Nurse fitness to practise referrals soar amid high case backlog
NMC pledges £30 million to tackle disciplinary backlog, but campaign group condemns ‘waste of money’ and urges it to move away from adversarial process
A £30 million action plan to tackle the spiralling backlog of nurses’ fitness to practise (FtP) cases has been given the green light by the regulator, amid record numbers of referrals.
The Nursing and Midwifery Council (NMC) received 5,916 new referrals in the past year, an increase of 18% and 900 more than predicted. In February alone 596 new concerns were raised, the highest in a single month in the past five years.
The regulator has pledged to invest £30 million from its coffers to tackle the caseload, while agreeing to freeze the annual registration fee for nurses and midwives at £120.
‘Despite the best and sustained efforts of our NMC colleagues, people are waiting longer than they should for cases to be resolved,’ it said in a statement. ‘That has a personal impact on members of the public and professionals and impedes our ability to regulate well.’
NMC will increase recruitment and panel capacity so it can hold more hearings
The NMC pledged to invest in increasing recruitment and panel capacity to have more hearings, expand outsourcing of work to progress cases and improve its internal IT systems for case management.
But campaign group NMC Watch said it had no faith that the latest investment would address deep-seated problems at the regulator, which sees nurses waiting years to have their cases heard.
A spokesperson from the group, which is currently supporting around 600 nurses and midwives going through the FtP process, said: ‘We have no faith that this latest investment will resolve the issues that contribute to the backlog and believe the NMC is wasting money.
‘We see time and time again extremely poor levels of investigations, biased investigations focused on building a case against registrants rather than fact-finding, with thousands of pounds spent on lawyers for the NMC, many of them outsourced and expensive.
Drop legal, traumatic process and look instead at safe practice and over-regulation, say campaigners
‘These issues have been going on for decades. If they truly want to make regulation person-centred and patient-focused, they need to move away from this legal driving and traumatic adversarial process, and start looking at safe practice and the impact of over-regulation.’
NMC Watch pointed to a previous decision approved by the NMC’s governing council in December 2020 when it was agreed to hire 59 temporary staff at a cost of £1.1 million and outsource 50 cases to external law firms, at a cost of £366,000.
It added: ‘The council are signing off these spends without question and not asking for any scrutiny around why the issue keeps reoccurring. Our annual fees are being used to fund these reviews and investments, and yet we have no say over how these are being used.’
Latest NMC papers reveal an FtP caseload of 5,711 at the end of December 2023, with 499 cases yet to be assigned an investigator.
The papers reveal that the NMC received 446 expressions of concern relating to one social media post, which ‘created a significant amount of work for FtP colleagues’ but it was closed at the screening stage as no registrant was involved.
Referrals tended to centre on patient care, prescribing and medication management, the NMC said, pointing to an increase in the number of professionals on its register to explain the increase. It said other regulators had also experienced an increase in the number of referrals received in recent months, reflecting ‘a rise in levels of dissatisfaction across health and social care services’.
Processes have improved but cases not being resolved swiftly enough, says NMC
The Charity Commission and the Professional Standards Authority (PSA) are both carrying out investigations into whether the NMC is meeting standards, including concerns raised by whistleblowers around the FtP backlog.
NMC executive director of professional regulation Lesley Maslen said processes had improved, but cases were not being resolved swiftly enough and ‘feedback from our colleagues tells us they’re feeling overwhelmed’.
She added: ‘That’s why our new plan commits £30 million to FtP over the next three years, with a particular focus on investment and improvement over the next 18 months.’
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