NMCWatch:Registrant Care: Aims Introduction

• Nurses and midwives – like all professionals working in health and care – are subject to scrutiny by a regulatory body.

• The Nursing and Midwifery Council (NMC) is established by law: it aims to maintain health standards and public safety by making sure that registered nurses and midwives (“Registrants”) are doing their job properly.

• One way that standards are kept is when Registrants are reported (or “referred”) to the NMC, usually by employers after disciplinary action. The NMC then assesses the Registrant’s actions and decides what further action – if any - is appropriate.

NMC Watch has two main aims:

1. To provide short-term individual support to Registrants involved in this process – to try and get the best possible result for patients, for the health service, and for individual Registrants

2. To work in the long-term to improve the whole process so that there is less need for our individual support

​

Why do we need to do this? Individual support

• Our experience shows that the whole system – from disciplinary action by employers though to NMC hearings and appeals – places Registrants at a big disadvantage. Enquiries can take a long time; can result in the ending of a career; and (because of that potential) are conducted very formally. Few Registrants – even if funded by their Trade Union – can afford professional support. Many have faced public hearings, and even High Court appeals, without a lawyer or any other source of help.

• We know that there are, clearly, some Registrants who lack the necessary skills and attitudes to be good nurses or midwives. They need help to

• But our experience - and the NMC’s own statistics – also show that often no official sanctions are imposed - a “no case to answer” result. Even when there are no formal sanctions, everyone subject to the system gets punished. They are punished through stress over the months or years that it often takes; through unrecoverable financial losses; and through the shadow over their future career prospects.

• Our knowledge of individual stories also tells us that there are many cases where the whole referral process results from actions by supervisors that are at best unthinking - and at worst stem from bullying and victimisation.

Longer-term

• We want to see the regulatory processes improved. We want to see spurious referrals discouraged – and sanctioned if there is evidence of malice or incompetence. We want to see the whole system speeded up so that trained healthcare professionals return quickly to where they are needed (if that is appropriate for them).

• Above all we want to see improvements to the health of patients and Registrants by securing better ways in which past failures in professional practice can improve future actions. Better ways of regulating skilled professionals are gaining acceptance, and these methods focus on learning from past issues, rather than merely on deciding who was at fault and apportioning blame.

How do we do this?

We give support to individuals

• We arrange for peer-to-peer mentoring and advice from other Registrants, especially from those with first-hand experience of the process. This is either confidential one-to-one discussion or – where appropriate – in a group. We understand that everyone’s experience is different and we seek to support people through the challenges they have to face, whether personal, emotional or professional. We know that there are very practical and simple steps that Registrants can take with peer advice, before, during and after their encounter with the process.

• Where necessary we also arrange for help from legal and HR professionals, where we can secure the funds to do that.

​

We work strategically​

• We progress our longer-term aims by

• Monitoring – collecting information about the current process that helps us to understand how fair and effective it is.

• Researching – co-operating with and learning from any organisations which can suggest how the process could be improved for a better health service

• Educating and lobbying – showing people working in the health service, and those with the influence to make changes, where the process is failing and how it could be better

• Focussing - where we need to ration our help to Registrants, we try to concentrate scarce resources on individual cases which have the widest strategic implications