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EDITOR’S COMMENT

'The regulator must not be seen as an HR service'

  • 24 Comments

Every nurse I meet is fearful of the Nursing and Midwifery Council.

From fresh-faced students to those nearing retirement, I haven’t met one nurse who doesn’t dread the prospect of being “called into the headmaster’s office to be told off”, which is how some nurses have described it to me.

It’s understandable. Here is the judge and jury that can take away your whole career and everything you’ve worked hard for. Being referred to the NMC is an upsetting experience and in many cases it is one that nurses are subjected to without real justification.

The new interim chair of the regulator, Judith Ellis, executive dean at London South Bank University, has said that one of the many things that isn’t helping the NMC to clear its backlog of cases is inappropriate referrals.

In a statement that echoed a similar point made by the Royal College of Nursing’s Janet Davies at the Florence Nightingale Foundation conference last month, Professor Ellis says that 40% of fitness to practise referrals are thrown out at the pre-screening stage. From April 2011 to February 2012, the NMC had 4,035 new matters and in many cases, they could have been dealt with by the employer. The NMC forecasts that this financial year it will spend £31.3m on case referrals, which is about 50% of its total expenditure.

That means nearly half the referrals it is asked to process should not be taking up any of its time. Isn’t that just the biggest waste of your registration fees?

Some nurses, who are wholly fit to practise, are referred to the NMC by people they simply don’t get on with. But in many cases, the employer is passing the buck to the regulator, largely because of its own lack of understanding of just what is performance management and what needs referring.

We all know that there will be practitioners whose right to work as a nurse should be withdrawn. But the NMC seems to be turning into an HR department for those organisations that are not tough enough to take responsibility for their staff’s performance.

Strong leadership should start with strong team management, and an ability to distinguish between a misdemeanour that can be best handled internally and a genuine cause for referral. This isn’t just to cut the NMC’s worklist. It’s about treading carefully around nurses’ careers and confidence. No one should be forced to endure the stress of a referral when they haven’t done anything to warrant it. Nursing is a hard enough career as it is – it’s not too much to expect those in charge of managing it not to add to the emotional burden.

  • 24 Comments

Readers' comments (24)

  • well said!

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  • Absolutely well said!

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  • Some one needs to get a grip on the NMC's fitness to practice dept - it hasn't been fit for purpose for years and lacked any sort of leadership

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  • & yet, despite the comments from NMC & RCN quoted above, as of last week, partly to help them focus on volume of referrals & their public protection role, the NMC are planning to close their professional advice line, & those self-same managers making inappropriate referrals are one of the recommended alternative sources of professional advice?

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  • It would be illumimating to find out who is actually responsible for this huge volume of inappropriate referrals? If indeed Directors of Nursing are labouring under the misapprehension that the NMC is simply another tier of management of the organisation they work for, then this demonstrates either a wilful abuse of power - or - an ignorance of the NMC's role.

    Neither is acceptable. May I suggest that the NMC would do well to occassionally summon an offending Director in person to the NMC to remind them that practitioners are individually accountable (whatever their exalted position) for their practice and that wasting NMC's time and money either wilfully or incompetently is not a terribly good idea.

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  • George Kuchanny

    Welll said Phillipe - the biggest problem by far in the NHS is that managers get to be managers not because they can actually manage but because they sing the same song as their immediate superiors.

    This is no way to operate. The organisation becomes a strange kind of Municipal employer first and foremost. Efficiency, raising concerns and patient care sink to the bottom of a priority list that is mostly concerned with keeping everyone kissing each other's bottoms to put it crudely. Anyone who does not play the game may be targeted.

    All a bit Alice in Wonderland in the end with Mad Hatter tea parties (Trust meetings) where important matters are constantly fudged.

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  • Over the years I've noticed how similar in behaviour managers are. No matter how many hospitals I work in, they are all the same. I wonder if it is character trait. One group of managers were so unimaginative; they would force through any order no matter how awful the consequences. We nick named them the "hitler youth".

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  • Often in the press the NMC is reported negatively. When a 'bad' nurse is struck off there's usually little mention of the NMC. A 'good' nurse being unfairly struck off though, such as the case of Margaret Haywood, is widely reported. Just need to remember if you do nothing wrong you've nothing to fear.

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  • Grant Byrne
    Have you read some of the fitness to practice statements? Half of them are clearly hatchet-jobs by management against people. Now, if you were an incompetent manager and didn't want it to get out, you would surround yourself by cronies and make life difficult for those who can see your shortcomings. What better way than to report them to the NMC, it'll take years to be heard, by that time the real minutiae are forgotten, staff will have retired, and people will get other jobs away from nursing (check how many dismissal orders there are, see what they are accused of and weep). Can you remember the details of one drug round from 5 years ago? No? Can't remember why that patient didn't get paracetamol? No? STRIKING OFF ORDER. Shit sticks.

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  • There is also something nasty and umpleasant going on here. The very fact that so many fitness to practice referrals are thrown out at pre screening stage demonstrates in the most explicitely way possible that certain managers out there have an unhealthy enthusiasm for wishing to destroy indiviudual nurses careers.

    I repeat: whichever Director puts their signature under the inappropriate referral might think twice were they aware that in the event of either wilfully or incompetently wasting NMC time they risked being summoned to explain and justify their actions in person.

    Sauce for the goose is sauce for the gander: individual accountability for nursing practice is a mantra which should not just apply to those who work at first hand with patients .

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