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Managers 'hiding behind' NMC referrals


Managers have been accused of referring nurses to the regulator for performance issues that they should be sorting them out themselves.

Royal College of Nursing executive director for nursing and service delivery Janet Davies said last week that managers were “hiding behind” the Nursing and Midwifery Council.

Latest figures from the NMC and the professional regulators, such as the General Medical Council, have shown a recent hike in fitness to practise referrals. In its annual report for 2010-11, the NMC said it received an “unprecedented” 4,211 new cases. This compares to 2,988 the previous year.

It suggested its work to make it easier for people to complain about nurses, for example its increased web profile and social media presence, may have “contributed to the dramatic increase in the number of referrals”.

The issue was last week discussed at the Florence Nightingale Foundation annual conference in London.

During a panel discussion, Ms Davies said: “It’s important we look at this and make sure it isn’t more people who are performing incredibly badly in their role and they are not fit to practise.”

But she added: “From my experience there is also a move from managers who are not their taking their leadership responsibility enough in managing poor practice.”

She said people knew about poor practice going on in their clinical areas, “but they haven’t done anything about it”. They were not necessarily things you can be struck off for, she added, but were usually more minor problems that could be overcome with support.

“People are referring to the NMC to let them sort it out, rather than actually sorting it out themselves,” Ms Davies said.


Readers' comments (35)

  • I agree in my experience poor performance from any worker in the NHS is often not tackled, be they Nurse/Doctor/manager.
    No one wants to take responsibility for tackling the issue. Often the person is simply moved to another area - as though that helps!
    Then eventually a serious error may occur and the NMC is involved as a result of not helping that individual with their issues long before.

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  • This is so true, & you only have to look at some of the hearings and outcomes on the NMC website to see this in some of the cases.
    The NMC website also has clear guidance for managers on when they should refer & actions they should have performed 'in-house' before doing so. I spoke to the NMC Professional advice line recently, about what happens if an investigation into one nurse unearths that other nurses (inc managers) have breached their code of conduct. I was told NMC wouldn't routinely investigate them & it would require someone to make a complaint against them - even though the NMC would have evidence of misconduct???
    Especially with the additional pressures everyone has in their jobs at the moment, I can see why it's the easier option for a manager to pass on to NMC rather than spending their own time on it. But if there's no comeback on them for 'managing' the situation that way there's very little motivation for them to change - that's a situation that needs addressing.
    (And that's ignoring the impact on the individual reported of having the 'NMC referral' tag hanging over them for c.18mths, when complaint may then be thrown out at investigating stage before full hearing).

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  • The NMC need to grow a pair and take managers to task if they are not acting on concerns raised. What is the point in Nurses raising concerns if nothing is done. Trained Nurses should be accountable at all levels

    It appears the higher up you are the more protection you have got. If the NMC have
    evidence of wrong doing, no matter how it has been obtained it should be acted on, this just proves they are not fit for purpose

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  • I totally agree ,in my current employment, in a private nursing home ,All six contracted registered nurses are currently going through `in house' disiplinary procedures for raising concerns verbally and in writing .We have been threatened with being reported to the NMC .We are powerless. The management are systematically undermining the role of the nurse using it as a smokescreen to cover their own failures to provide the support required to allow all of us to work in a safe environment.

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  • It must be a very unhappy ward where your manager can't be bothered to speak to you directly if they see you are having a problem, are stressed, are not performing as well as well as you should.

    I'd have thought that it is their job to support their staff and see when things are going wrong and work together with staff to improve performance.

    In previous jobs I saw staff being told off for doing something 'wrong' when no-one had ever taken the time to show them the correct way. Raising concerns is all well and good as long as it is genuine and not just backstabbing, bullying and a spiteful way to get rid of staff you don't like which I have also seen happen.

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  • And is noone mentioning the fact that many of these performance issues arise as a direct result of the conditions imposed on us by managers? What is being done about that exactly?

    How many things are missed, bits of paperwork left undone, patients not being given enough time, etc etc etc, due to the fact that there are nowhere near enough qualified staff to look after the amount of patients we have safely and effectively? I mean how many of us have raised concerns only to be told it is down to our 'time management?'

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  • Anonymous 11- Mar -2012 2:34pm

    Following a period of time off work due to stress I have been told it is my time management that is the problem. How can you time manage elderly patients? Making time for documentation is my biggest problem as I get interupted everytime I pick my pen up. Seriously thinking of packing it in or is that their idea?

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  • If I thought it would help I would quite happily toalk to the NMC about some dodgy and dangerous situations I have found myself in, whilst my immediate management is supportive, all of our hands are tied and we continue to attempt to work the unworkable seeking a solution to a problem that I am certain is nationwide and not just in my trust. Queues into the hospital via the ED and insufficient staffing levels. The higher echelons of management do not seem concerned and as has previously been stated the NMC refuse to act even when they have proof. I can only say that I do my best for my patients and the day that is enough to warrant me justifying my actions to those that never seem to be around when we need them, in order to keep my job, will be the day I hang it all up and get myself a well paid job in relation to the responsibility that I hold!

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  • Anonymous | 11-Mar-2012 9:09 pm

    If time management is blamed for stress-related problems then support should be offered on your ward to see where the problem lies and demonstrate how the time available can be better managed. I suspect those who offer such criticism are completely out of touch with the reality of working on your ward with this particular group of patients and the available resources.

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  • Anonymous | 11-Mar-2012 9:19 pm

    I so agree, but the emphasis is on 'should' be offered - that wonderful 'theory-practice gap'! The reality is the easier option is to scapegoat the front-line staff & if you need to save money/make a few nurses redundant before end of financial year, what better way to do it? & if they're discredited/referred to NMC in the meantime, well that keeps manager/management style out of the spotlight - actually probably gains them brownie points for controlling budget & 'demonstrating their commitment to maintaining professional standards'..
    (may sound cynical, but aware of several incidents of that kind & not unique to one employer/manager)

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