NMC referral threats: nurses pay heavy price for speaking up
Nurses who speak out about care concerns too often find managers use the threat of referral to the Nursing and Midwifery Council against them

Nurses leave the profession for many reasons, and being overworked, underpaid and undervalued are notable among them.
But surely one of the saddest stories is that of a nurse explaining his move to retrain as a teacher after being victimised for raising safeguarding concerns.
‘Teaching is a normal job. It’s stressful with good days and bad days, but at least no vulnerable person is being abused in front of me while I pretend I don’t know,’ he said.
NHS can ill-afford to lose those nurses brave enough to raise concerns
He is one of a number of nurses who told us about their experience of speaking out about a concern only to find themselves the subject of an investigation and/or referred to the Nursing and Midwifery Council (NMC).
This nurse, whom we call Steven, describes a toxic working environment in which staff were afraid to say anything about widely known abuse and how he was pushed out when he did. This is a form of bullying, resulting in the NHS losing a conscientious nurse it can ill afford to lose.
Nursing and Midwifery Council’s fitness case process needs marked improvement
It is now accepted that the NMC fitness to practise process is not fit for purpose, as found by an independent review led by former chief Crown prosecutor Nazir Afzal. The regulator has pledged to act on Mr Afzal’s recommendations and we will shortly publish an article on its progress six months since the review report.
The need for improvement in the screening of referrals is urgent, and latest data may point to this starting to happen. In November last year, the number of cases decided at screening stage overtook new referrals and represented a five-year high.
The insidious problem of the whistleblower becoming the scapegoat still needs to be addressed.
That the nurses we spoke to felt Freedom to Speak Up guardians lacked the confidence to support them and the NMC didn’t want to know either suggests current mechanisms for raising concerns aren’t working.
This means we will continue to lose excellent, caring nurses to other professions because too many of those who need to hear the truth don’t want to.
Flavia Munn is editor of Nursing Standard