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Regulation, Code of Conduct and Fitness to Practise

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Since the Nursing and Midwifery Council took over regulation of nursing in 2002 from the UKCC, the issue of regulation has hardly stood still.

Nursing has enjoyed self-regulation since 1919, allowing it to scrutinise the activities of its own and self-police, but that is now in question following proposals made recently by the government.

Consultation is now taking place on various options set out by the Department of Health, but it looks likely that the NMC will loose its monopoly on being able to strike nurses off the register for misconduct under fitness to practise hearings.

The government seems keen on setting up a new body to run tribunals on misconduct for all healthcare professionals, thus allowing people from outside of nursing to decide on sanctions against poorly performing or bad nurses.

This approach was prompted by findings from an inquiry into the infamous case of serial killer Harold Shipman, which heavily criticised doctors’ regulator the General Medical Council and its ability to protect the public. These led the government to question and review all medical and non-medical healthcare regulation.

Having an independent panel adjudicate in nurses’ fitness to practise hearings has worried many in the nursing profession because they fear decisions made by panels of various people including the lay public, doctors, therapists and employers will not be sufficiently informed or suitably experienced.
Such a change could also be costly and cause registration fees to rise – a price some nurses may feel they are unwilling to pay if they are no longer allowed to self-regulate.

The registration fee is already a current cause of discontent as the NMC is considering an 86% hike in the annual £43 registration fee from 2007.

The NMC’s other functions including maintaining the register of more than 650,000 nurses, midwives and specialist community public health nurses, and setting standards for conduct, performance and ethics, look likely to remain intact.

The NMC code of professional conduct is the key tool that underpins public protection and is often referred to as the regulatory ‘bible’. It is intended to support nurses in providing safe and appropriate care to patients.

However, because practice is continually changing, the NMC is currently consulting on changes to the code following feedback from practitioners that the code no longer meets their requirements.

The idea of common policy across the various health regulatory bodies has been strengthened in recent years, mostly by the Council for Healthcare Regulatory Excellence (CHRE), the statutory body responsible for monitoring the nine UK regulators, which was set up in 2003.

Updated: September 2006

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