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NMC merger with other regulator unlikely

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Merging the Nursing and Midwifery Council with another regulatory body is not an option being considered, the man leading the latest strategic review of the troubled organisation has said.

The terms of reference for the review into the nursing regulator’s continuing failure to satisfactorily improve its performance on handling fitness to practise cases were published last week by the Council for Healthcare Regulatory Excellence.

CHRE chief executive Harry Cayton said, despite internal changes implemented since the last major review of the NMC in 2008, not enough improvement had been seen on cutting the fitness to practise backlog. He said: “The problem has proved fairly intractable.”

The “vigorous and constructive review” will seek to answer two overarching questions (see below). Initial recommendations are expected in April with a final report in May.

Mr Cayton said the CHRE would work with the NMC to identify “why there have been problems over really quite a number of years”, and why “goodwill and hard work” had not produced significant improvements.

However, he said the review would not consider merging the NMC with another regulator, noting it was already responsible for the largest professional register in the UK. He said: “The idea we could merge this into something even bigger and in doing so solve the problem, doesn’t seem very common sense. It’s not in my view likely.”

He said the NMC and CHRE had met with ministers before Christmas and agreed a six month plan “to move forwards”, but this had been followed on 12 January by the resignation of NMC chief executive Dickon Weir-Hughes, due to ill health.

Mr Cayton said: “At that point we all said, ‘stop, let’s take a big breath and have a proper look at this’. Let’s really have a look at what this organisation is doing, what the problems are, and try and them out once and for all.”

Key questions the CHRE will ask:

  • Are the leadership, management, organisational structure, and resource allocation, of the NMC correctly aligned to ensure that it can deliver its regulatory functions in the most efficient and effective manner?
  • If not, what changes need to be made to ensure that the NMC (at strategic leadership, management, organisational, and resources allocation levels) is focussed on delivering against its statutory duties, and is able to build capacity to deliver its core functions in a more efficient and effective manner?
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