Reflections from a back bench ( first published 22.8.18 )

My back bench supervision has come in the form of the work I do on the campaign. I have been lucky enough to work on a case with another member and observe proceedings closely, learning from my peer’s calm but wistful approach and hoping that I may be able to do as good a job in the future if I ever get over my fear of facing a panel from the other side. The registrant got a good outcome, a fair compromise that fulfilled the NMC requirements and her own. The support to registrants is not only representation, it is practical. For many finances are limited and so any way we can help with that is readily appreciated. This recent registrant stayed with me for the night before her case started, which we both acknowledged was a big step as we hadn’t physically met before. We had had lots of chats on the phone and on line but still a big step for me and for my family – “mummy what if she is an axe murderer” my oldest daughter – ever questioning… Luckily she wasn’t and as expected we got on well, having experienced similar themes and having the same goals for moving forward. At her case I also got to meet someone who later joined our crusade. Again he is an ex nurse who now provides legal representation. A very unassuming man who I have shared many discussions with and is helping already to shout about the cause and push for some answers and change.

Watching this registrant’s proceedings was very educational but also very sad. There were points in her evidence where the themes ran so close to home and I felt physically upset as could remember also experiencing the same difficulties she did, except hers led her to her current position. Being present when someone is discussing the raw emotion of the situation, witnessing the pain and self remorse that the person goes through but from the back bench being able to nothing to sooth their pain or reassure them was particularly hard – against the grain as a nurse. It brought back to me my own emotions and at this point I did question whether I would ever be able to separate my own past experience but then it makes me human! Seeing the whole process through from beginning to end was definitely very useful and gave me confidence for that hearing, at that time and for that particular registrant things were conducted fairly.

However, what for all those that don’t have the support we could give that particular nurse. We met a few who were there only with relatives and some who were alone. Completely impotent to be able to represent “their case” properly and so in the hands of the wolves, alone and terrified. The power balance is absolutely tipped in favour of the NMC in these cases and that needs to be addressed.

The distance people travel to attend their hearings is incredible – we had one lady who had travelled up from Cornwall that day / overnight and another who had come from Ireland. Most registrants in that position have limited disposable income so arrive in the Big City with little money in their bags and no pre warning of how long proceedings will take. If you are a witness for the NMC, their admin personnel will liase with you, book and pay for your travel to attend the hearing, pay and book for your accommodation and ensure you feel comfortable so that you can attend refreshed and ready. They will even reimburse you for loss of earnings to attend and ensure that you are fed and watered at their expense and the case presenter will become your best friend. However for the registrant it is a different story.

You need to be present on Day 1 at 9am. This will for many mean either leaving home in the early hours, which will no doubt mean you are exhausted before it has started or that you have to stay in accommodation the night before. This will be at your own expense. The NMC will consider a hardship application but it is not a straight forward process, is not offered routinely and has to be sought after with some strong evidence to ensure you get financial assistance. If you get granted hardship, you will get a daily allowance for meals and have accommodation booked for you, you may also get your rail fare of equivalent organised too. However the accommodation is often basic, air b&b, shared bathrooms and no facility to get food so you have to then navigate yourself round a city that you might never have been to before and find somewhere you can eat within budget. The card details the NMC give you to pay for meals does not work at many establishments so that means you have to pay upfront and then claim the money back, not that easy when you have no money in your bank. This is whilst the NMC witnesses have all travelled down together, booked in to accommodation together and able to eat at hotel restaurant – an enjoyable night out.

As a registrant you have the added stress that until Day 1 of your hearing you have no confirmation of what day your witnesses need to be called, so are hoping that their good nature, and supportive managers ( some of which may be managers who have reported you originally ) will support last minute arrangements. If they can’t attend you have no one on your side and are once again alone.

You arrive and are bundled into the “registrant’s room” a stark and faceless room with little in it other than chairs and tables, luke warm coffee or tea and if you are lucky a curly sandwich at lunchtime. Refreshments stop at 3pm so there is then only a drinks machine for you to use, more money. You wait to be called, this could be at 9am but could also be anytime until lunchtime depending on how the panel choose to run the show. You sit and you sit, waiting and waiting, getting more and more nervous and more likely to completely breakdown when you are finally let in the room of doom. Despite being told to arrive at 9am some registrants have told us that they have not been called into their hearing until 11am or later – sitting getting more and more scared imagining the worst.

When they are called in the panel introduce themselves and deal with fundamental issues of the day, charges outlined and any process clarifications. You sit there, completely confused as to what is going on and when you will be expected to speak. You are asked to clarify your name and PIN number only, similar to a criminal in the dock. There is inevitably a recess whilst the panel read things they need to, you wait again and so the process goes on a ping pong in game in and out of the room with limited information about what the hell is occurring. You will be able to give your evidence and your legal person will help you but ultimately you are on your own, if you are lucky you will get a Case Presenter (CP) prosecuting for the NMC who has a heart – they are few and far between. Generally the CP sees it as an opportunity to audition for the next part in CSI and you sit bewildered as they treat you like some serial offender that deserves to have commissioned the reopening of Alcatraz!

My observations from the NMC hearing backbench:

• No one should go through this process on their own

• It is most definitely about the process and most definitely not about you.

• It is a disproportionally expensive process. I estimated the costs for the hearing that I witnessed;

1) Daily fee to panel members = £360/day plus expenses = £400/day. 3 panels members = £1200 / day / 7 days = £8400 .

2) Legal Assessor – £500 / day = Total cost £3500

3) Panel secretary – £250/day = Total cost £1750

4) Witness expenses: rail fare £200 / person x 9 persons = £1800 ( 2 of which were not called so had a wasted trip!)

5) Hotel accommodation x 1night for 3 witnesses @ £75 each = £225

6) Witness expense claim @ £25 per day – (applicable to 7 witnesses) = £175

Total witness expenses = £2200

Total cost for hearing alone ( conservative figure ) £15,850

Would the public interest really support this level of expenditure – particularly when it comes from registrant’s registration fees?! We continue to ask this and many other questions.

I have founded an on line support group for nurses and midwives undergoing Fitness to Practice ( NMCWatch.)

More information can be seen at: www.nmcwatch.co.uk.

Part of the work involves campaigning for fairer regulation – if you would like to find out more and support us – have a look at the online petition here