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NMC to review serious cases before internal investigation


Nurses and midwives involved in “very serious cases” that pose a risk to patients should be referred to the Nursing and Midwifery Council prior to an internal investigation, the regulator has stated.

In updated guidance on referrals, the NMC has called on employers to make referrals as quickly as possible in order for it to consider issuing an interim suspension until the case has been fully investigated.

The regulator said it had “clarified its advice as a result of cases in which employers have misunderstood their responsibility to refer quickly if patient safety is at risk”.

It states: “The revised advice specifically encourages employers to refer a nurse or midwife at an early stage in very serious cases, even before they conduct their own internal investigation.”

NMC director of fitness to practise Jackie Smith said: “We would like to remind employers that if they believe the public’s health and wellbeing is at immediate and serious risk, they should contact us straight away.

“This will give us the opportunity to issue an interim suspension or restrict the person’s practice while the case is investigated,” she added.

The revised advice and information also notes that in less serious instances cases may be referred back from the NMC to the employer to be dealt with locally.

The guidance also includes more detailed information about the existing responsibilities of employers to check references, identity and competence.


Readers' comments (21)

  • When it comes to protecting the public, the NMC is not doing it's job.
    We pay the NMC to do a job and yet tens of thousands of very ill people are suffering in this country because of work capability assessments that are structurally flawed.
    Nurses are supposed to report report dangerous equipment as soon as possible but yet they continue to use these impersonal computerised checklist tests.
    Our profession is being used as a rubber stamp to take away support from those who need it.
    The NMC have no problem with this.
    I became a nurse to try and make a positive difference to peoples lives and to fight for those in need.
    DO mental health nurses and psychiatrists feel comfortable that those in their care are being assessed/tested by non mental health practitioners ? Do they feel comfortable with the fact that the regulatory bodies NMC and GMC are happy with this ? Do they feel comfortable when they are seeing more and more people in their care deteriorating as a result of the stress of these Work Capability Assessments ? The NMC seems to be supine in this regard and likes have it's tummy tickled by french feather when it comes to corporate matters but when it is protecting the public it is failing.

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  • i was involved in a nmc investigation, that took 3 1/2 yrs to get to a hearing. and yes it does distroy your career. I had a NO CASE TO ANSWER decision from the NMC if only the incompitent employer i worked for had investigated the situation properly and had interviewed the relevent witnesses. The nmc people that were on the panel were no fools and saw through the witnesses bought against me, and thankfully justice was done. and compensation can still be taken out against your employer as they have a duty of care to you to investigate any allegations made against you are true and i agree with above comment, that more often than not the work environment you are subjected to can leave you open to making mistakes or having too many patients to care for to give the quality of care you would like to give and know the patient deserves.

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  • I find it really disturbing to know that nurses are forced to register so they can practise and yet, the employers and the NMC do not understand each other. Ironic. I have observed nurses being treated unfairly and suspended willy nilly by employers before and investigation is started. As a result a lot of nurse's have been left feeling humiliated and lose confidence. At the end of the day, the nurses ave been found competent after 2years by the NMC. In those 2 years they have not been practising or participating in any CPD. Then they have to go back to their jobs. I think NMC needs to think through this thing thoroughly before they implement it. Are they going to fast track cases, do they have manpower to investigate and sit on the panel? I mean, is this not going to destroy a lot of careers. In what I have observed, some nurses have been targeted racially and send to NMC. Suspended, then NMC makes a decision after 2years. In both cases I have witnessed have been acquited by NMC. Of course they left their employers and moved elsewhere. Their confidence was battered and they had to go through counselling. NMC needs to decide who governs nurses and not confuse them.

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  • I too am in limbo following a spiteful complaint to the NMC by my ex-employers after I took them to a tribunal. Luckily I have been able to find work in the meantime but do not know what the future holds. I can only hope the NMC sees through the imcompetence of my ex-employers and all the stress and distress they put me through, bourne up by an occupational health report vindicating me which they chose to ignore.

    It's not fair to leave innocent nurses worrying about their future and having their career prospects seriously jeopardised, the NMC needs to fulfil it's obligations to investigate with speed, not spend months or years investigating frivolous cases.

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  • I did not post a comment on a very serious matter to have links to adverts running through the text. These are my own words and how dare they be contaminated with adverts...

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  • Re:- NMC director of fitness to practise Jackie Smith said: “We would like to remind employers that if they believe the public’s health and wellbeing is at immediate and serious risk, they should contact us straight away.

