Our review of the NMC’s performance was drafted before the Covid-19 pandemic struck the UK (and covers April 2018 to March 2019). In the report we make reference to some of the NMC’s future plans – but recognise that responding to the current situation will likely cause delays as priorities are re-focused to tackle the Covid-19 emergency.
Guidance and Standards: standards of competence and conduct reflect up-to-date practice
In this review period, the NMC published its new standards of proficiency for registered nurses, describing the knowledge/skills nurses should have at the point of joining the NMC’s register. The NMC reported that the standards have been updated to reflect changes in healthcare and to ensure that nurses are equipped with the skills and knowledge they need to deliver good quality and safe care now and in the future. The new standards came into effect from January 2019. We received positive feedback from stakeholders in relation to this work.
Registration: registrants maintain the standards required to stay fit to practise
The third and final annual evaluation report on the NMC’s revalidation process found that the implementation of revalidation had progressed as intended. By March 2019, 93 per cent of registrants due to undergo the process had successfully revalidated. No evident adverse impact on renewal rates had been observed compared to the previous process. The report described positive changes in registrants’ behaviour resulting from undergoing revalidation, including an increase in registrants proactively seeking feedback from patients/service users, undertaking CPD activities, and reflecting on their practice.
Fitness to Practise: the process is transparent, fair and proportionate
Last year this Standard was not met. We had concerns about: the NMC’s handling of complaints about registrants conducting personal independence payment (PIP) assessments; the NMC’s approach to evidence gathering and presentation; the number of cases where charging amendments were made at final hearings (potentially affecting the fairness of proceedings). This year we continued to observe similar concerns in cases we reviewed around evidence gathering and presentation and late amendments to charges. We recognise that the NMC has undertaken considerable work to improve its process and is making significant changes under its new fitness to practise strategy to address our concerns. However, that work was at an early stage and we have not yet seen evidence of its impact to say that this Standard is being met. We will continue to review this.
Fitness to Practise: all parties are supported to participate effectively in the process
The NMC continues to undertake extensive work to address concerns we raised in our ‘Lessons Learned’ review (2018) and is working to improve its processes and how it communicates with stakeholders to ensure that all parties to the fitness to practise process are supported to participate effectively. For example, launching its Public Support Service (PSS) in September 2018. The PSS is intended to provide support to anyone raising concerns from first contact to conclusion of a case. This is important work, but we considered that much of it was at an early stage during the period under review. The NMC has not yet provided us with a detailed analysis of the impact of the changes made. We received mixed feedback from third party organisations. We therefore could not make an informed judgement as to the effectiveness of the NMC’s new approach and for this reason we decided that this Standard was not met this year.