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Review concludes NMC is failing 'at every level'


The Nursing and Midwifery Council has problems “at every level”, according to a highly critical report into the regulator published today.

The Council for Healthcare Regulatory Excellence has completed a strategic review of the nursing regulator, which it began in January.

The final report from the review identifies failures in “leadership, strategy, decision making, finance and culture”.

“The NMC has long standing problems ‘at every level’….including confusion about its regulatory purpose, weak governance, poor planning, unreliable management information, and inadequate information technology,” the CHRE said in a statement on its findings.

The review looked into the regulator’s long standing inability to reduce its fitness to practise caseload. It was sparked by the departure just before Christmas of NMC chief executive and registrar Dickon Weir-Hughes.

In particular, the CHRE criticised the NMC for being distracted from its core fitness to practice functions by issues such as the regulation of healthcare assistants, and its poor financial decision making. The regulator’s “weak” information technology capability was also criticised.

While highlighting the failings of the NMC, the CHRE insisted its report should be viewed as “forward looking” and set out 14 key recommendations.

These included ensuring that the “crucial” appointments of a new chair and chief executive – which are both currently held by interims – were carried out with sufficient due diligence.

In addition, it called on the internal culture of the NMC to be changed from one of “resigned resilience” to one that encouraged openness and listened to staff.

CHRE chief executive Harry Cayton said: “The NMC must finally leave its troubled past behind and apply itself to protecting the public and rebuilding confidence in regulation.

“New leaders must be appointed who are competent, credible and capable of addressing the NMC’s very serious organisational problems and transforming the NMC into the regulator that the public, nurses and midwives deserve.”

Responding to the CHRE report, acting NMC chief executive and registrar Jackie Smith said it made “difficult reading” for the regulator.

“We recognise the failings that CHRE have set out in their reports, and we are sorry. It is clear that the NMC has not delivered effective and efficient regulation, and we are committed to putting that right,” she said.

“We look forward to the appointment of the chair and chief executive later this summer. Change is already underway and will continue, to ensure the NMC’s focus is wholly on public protection.

“CHRE draw attention to the hard work and commitment of the NMC’s staff. I would like to add my personal thanks to all those who have responded so positively to the strategic review of the NMC and are working hard to ensure the protection of the public.”

Royal College of Nursing chief executive and general secretary Peter Carter, said: “The RCN welcomes this report which clearly goes to the heart of some fundamental weaknesses within the NMC.

“It is extremely concerning to read that the NMC has failings right across the board and we know that many of our members have been losing confidence in the regulator for some time.”

Unison head of nursing Gail Adams said: “We welcome the CHRE’s report, and call for its recommendations to be implemented in full with urgency.”

Royal College if Midwives deputy general secretary Louise Silverton added: “[The CHRE report] raises major and important concerns about the NMC and is a forward-looking report and should be a wake-up call.”


Readers' comments (49)

  • And us nurses have to bail you out

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  • Appalling state of affairs. Why should nurses bail NMC out of financial trouble? Makes me no longer want to be a nurse. Roll on retirement!

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  • michael stone

    I heard the key players on Radio 4 this morning, and it is pretty clearly this report, which led to the NMC dropping its advice line for nurses - the CHRE said the NMC was trying to do too many things, and needed to concentrate on dealing with protecting the public. I know that there is an argument that not understanding 'the rules' leads to bad practice, but it seems clear someone (perhaps the CHRE, perhaps not) has decided that the NMC has got plenty on its hands assessing bad practice, and hasn't got the resources to also explain what good practice is.

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  • Forget bailing out the NMC, bankers have already stitched us up (a few times). Besides a fee increase to £120 probably won't be enough. We shouldn't be paying for the privilege of just being on the register and then to enable us to do our work.
    Maybe I'll consider going into auditing, researching or managing/clip-board holder, or a documentary/TV producer (hmm alternate reality NHS) - don't think you need to be registered for those roles, ok maybe not ;)

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  • We were promised localised investigations and doing away with the need for expensive London lawyers investigating every referal but that is not happening. Meanwhile we wait for 2 years and more till the London crew get round to other areas. Why do we not have senior officials based in regions who can oversee local complaints?????.

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  • DH-Agent

    they are the ones who make the rules so maybe they need to drop this role as well if they are no longer in a position to advise on their application after all they are guidelines to be used at a professional's discretion and are not hard and fast rules but it is the nurses' sole responsibility if they get something wrong if they are uncertain how they apply in a particular case.

    It is a question of interpreting them and applying them to particular situations nurses may encounter and not a question of understanding as you suggest! If a nurse has got as far as the NMC register it is not likely that they have cognitive problems or with their comprehension of the NMC guidelines unless there is some fault in the writing of them!

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  • If a nurse was found to have 'problems on every level' in a professional capacity, I think the public would rightly expect that nurse to be disciplined/retrained/struck off, depending on the circumstances.

    Now the Nurses regulatory body has been found similarly guilty, and bearing in mind they are there to protect the public as we are forever being told, what hope can the public have of ever being sure that Nurses are all working in the best interest of the patients. The NMC has, with this indicment, done more in a single stroke, to destroy the credibility of Nurses than any other event, it seems.

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  • George Kuchanny

    Well, at last this review shows us what we all knew. The NMC has been dysfunctional for many years now. Much to the detriment of nursing as a whole when we all have to read about 'bad nurse' in one daily rag followed by 'incompetent idiot' in another almost every day. Then we see 'reinstated' - that's after doing the worst. Actually killing folk. I do hope this begins to turn around now so that we can hand over care of our patients to others without having doubts that we see them breathing the next day.

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  • Why sould we pay the extra. What does the NMC do for us. Let them publish this and then try to gice the rationale for the increase

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  • any few rise should be kept on hold- throwing more money at the NMC will not solve the problem- we need proper investigations by employrs, sending people to the NMC fr " probalbe proof, rather than real proof and some employers need to get their own house in order-- you can't push the blame onto nursing staff if your expecting one registered nurse to manage large nursing homes without support- then loclised investigations so it is only the serious situations that go to the big lawers- One i saw was a conviction for false identification and frudulatly obtaining the training!! this took more than one visit to the NMC- a no brainer guilty- strike off

    when they get things in place- then they can start asking us for more money- in real life i wouldn't be paing my builder any more cash until he did the work to the correct standard! simple really

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