NMC: ‘numerous concerns’ over its handling of personal independent payment complaints

Annual review also reveals that it met 22 out of 24 standards of good regulation  

Annual review also reveals that it met 22 out of 24 standards of good regulation  

The NMC’s headquarters in London. Picture: Barney Newman

‘Numerous concerns’ have been raised about the way the Nursing and Midwifery Council (NMC) investigated complaints about nurses who performed benefit payment assessments for people with disabilities or long-term health conditions.

The concerns were highlighted in an annual review of the regulator by the Professional Standards Authority (PSA), which oversees nine health and care professional regulatory organisations in the UK.

Meeting standards

The PSA found that the NMC met 22 out of 24 standards of good regulation between April 2017 and March 2018.

It did not meet two fitness to practise standards: one relating to the transparency and fairness of its processes, and the other relating to keeping parties updated and supported to participate effectively in the assessment process.

In its annual review report, the PSA said it had been contacted by members of the public and advocacy groups about the NMC’s decision not to progress concerns about nurses conducting personal independent payment (PIP) assessments.

These concerns suggested that the NMC relied on the findings of employers and/or advised complainants that no credible evidence existed, even where the NMC had been advised that witnesses were present, or that audio recordings had been made. 

The NMC’s own figures show that in 2017-18, only two out of 83 such concerns progressed from the screening stage to the investigation stage.

Barrier to raising concerns

The PSA subsequently decided to review 28 cases related to registrants delivering PIP assessments, and found ‘numerous concerns’.

‘We considered that the NMC did not systematically consider all the concerns raised by complainants, relied on the views of employers as reasons to close cases, without proper scrutiny, and did not obtain sufficient evidence to reach its decisions,’ the PSA said. 

‘These issues created a barrier to vulnerable people raising potentially serious concerns. We also noted that the NMC agreed with our findings and is taking steps to address the concerns.’

Cultural trait

The PSA also drew parallels between the regulator’s approach to PIP cases with its lessons learned review (LLR) into the NMC’s handling of fitness to practise cases of midwives at Furness General Hospital, which was published last May.

It found that culturally, as an organisation, the NMC did not recognise the value that evidence from patients or their families can provide.

The PSA report states: ‘Our audit and the NMC’s review identified a lack of independence demonstrated in the screening decisions, and a lack of engagement with the concerns raised by complainants, an issue which was also identified in our LLR.’

NMC head Andrea Sutcliffe.
Picture: Barney Newman

Quality assurance

NMC chief executive Andrea Sutcliffe said measures put in place since 2018 included additional training for individuals making and communicating case decisions, and a new quality assurance approach to the way the NMC initially reviews cases.

‘I’m sorry that our approach to a small number of PIP-related cases fell short of what is expected,’ she said.

‘Our failure to fully address the concerns of some people making complaints, and the lack of clarity in our decision-making, was not good enough.’

Improving communication

The PSA said the regulator had done significant work around its review of education and training. Regarding fitness to practise, it noted that progress had been made around how the NMC communicates with patients and families – including setting up a public support service and reviewing the tone it uses when corresponding with members of the public. 

Further information

Read the PSA’s annual review of the Nursing and Midwifery Council’s performance

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