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.