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‘Outsiders’ culture drives black and male nurses to FtP hearings

Nursing and Midwifery Council raises concern about lack of support for nurses from ethnic minority backgrounds going through fitness to practise process

Nursing and Midwifery Council raises concern about lack of support for nurses from ethnic minority backgrounds going through fitness to practise process

An ‘insider/outsider’ culture is leading to the disproportionate referral of black nurses and males nurses to fitness to practise (FtP) hearings, research from the Nursing and Midwifery Council (NMC) suggests.

Of the nurses and midwives who took part in the research, a majority said this culture left them feeling unsupported at work, with many saying they felt their diversity characteristics played a part in their referral from their employer.

Referrals driven by perception of being ‘different’

The findings form part of the second phase of NMC’s

Nursing and Midwifery Council raises concern about lack of support for nurses from ethnic minority backgrounds going through fitness to practise process

Research from the Nursing and Midwifery Council raises concern about lack of support for nurses from minority groups going through a fitness to practice process
Picture: Charles Milligan

An ‘insider/outsider’ culture is leading to the disproportionate referral of black nurses and males nurses to fitness to practise (FtP) hearings, research from the Nursing and Midwifery Council (NMC) suggests.

Of the nurses and midwives who took part in the research, a majority said this culture left them feeling unsupported at work, with many saying they felt their diversity characteristics played a part in their referral from their employer.

Referrals driven by perception of being ‘different’

The findings form part of the second phase of NMC’s Ambitious for Change research, which looks at why certain groups have different experiences of FtP processes and how that can be mitigated.

‘Professionals feel that referrals of particular groups are often driven by perceptions of them as “different” or an “outsider”,’ the report found.

‘People described feeling like an “outsider” in many ways, but key factors included being in minority groups when it came to ethnicity, gender, age, sexual orientation, gender identity, nationality or religion, as well as a person’s type of employment.’

Concern about lack of support for nurses from ethnic minority backgrounds

Drawing attention to the NHS England Workforce Race Equality Standard, which found black professionals report higher rates of harassment, bullying or abuse from managers and colleagues at work and are more likely to enter the formal disciplinary process compared to white staff, the NMC report also concluded that black nurses and male nurses are more likely to be referred to FtP processes compared to white staff or women.

Findings like this are prompting concerns about a lack of support for nurses from ethnic minority backgrounds, particularly given the UK’s current reliance on international nurses.

Speaking at an NMC meeting last week, council associate Gloria Rowland, chief nurse at NHS South West London, asked whether more could be done to support nurses moving to the UK to help address the problem.

She also flagged that current intense international recruitment could contribute to an already large backlog of FtP cases.

A problem affecting British nurses, as well as those from overseas

NMC chief executive Andrea Sutcliffe said she had raised the issue with England's chief nursing officer Ruth May and deputy chief nursing officer Duncan Burton.

‘We should also recognise that it’s not just international nurses who will be referred to us in terms of black and other ethnic minority backgrounds,’ Ms Sutcliffe said. ‘It will also be nurses and midwives who are educated here, born here, brought up here but, for all sorts of different reasons, are ending up in our processes as well.’

Latest NMC registration data shows that almost half (48%) of last year’s 48,436 first-time joiners trained overseas, with the majority recruited from the Philippines, India, Nigeria, Zimbabwe and South Africa.

Latest FtP data provided by the NMC shows that while black nurses make up 10% of its register, they made up 15.7% of FtP cases between March 2016 and 2019.

Research highlights opportunities to improve

Following the findings of Ambitious for Change, the NMC vowed to improve how it regulates by offering further training for staff, working with employers to provide more tailored information about FtP, and working with partners to understand the wider societal issues affecting FtP caseloads and how to eliminate bias.

Ms Sutcliffe said: ‘The findings highlight opportunities for us to improve our regulatory activities, to ensure our processes are fair for everyone. It is also evident that deep-rooted systemic issues of inequality are contributing to the disparities we’re seeing.’

An NHS England spokesperson said the organisation is providing financial, practical and wider support to trusts recruiting international nurses.


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