants.
In 2016-2017, the lion’s share of referrals – nearly 40% – came from employers with 28% from patients and the public.
The NMC said it continued to work with employers to ensure referrals were appropriate and a key development included a new an advice line to enable them to discuss particular concerns.
The report shows about 2,000 calls were received during 2016-17 and most were from employers seeking advice on potential fitness to practise cases.
Nearly half – 49% – were advised to make a referral, while a quarter were advised not to refer and 26% were advised to conclude a local investigation before deciding whether a referral was necessary.
Meanwhile, the regulator consistently exceeded goals for imposing interim orders designed to protect the public.
The NMC’s aim is to impose 80% of interim orders within 28 days but achieved an average of 91% by the end of the year.
The average cost of a hearing fell from £25,000 to £18,000 as a result of improved efficiency, meaning resources could be spent on resolving more cases, says the report.
“This reduction in cost has freed up resource and helped us to increase the number of final decisions made from 960 in 2015-16 to 1,513 this year,” it said.
Changes to fitness to practise rules – set to come into force later this year – should enable further improvements, said the report.
“The new powers will allow us more flexibility when dealing with cases, and remove cumbersome restrictions on our process, making it timelier, less expensive and more proportionate,” stated the report.
Of the just over 1,500 hearings concluded in 2016-17, 80% found a nurse or midwife’s fitness to practise was impaired with most resulting in sanctions.
In all, 23% per cent of cases that progressed to a hearing led to a nurse or midwife being struck off 0 344 cases in total – while 28% resulted in suspension orders.
A further 18% resulted in conditions being placed on a nurse or midwife’s practise and 11% received a caution.
In 278 cases, the NMC panel concluded the individual’s fitness to practise was not impaired and in 31 cases the facts were not proven.
The report shows there were 48 appeals against NMC decisions in 2016-2017 – slightly fewer than the 52 the previous year.
Of those, 26 appeals were thrown out but 22 decisions were overturned or referred back to the NMC by the High Court or equivalent.
The NMC has started gathering more detailed information on the types of cases referred. The very first data to come out this work covers the 706 allegations reported between 1 January and 31 March this year.
The greatest proportion related to concerns about patient care – 19% – or prescribing and medicines management – just under 18%.
Next in line were registrants’ health, criminal proceedings, record keeping, behaviour or violence and dishonesty.
Meanwhile, the regulator has also published its annual finance report, which reveals details of its pay structure for senior managers.
It revealed that the NMC’s chief executive had received a “significant” pay rise this year, in order to bring it into “alignment” with leadership roles at other similar organisations.