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NMC considers screening public referrals in bid to reduce FtP cases

  • 28 Comments

Members of the public could find it harder to have a nurse investigated by the Nursing and Midwifery Council under possible changes to its fitness to practise process.

Under the current system, when an allegation from a member of the public raises concern that a nurse’s fitness to practise could be impaired it is referred directly for investigation.

But the NMC has said this has resulted in some cases where nurses have been investigated, despite their employer having no concerns about their safety to practise.

As a result, the regulator is considering a proposal to increase the involvement of NHS trusts when it initially receives a complaint from a member of the public.

Following a referral, trusts could be asked for their views on whether the nurse involved posed a risk. Depending on the trust’s response, the NMC could decide to drop the referral at the screening phase without launching a full investigation.

It is one of a number of changes the troubled regulator is considering in order to try and reduce its caseload – there has been a 52% rise in the number of FtP referrals made to the NMC over the past two years. Its current FtP caseload is believed to be around 4,500.

The costs associated with the jump in caseload has led to the regulator’s financial position becoming “fundamentally unsustainable”, and resulting in its unpopular plan to increase registration fees by nearly 60% from next year.

If the FtP changes are adopted by the NMC council, a registrant’s employer would be asked for their comments and, if they satisfy the screening team there was no practise impairment, the case would be closed without investigation.

Where a risk was identified, but action had already been taken by the trust and the nurse was complying, the case would be referred with a recommendation it be closed.

A spokesman for the regulator said initial proposals discussed by the NMC council members on 19 July had not been adopted, but “further work would be done”.

It is expected final recommendations will be submitted to the council in November.

However, the Patients Association criticised the proposals as a “disastrous move and a backward step in regulation”.

Its chief executive Katherine Murphy said: “We hear far too many appalling cases of poor quality patient care, such as a lack of adequate nutrition or no support going to the toilet.

“When relatives raise a concern at a local level they are frequently ignored – they turn to the NMC in the hope that their concerns around individuals who continue, for whatever reason, to provide substandard and often dangerous care will be held to account for their actions.”

Other changes are also being looked at to reduce the number of investigations required by the NMC.

These include removing the need for full investigations into cases where nurses have received minor motoring convictions, minor cautions and convictions involving dishonesty that are not related to clinical practice, and some offences involving alcohol or drugs.

  • 28 Comments

Readers' comments (28)

  • Viva la Revolution! NMC in progressive thinking shocker. Amazing what the threat of a rebellion and suggestions of moving out of their comfortable London pied-a-terre will do.

    Welcome to the 21st Century.

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  • This is what the other regulators do and they don't have the trouble the NMC does, so it must be a step in the right direction. But surprise the Patients Association says "no" but is it campaigning for the other regulators to change? No, just jumping on the bandwagon....

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  • About time things changed, it is not fair that an individual nurse is referred to the NMC because they genuinely didn't have time to help take someone to the toilet.

    Managers have a responsibility to ensure their staff offer a high level of care. Employers have a responsibility to ensure there are enough staff, suitably trained, to offer a high level of care. It's time they took a bit of responsibility.

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  • At last, some common sense sneaking in.

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  • Employers have a duty of care to their staff to ensure that they work in an environment free of bullying and harassment. I see little intrinsic difference between a patient or visitor shouting at a member of staff or making a spurious referral to the NMC.

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  • Seems sensible. I see Rita Newlands Head of Education has also left today. Is there anyone left at the NMC?

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  • I agree with this proposal.

    Many complaints arising from the public are at best misguided and at worse malicious.

    Whilst I would not wish to see the public prevented from raising concern about a Nurse/Midwife's FtP an initial screening followed by a discussion with the individual Nurse/Midwife's employer would seem appropriate.

    I believe the GMC routinely employs a pre-screening of complaints received from the public and others

    If an employer has satisfied themselves that an employee does not present a risk to patients that should be the end of the matter.

    It must be recognised that some complainants will never be satisfied and it is regretful that organizations such as the Patients Association actively encourage the pursuance of complaints beyond the point of reason.

    In the present climate , with examples such as Stafford fresh in the public's mind, it is important that every effort is taken to avoid giving the impression that concerns raised by the public are being "ignored"

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  • Florence

    I agree that more complaints should be dealt with at a local level. This will make sure that managers start to take responsibilty for conducting proper investigations . And addressing the issues that lead to problems. I do agree that many complaints are mis guided and even
    malicious.
    It appears to me from conversations with non- nursing friends that reporting a Nurse to the NMC is a quick fix and will ensure that the Nurse gets dealt with. However I have seen the frustration of people who feel that their complaint at local level has been ignored.
    However if we got to the root causes of complaints I believe that it is usually down to lack of resources to do our jobs properly.
    I don't blame the public for being disillusioned and frightened . And perhaps it is a lack of understanding on how to and who to complain to that leads to cases being referred that are clearly inappropriate.
    Most of the complaints we deal with are due to poor communication. Not poor practice. Although poor communication is actually a form of poor practice . And my heart goes out to some of my patients and relatives as I don't believe they do always get information in a timely manner.
    The media has had a huge part to play in this. It seems to delight in sensationalising complaints.I absolutely believe we should be held accountable for our actions. However I believe that the NMC has left the door open to allowing their complaints system be abused.

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  • Why does a nurse need investigating for a minor traffic offense or a minor caution that doesn't affect their clinical practice?

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  • is all this complaining a British epidemic? it is often done behind peoples' backs which gives the person no chance to defend themselves and if they have only made a minor error the first thing they know about it is when they are hauled up before somebody 'in authority' to be reprimanded. certainly a very unpleasant and unhealthy way of going about things and will do nothing to enhance motivation and good care.

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