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No system of nurse checks could 'prevent murder'


The head of the nursing regulator has said “no system” of checks, including the forthcoming revalidation programme, could stop a nurse determined to commit murder.

Nursing and Midwifery Council chief executive and registrar Jackie Smith spoke to Nursing Times this week in the wake of the life sentence given to Victorino Chua for murdering two patients and poisoning 19 others at Stepping Hill Hospital in 2011.

“Let’s not forget the employer is key”

Jackie Smith

The nursing regulator unexpectedly found itself at the centre of a media storm earlier this week over background checks on overseas nurses after concerns were raised about whether Mr Chua’s Filipino nursing qualifications were genuine. 

She defended the regulator’s system for assessing overseas nurse applications, describing it as “pretty robust”.

However, Ms Smith noted that “no system in the world” could prevent people from committing “hideous” crimes such as murder.

She told Nursing Times the regulator had tightened document checking procedures since Mr Chua had joined the register in 2002.

“The fact of the matter is, if he’s not a nurse, no one spotted it”

Jackie Smith

It now used the same scanning equipment as the UK Border Agency to check certification and required overseas nurses to provide original documentation as opposed to copies, she said, noting that the NMC was “not a fraud agency”.

Ms Smith also said in future it would be easier to identify registrants who are breaching safety standards through the forthcoming system of revalidation, but that it “will not prevent murder”.

In light of recent concerns the NMC had reviewed every successful application to join the register made by Filipino nurses from 2002-06 – more than 11,500 records – finding no cases of forged certification.

Over the last decade, it had identified 10 cases of fraudulent entry on the register from outside Europe, including four with fake documentation. All had been removed from the register.

“We had no complaints about Victorino Chua before the poisonings”

Stockport FT

Ms Smith also highlighted the responsibility of employers to ensure staff did not compromise patient safety. She said: “The NMC is not the only organisation that has a role to play in this. Let’s not forget the employer is key.

“Employers need to take responsibility for ensuring that the people they take on have the skills to do the job properly and put their patients first,” she said.

She added: “Everyone is understandably concerned about whether he is nurse or not. The fact of the matter is, if he’s not a nurse, no one spotted it.”

A spokeswoman for Stockport Foundation Trust, which runs Stepping Hill, said it had recruited Mr Chua in line with NHS policy, including checking he was registered to practise with the NMC.

“We had no complaints about Victorino Chua before the poisonings,” she said. “Staff had raised concerns about his interpersonal skills only latterly.”

Ms Smith added that Mr Chua would put through the fitness to practise process as quickly as possible.

Jackie Smith

Jackie Smith

“I think nurses recognise that [Monday] was a really bleak day for nursing,” said the NMC chief executive.

“But they also recognise that…there are 680,000 nurses and midwives on the register and the NMC gets about 5,000 complaints a year, which is less than 1%. Most nurses and midwives turn up every day to do an excellent job and put their patients first,” added Ms Smith.

In a statement, Stockport chief executive Ann Barnes said no hospital’s systems and processes could stop the actions of a “determined criminal”.

However, she said the hospital now had additional measures in place that go beyond standard practice.

“These put our organisation at the forefront of best practice in this field and include CCTV in all ward treatment and drug storage rooms, electronic prescribing and an enhanced system for locking treatment rooms and storing insulin,” she said.

On Tuesday, Mr Chua was sentenced to life imprisonment after being found guilty of murdering two patients in his care and poisoning 19 others.

Mr Chua, who pleaded not guilty to 36 charges including three counts of murder, was told by a judge that he would spend a minimum of 35 years in prison for his crimes.



Readers' comments (11)

  • michael stone

    Of course it isn't possible to prevent 'all bad things' - regulators/trusts should not be blamed for things they could not reasonably have prevented, but they should be blamed for being incompetent (for example, by having clearly dubious systems in place). I don't know enough, to decide if someone 'was incompetent' here or not.

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  • When I worked overseas in Saudi Arabia we underwent the Joint Commission International accreditation. As part of the accreditation any licenced nurse, doctor and other required “Primary Source verification". The hospital HR department had to contact all employees original university to confirm that they had studied there and did graduate as per stated in their qualification documents. This did detect on a number of occasions false clinical qualifications.In fact there are professional companies in the middle east that perform this service for a fee to prevent people working on fake qualifications. I feel that each individual hospital has responsibility to make sure the staff they employ are who they say they are.

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  • To be fair the NMC cannot be blamed for Chuah's behaviour any more than it could be blamed for an RN knocking someone down on a pedestrian crossing.

    One thing from this article is that the NMC was surprised to be caught up in the furore around the case. They should know by now that their reputation as the profession's scapegoat means that the default position is for them to be involved in some way, shape or form.

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  • The NMC cannot really be blamed for this sad "outcome". People that worked closely with him probably can be though.

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  • I don't think the people who worked closely with him can be blamed at all unless there was uncertainty in his behaviour as a nurse from the beginning. I wonder why are we paying the NMC £100 a year, as this money should be put into robust verification of nursing qualifications like other country's

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  • perfect out come remove all nurses from register, no risk

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  • That has raised everybodies confidence

    Jackie Smith is in urgent need of a media training course

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  • it is always a question of best practice and seeking and putting in place the best possible measures for vetting clinical staff and their qualifications. it is also a matter of engaging with previous employers or training school and the regulatory body and register of their country for their track record and not engaging somebody if this is missing or poor. despite all of this one can never 100% insure against the unpredictability of human behaviour. the nmc should also hold a police record or absence of alongside every registrant.

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  • I am not the greatest fan of the NMC but in this case his qualifications were verefied. Nobody could prevent an individual intent on pre meditated harm or murder.

    It was simply trust repaid with treachery of the worst kind: Shipman did it. So did Beverley Allitt.

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  • We nurses all wonder why we pay the NMC. The system for checking overseas nurses is "pretty robust"!!!! Mmmmmmmm...... Fills you with confidence as a service user eh.... However, British nurses are hounded by this ridiculous organisation who are perfectly happy to strike off a perfectly caring and competent nurse who is maliciously reported for having one too many ony a Saturday night!
    Come on NMC. get your act together! You are still waiting for the reincarnation of Florence Nightingale and letting frauds from overseas destroy our profession, or can we still call it a profession? Certainly not while you self righteous puritans continue to punish minor misdemeanours rather than checking the validity of "overseas nurses" qualifications!
    For the record, most of us seriously resent paying the annual fee to sit back and watch your pathetic attempts to regulate a '"profession" that is dear to our hearts! For your information, most of us don't do it for the money, we love it, and live in fear of being struck off by you!!!!!

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