    In my experience as a patient of 22 years, they silence it internally and keep it quiet, particularly where club culture is thriving, amongst nurses and doctors.

    For example I asked a nurse to get me my medicine from their medical cupboard, as on this rare occasion I forgot to bring it with me.

    I am also a diabetic, due to hefty doses of steroids they needlessly gave me at sussex county in the kidney unit.

    This particular nurse was responsible for my care, but she refused to get me my medicine for me, even though I am a highly vigilant patient who brings her medicines usually and rarely ask her to do anything.

    When I had words with her, I was targeted and my care was cut-off, made a medical orphan. I suspect that they were looking for an excuse to get rid of me as I was asking questions about the faulty blood kit in my "steroid-induced diabetes".

    Returning to the nurse, this nurse was rubbish at her job, she could not do bloods, the health care assistant carried her. But this nurse was in fact promoted to give 'integrated care' , a specialist renal nurse. It seems there is a lot of exploitation going on - including cover-ups, whereby health care assistants get poor wages but carry specialist nurses, like the ones I mention.

    I thought I would expect the same thing at my gp surgery at Beaconsfield Villas, but much to my amazement and relief the senior nurses could do their jobs. We have mutual respect for each other!! This is so rare for me, so have to mention it. So although the Sussex County Hospital caused maximum disruption in my care, I was so very lucky that I have not encountered bullying and poor care at my local GP's surgery.

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  • Why does it take so long!!! as a nurse who has been suspended by the nmc for the past 14 months (a health case), no-one gives you ANY information about what will happen at the hearing, how you'll be dealt with, lawyers are "just being honest with you" ie giving the grimest picture imaginable, it's so stressful, it's all you can think about, it ruins your life. And it took a YEAR for the "allegations" to reach me, by which point I'd left practice many months ago and had only just come out of hospital following major surgery! they expect "remorse and insight" from you, but do they EVER show that same quality themselves, and recognise the impact of it all on you?

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  • michael stone

    Unusually for an NT discussion, this one seems to be sticking to the point - and the comments make sense.

    Minor problems, should be handled at operational level, and never get anywhere near to the NMC to 'clog up the system' - managers reporting people to the NMC for trivial things, when that simply makes no sense, was the subject of a recent NT piece.

    Serious problems, need reporting AND PRELIMINARILY INVESTIGATING as quickly as possible - and I don't mean within months, I mean within hours preferably. Because, as people have pointed out above, the 'who did and said what ?' needs to be collected and recorded very quickly, before memories become unreliable. I think that ideally, something such as a hospital should have a few 'neutral people' in place, to rapidly collect that stuff, before anybody from the NMC would be able to come and further investigate. 'Neutral' means 'who are accepted as impartial, by clinicians, patients and managers'.

    The detailed investigation and judgement can come later - however years later, is too long and unfair on both clinicians and patients - but 'delayed collection of 'the evidence'' is enormously problematic: my instinct is that in many cases, by the time the NMC becomes involved, it has become impossible for the NMC to investigate properly, because 'the trail is too cold to follow, and everything is too vague'.

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  • i have been under investigation since january 2010 after a previous private employer referred me to the nmc for sending a xmas card. my new employer was given the details and felt it was not serious but carried out a risk assessment on me and i carry on in my role without any restriction etc. the nmc have had 2 panel dates that i was not allowed to attend (or my solicitor) and could not reach a decision so i have now been referred to a competancy committee as my judgement may still be impaired. i had an interim hearing to determine if i was a danger to the public 2 months ago. this should have been referred back to my employer to investigate and discipline (if necessary) instead of years of external investigators, solicitors fees etc and secret meetings were no one seems to be able to make a decision. also if i was a danger to the public why was i left for over 2 years to practice?
    i feel the nmc needs to properly triage allegations and act quickly for the sake of all involved.

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  • michael stone

    Further to my comment above, on radio 4 this morning the NMC said that if a serious fitness to practice issue is raised, it will make an initial assessment of the case within 24 hours - that might lead to immediate suspension, but not necessarily.

    But Anonymous | 3-Jul-2012 9:23 am does rather make me throw my arms up in the air in horror !

    The only time I myself had direct contact with the NMC, one of their advisers promised to get an answer to a question I had asked, and then 2 weeks later said 'unfortunately I can't get permission for our legal team to look at it' - regulators tend to get twisted into knots, by their own protocols (which they sometimes use as an excuse, anyway), and 'pretty useless, the lot of them' is my not deeply considered 'instinctive view' !

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