Nurse fitness to practise: warning over plans to bypass hearings

Proposals on how Nursing and Midwifery Council might conclude some FtP cases without a formal hearing could make nurses fear repercussions of accepting ‘guilt’

The Nursing and Midwifery Council (NMC) has raised concerns about proposed guidance for new powers around fitness to practise (FtP), which will allow some hearings to be bypassed.

The NMC’s own regulator the Professional Standards Authority (PSA) sought feedback on new guidance on an ‘accepted outcome’ process, where the registrant and the NMC would agree a sanction without the need for a hearing. A case examiner would be able to conclude a case if the registrant agreed to a final measure, accepted their FtP was impaired and agreed the case examiner’s findings.

But the NMC and NHS Employers believe the guidance is confusing and could lead to registrants fearing repercussions of accepting guilt.

• RELATED: Fitness to practise referrals soar amid high case backlog

Why nurse FtP cases could be resolved without formal hearing

The proposed guidance also suggests the NMC should consider four factors when deciding whether a case should be resolved ‘on paper’ or would need to go to a hearing. Those factors would be:

1. Whether the registrant failed to accept the findings or impairment.
2. The complexity of the case.
3. Whether the evidence is disputed.
4. Whether a hearing would be beneficial or proportionate to test insight of the registrant.

However, in its consultation response, the nurse regulator said the guidance is not clear what ‘failing to accept findings’ means, and whether disputing facts during the investigation stage would lead to a panel referral. It argued that a case examiner would still be able to resolve the case in many circumstances.

• RELATED: Fitness to practise referrals soar after Letby conviction

It stated: ‘We disagree that complexity of a case should be a reason in itself for a case to be referred to a panel. Case examiners will be able to make decisions on complex cases.’

• RELATED: All you need to know about NMC fitness to practise cases

Mediation or face-to-face meetings would help minimise need to prolong the process

NHS Employers called for face-to-face or mediated sessions to be added to the process, rather than cases being fast-tracked to a full hearing if they could not be resolved on paper.

It stated: ‘The guidance relies on a paper review for accepted outcomes and where this is not effective, they proceed to full hearing. Effective agreed outcome processes usually include a face-to face meeting to assess facts, acceptance and insight and learning.

‘This middle ground may improve the uptake of accepted outcomes where some clarity or negotiation is required.’

The consultation closed on 15 April and the PSA will publish its findings in due course.

In other news

• Nurse career progression: men are promoted faster than women
• Nurse-led work to cut caffeine use helps reduce care home falls
• Retired nurse died after DNACPR notes mix-up