We recently published our Lessons Learned Review of how the NMC handled fitness to practise complaints about midwives at Furness General Hospital. In that review, we concluded that there are two urgent areas requiring improvement by the NMC: its engagement with patients and families who complain and; its commitment in practice to transparency. However, we also noted that the NMC’s performance has been improving – reflected in our performance reviews for 2014/15 and 2015/16. In 2016/17 the NMC has failed to meet the seventh Standard for Fitness to Practise but we are pleased to note that it has met the sixth Standard for Fitness to Practise.
Education and Training
The NMC undertook extensive work to update its education and training Standards during this review period, including developing new Standards of proficiency for the future graduate registered nurse and working on a new education framework to develop a single set of requirements for becoming an approved provider of nursing/midwifery education. The NMC consulted on these proposals as well as on new Standards for prescribers. This work has involved extensive stakeholder engagement. Its Council agreed a new timeline for the development of new Standards for future graduate midwives; estimating adoption by September 2020. The NMC is carrying out an independent review of its education quality assurance process. A two-year programme of work is also underway to ensure that the NMC is ready to begin registering nursing associates in early 2019. We will monitor how this work progresses over the coming year.
Registration: registrants maintain the standards required to stay fit to practise
Initial findings and evaluation of the process indicate that revalidation has been successfully implemented in its first year and the NMC continues to monitor its effectiveness and impact on different registrant groups.
Registration: the process is fair, efficient and transparent
We noted a substantial increase in registration appeals in recent years (including in the number of appeals upheld) – which were not proportionate to changes in the overall number of applications received. We conducted a targeted review. The information provided by the NMC explained how it manages its appeals process and how it identifies learning points from appeals and uses them to update and improve the process. There was no evidence to suggest problems with the process. The NMC continues to monitor how long it takes to conclude registration appeals and its performance against this measure has remained stable. Taking this into account, along with work the NMC has done to limit the number of registrants unintentionally lapsing their registration, we concluded that this Standard has been met.
Fitness to Practise: all parties are kept updated
The NMC has not met this Standard this year. It was met in 2015/16, though we had some concerns about the experience of one family in dealing with the NMC. Our Lessons Learned Review, though largely concerned with matters before this performance review period, identified concerns about the way in which the NMC deals with families which apply beyond the cases we considered as part of that review. The NMC has taken a positive step in establishing a Public Support Service to address how it deals with members of the public who raise concerns about the fitness to practise of nurses or midwives. However, the service is not yet fully operational, so it will not be possible to assess whether it will make a difference for some time.
Fitness to Practise: cases are dealt with as quickly as possible
The NMC did not meet this Standard last year. This year we have seen improvements to meet this Standard, including a reduction in the number of cases running part-heard; the closure of a significant number of older cases; and slightly improving timeliness at the earlier stages of the process. It is clear the NMC closely monitors how cases progress and can reallocate resources should it need to. The increase this year in the overall median timescale is relatively small given the size of its overall caseload, but performance on that measure will be monitored.