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At the Nursing and Midwifery Council (NMC) we often say fitness to practise (FtP) affects a tiny proportion of those on our register each year.
And that’s right – at last count, we had 808,488 registrants, and we usually receive around 5,000 new referrals a year. But the statistics don’t convey the wider impact for those professionals on our register and the fear factor that, one day, a mistake might lead to a referral.
“We’re preparing to invest up to £30m in fitness to practise over the next 3.5 years”
Most referrals don’t meet the screening threshold for further investigation and are closed on initial assessment, but that’s little comfort for those who are referred – especially when we take too long to reach a decision on their case. And, despite hard work, we’ve been taking too long. To add to that, we’re seeing a sustained rise in the number of new concerns being raised – an average of 493 per month since April 2023, compared with 417 in the same period of the previous year, which is an 18% rise.
We are acutely conscious of the people behind each referral – be it a member of the public, an employer or a professional. We owe it to everyone to look into concerns and make safe, fair decisions as quickly as possible. That’s why we’re now making the biggest investment in FtP in years.
We’re prioritising improvements in seven key areas: referral quality, safety and supporting stakeholders through our processes; safe and swift case progression at screening and investigations; releasing capacity in case preparation and presentation, and investigations; delivering sustainable change in case preparation and presentation; improving the quality and timeliness of decisions; people, culture and organisational design; and improving our systems.You can read more about that elsewhere in Nursing Times online and on our website.
What I want to highlight is our clear commitment to change so we can deliver quicker decisions that minimise distress for those referred. We’re preparing to invest up to £30m in FtP over the next 3.5 years. We’re calling it an 18-month plan because that’s our target timeframe for people to feel the most significant improvements.
Our overall aim for FtP is to support a professional, just culture in nursing and midwifery that values equality, diversity and inclusion, and prioritises openness and learning in the interest of public protection and patient safety. To deliver on this, we need an FtP service that’s truly person centred, collaborative and straightforward for all involved.
We will recruit more colleagues into the right teams and equip them with the right tools, including better IT and case-management systems. We’ll also improve our ways of working. Too often, my colleagues are held back by complex structures and lines of reporting that we can, and will, improve. In the longer term, improvements to the legislation that guides us will also help us resolve cases earlier and more efficiently.
We’ll run more hearings, which will be shorter and more efficient, but we will maintain our approach to considering the wider context in which mistakes happened. We only take action when necessary to prevent future harm – it’s not our role to punish people.
We’ll also focus harder on a person-centred approach to ensure better experiences for all involved. We’re ready to start, and I’ll keep you updated on progress in my future columns, and our ongoing reporting to the NMC Council. Andrea Sutcliffe is chief executive and registrar, Nursing and Midwifery Council
Andrea Sutcliffe is chief executive and registrar, Nursing and Midwifery Council
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