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Nurse directors asked to think before they refer to NMC

  • 13 Comments

Nursing directors need to think more carefully before referring registrants to the Nursing and Midwifery Council, the regulator’s new interim chair has told Nursing Times.

Judith Ellis, a former director of nursing at Great Ormond Street Hospital, was appointed to the role last week after incumbent Tony Hazell announced he is to stand down at the end of March.

His resignation follows that of former chief executive Dickon Weir-Hughes in January. The regulator is currently undergoing a strategic review by the Council for Healthcare Regulatory Excellence into its handling of fitness to practise cases.

Professor Ellis, executive dean for health and social care at London South Bank University, told Nursing Times the “key” problem faced by the NMC was a 52% increase in fitness to practise referrals over the past two years.

This had exacerbated an existing backlog of cases and contributed to a predicted £8.9m overspend by the regulator this financial year, she said.

Professor Ellis said 40% of referrals were found to have no case to answer and urged employers to consider if a referral to the NMC was appropriate.

She also encouraged directors of nursing to make more use of a helpline set up by the NMC last year to provide them with advice. So far it has had just 53 calls about possible referrals.

“Having been a nurse director myself, that opportunity to pick up the phone and say to somebody is this an appropriate referral would have been useful,” she said.

Professor Ellis has been a registered nurse for 32 years and a member of the NMC council for the past three years.

She did not rule out applying for the position of permanent chair but said she wanted a chance to get a feel for the two-day-a-week role first as well as awaiting the outcome of the CHRE’s review.

The CHRE is expected to recommend what skills and experience the board and the executive of the NMC will need. A separate review by the Law Commission looking at how regulation of different healthcare professionals can be made more consistent is also expected to shape the future of the NMC.

This could include less nursing representation within the regulator.

Professor Ellis said: “We need the right skills to run the regulator and that’s the vital thing. We can always get expert professional input. I think that’s something we need to consider carefully to get the balance right.”

  • 13 Comments

Readers' comments (13)

  • This increase complaints of 52% to NMC fitness to practice referrals over the past two years does not surprise me. Since nurses stopped working as nurses they took over the role of monitoring doctors. Nurses seem to have forgotten their role and responsibility.

    This has not only brought shame to the nursing profession but also made patients loose trust in doctors.

    I do not think we can rectify this no matter who replaces Dickon Weir-Hughes with the threat of antibiotic resistant bacteria looming over our head. It looks as if this profession claiming to care is the sick and suffering is likely to collapse.

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  • Professor Ellis said:-

    "Having been a nurse director myself, that opportunity to pick up the phone and say to somebody is this an appropriate referral would have been useful,”

    As a newly qualified nurse (many years ago I may add) one of the best bits of advice I was given by my then Divisional Nurse was, "always remember there is someone on the end of a phone that can help you if you are struggling", this was something I carried with me throughout my career ( now over) and which I passed on to others.

    It's loosely called the application of common sense, something which seems to have gone out the window in this age of covering your own back.

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  • Nurse directors are having to refer staff to the NMC because they are dismissing them for alleged gross misconduct for events that never were gross misconduct.
    That Professor Ellis doesn’t know about the Incident Decision Tree of the National Patient Safety Agency (NPSA) and Root Cause Analysis (also NPSA) is very worrying. Those tools are there to guide these decisions.
    When Sue Osborne was joint chief executive of the NPSA with Susan Williams, she told me that a significant part of their brief was to change the culture of blame. She thought it would take about 7 years to achieve. She also said that of the 20 suspensions she had instigated, 17 she would deal with differently in the light of the knowledge she now possessed. Ironically, she and her colleague were subsequently sent on special leave and paid off, for failing to make significant progress.
    Until managers are accountable to an outside body for their actions, nothing will change.
    Julie Fagan, founder member CAUSE
    CAUSE (UK)
    Campaign Against Unnecessary Suspensions and Exclusions in the NHS (UK)
    Web site:www.suspension-nhs.org E-mail:enquiries@suspension-nhs.org
    Campaign Co-ordinators: Julie Fagan, Craig Longstaff, Andre Downer,
    Elsie Gayle (midwifery spokesperson), Dave Williams (Welsh spokesperson)
    and Kate Wynn (Scottish spokesperson)

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  • 52% increase in fitness to practice referrals; well that is no surprise as far as i am concerned. If i can remember correctly, less than a year ago NMC announced that they must be made aware of all cases even if cases are going to be dealt with internally. And this year they are complaining of increase in referrals.
    The managers that are not ready to take responsibilities in first instance, will refer all cases to cover their own necks and put all blame on the nurse and NMC to sort it out. It's going to be like "what's the point of just telling you, when i can use the same time to refer the case and you can deal with it as you like; whilst i do nothing to increase the morale of my staffs".

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  • maybe the NMC have targets to reach like the NHS!

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  • The NMC NEVER challenges any employer about a referral or advises the employer that they should have thought it through better again when a no case to answer decsion is the outcome . Too many cases are referred because the decision tree is not used and the mangers just think by doing the referral they can cover their own backsides- the charges on the NMC website are sometimes just junk they have chucked in to try and make something stick having started the process

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  • It appears to me that we have a three fold issue here.

    1. NMC backlog due to high increase in referrals.

    2.Nurse managers passing the buck.

    3.A totally inadequate education of nurses.

    If we address item 3 and improve education and experience in the application of practical skills to match the academic levels reached, then we will automatically reduce FtP being called into question in the first place.


    Item 2 next, Nurse managers, you are responsible for overseeing nursing care. If a nurse is brought to your attention as being below standard, then I believe you owe a duty of care to that person and offer the appropriate training/guidance that they require to bring them up to standard. This of course, will mean looking very closely at mentors, for here, I believe, lies a major problem.
    If after this, disciplinary action is needed, then have the balls to take it and dont expect the NMC to do your dirty work.

    Item 1 ...well only the really dangerous/heinous acts will arrive at the NMC thus markedly reducing workload in this area.

    Common sense really, something that appears to be on the decline I fear.

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  • A thorough investigation of the many different reasons why nurses get themselves into the position of requiring referral to the NMC is required as there are obviously very many different factors involved at personal, team, resource, managerial and organisational, educational and training level.

    All the referrals to the NMC need to be thoroughly examined to see how many of these are genuine cases for serious concern.

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  • why is it that relatives can make allegations about a nurse of a sexual nature and allege that the nurse has texted them and been to their home, when in the investigation material was provided to prove their innocence the trust still dismissed the nurse. They took evidence from others when the nurse was in a very distressed state and used it against the nurse. the trust is now referring it to the NMC It appears that the trust dismissed this nurse to save face and that anyone can make unfounded allegations.

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  • I find it appalling the length of time the NMC is taking to do fitness to practice hearings, up to 2 years at least and then they feel it is justified to put a condition on a nurses licence when they have been free to work without conditons whilst waiting for their hearings to take place.

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