NMC cannot be the police of nurses, says new adviser
Posted 28 November 2024 - 16:00
Anthony Omo, temporary adviser to the Nursing and Midwifery Council, told council ‘healthcare is dangerous... there is a level of risk you need to live with’
The Nursing and Midwifery Council (NMC) cannot be the police of nurses and must learn to live with some risk in healthcare, it has been told.
Speaking at a full NMC Council meeting, General Medical Council (GMC) director of fitness to practise (FtP) Anthony Omo, who has been temporarily seconded to the NMC from GMC to advise the nursing regulator on reducing the caseload and share good practice, told members that ‘healthcare is dangerous, and so there is a level of risk you need to live with’.
Under fire NMC has ‘absorbed a lot of concerns’, says adviser
The NMC has been under fire for its mounting backlog of thousands of cases, along with the painfully slow process that some registrants must endure to get their case concluded.
In the recent culture review, published by former prosecutor Nazir Afzal and Rise Associates, it found six nurses had reportedly died by suicide in a year while under FtP investigation by the NMC.
‘If you think about the volume of complaints coming through screening, it needs to be as slick and as quick as possible to determine whether there is something for the NMC to look at,’ said Mr Omo.
‘My sense is that the NMC has absorbed a lot of concerns, because there is some risk. But I’m not sure it’s the NMC’s risk to bear.
Nursing regulator cannot police nurses and is ‘always on the back foot’
‘You are one of a number of players in the healthcare space responsible for protecting the public. You are not the player responsible. And you’re certainly not the police,’ Mr Omo told members at the NMC meeting.
‘You can’t possibly do it – you’ve got over 800,000 registrants – you’re a tiny organisation, comparatively, and most of the concerns come to you after the harm has happened so you’re always on the back foot.
‘So attempting to try and be the policeman doesn’t work for you. And a lot of the cases are stuck because you are trying to do that. You’re trying to get to a zero-sum risk, that is, this registrant is never going to be of any risk to anybody, and that’s not a place you can really quite get to.
‘Things happen, healthcare is dangerous, inherently medicine is risky, and so there is a level of risk you need to live with, which I don’t quite see through your guidance and your thresholds at the moment.’
NMC needs to identify, isolate and tackle backlog of fitness to practise referrals
Latest figures from council papers show the current caseload stands at 6,581. This is up from 6,059 in March 2024 and 5,519 in October 2023.
However, while the number of referrals continues to increase, the NMC has managed to increase its screening decision rate, with 508 decisions in September and 609 in October – the latter representing the highest monthly figure in the past five years.
Mr Omo told the NMC it must consider what is appropriate for the regulator and what is more appropriate for employers and other health bodies to look at. He told the regulator that the thresholds for registrant referrals ‘are not quite in the right place’ and ‘are driving a lot of problems’.
He said there was a distinct need to identify, isolate and tackle the backlog, which would remove a lot of registrants from the FtP system ‘that probably don’t need to be there’.
He concluded: ‘The presumption is, if you’ve identified them as low risk and they’ve been sat in your system for six months, a year, two years, and no new risk has materialised, then it’s probably something that you’re not going to take any action on. Or need to take any action on.’
‘Employers must take responsibility to deal with things in house’, says campaign group
Cathryn Watters from campaign group NMCWatch welcomed Mr Omo’s words at the NMC meeting. ‘Anthony Omo is absolutely right – the NMC is not there to police registrants. It is there to regulate and set standards,’ she said.
‘Employers must take more responsibility to deal with things in-house and the NMC must recognise when referrers are weaponising the FtP process.’
NMC chair David Warren thanked Mr Omo for his ‘very lucid and extremely helpful set of observations’ on the strategic issues and challenges faced by the nursing regulator.
Sir David said: ‘Behind all these issues, we are particularly conscious of the impact on registrants. The emotional and psychological impact of longevity of cases of those involved is at the heart of the people and culture review, and is at the heart of what we are doing.’
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