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Fitness to practise: potential use of patient impact statements sparks fears for nurses’ mental health

NMC to carry on assessing potential value of patient experience statements as evidence, despite stakeholder warnings
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NMC to carry on assessing potential value of patient experience statements as evidence, despite stakeholder warnings

Use of patient experience statements as evidence in fitness to practise (FtP) hearings could harm nurses mental health and prejudice their cases, the regulator has been warned.

Researchers commissioned by the Nursing and Midwifery Council (NMC) to explore use of such evidence told the regulator of stakeholder concerns in a report just made public .

The NMC has however, said it will continue to consider possible use of patient experience statements.

Stakeholders concerns about patient experience statements

Research consultancy Traverse interviewed 125 registrants, patients and service users, NMC staff, legal and union representatives to find out what they

NMC to carry on assessing potential value of patient experience statements as evidence, despite stakeholder warnings


Picture: Charles Mulligan

Use of patient experience statements as evidence in fitness to practise (FtP) hearings could harm nurses’ mental health and prejudice their cases, the regulator has been warned.

Researchers commissioned by the Nursing and Midwifery Council (NMC) to explore use of such evidence told the regulator of stakeholder concerns in a report just made public.

The NMC has however, said it will continue to consider possible use of patient experience statements.

Stakeholders’ concerns about patient experience statements 

Research consultancy Traverse interviewed 125 registrants, patients and service users, NMC staff, legal and union representatives to find out what they thought. It found a range of stakeholders were worried about the risk to registrants' mental health if patient experience statements were used in their FtP hearings.

‘Some patients could be quite vindictive and could make everything sound worse than it was’

Nurse and former fitness to practise subject

Some interviewees argued anyone subject to a FtP process – who may already feel guilty or upset – could be made to feel worse by hearing the statement or having to respond to it. 

‘Very few registrants would read an impact statement and not be devastated… the long-term effect of that is far reaching and needs to be considered very carefully’

Cathryn Watters, found of campaign group NMCWatch

One registrant who has been subject to a FtP process, and who featured in the Traverse report, told researchers: 'My concerns would be that some patients could be quite vindictive. And they could make everything sound worse than it was as they want the nurse to feel really bad.' 

Emotional narrative could help registrants reflect and apologise – NMC

NMC director of FtP Matthew McClelland believes understanding individuals’ perspectives could be valuable.


Matthew McClelland, FtP director
at the nursing regulator

He said: 'While the development of this work is still in its early stages, it could allow us to tread new ground as a regulator,’ he said.

'We look forward to taking the findings and recommendations of the research forward as part of future engagement with our stakeholders over the coming months.'

The NMC argues the use of 'emotional narrative' in FtP could:

  • Give nurses the opportunity to reflect on and improve their practice
  • Prompt registrants to acknowledge or apologise
  • Help case examiners and independent panellists to establish what happened
  • Assess harm, including the effect of an incident on the person’s mental health, wellbeing or family

 

Material could be prejudicial to nurse or midwife’s case

Another concern raised was that such subjective testimony could prejudice the registrant's case. 

Unions and lawyers argued an emphasis on the patient voice could ramp up adversarial nature of proceedings, and result in more punitive sanctions against nurses and midwives.

NMCWatch founder Cathryn Watters told Nursing Standard her group, which campaigns for better support for nurses and midwives referred to the regulator, was worried too.

‘There are very few registrants who would read an impact statement and not be devastated at distress caused – the long-term effect of that is far reaching and needs to be considered and planned for very carefully,' she said.


Further information

Read more about the NMC research


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