The recent case of nurse Helen Lockett before the NMC’s Fitness to Practice Panel has raised important questions about the significance of “contextual factors” in fitness to practise cases.
Helen Lockett was the former Director of Operations and Executive Nurse at the now-defunct Liverpool Community Health. She was found guilty by a Nursing and Midwifery Council (NMC) Fitness to Practice panel of 34 charges including bullying and trying to defer concerns raised about patient safety.
An independent review of the trust found that patients had suffered "unnecessary harm" after cost-cutting led to severe staff shortages.
The Fitness to Practise panel found Ms Lockett had failed to take adequate action concerning reports of inadequate staffing and medication administration and she did not properly respond to reports following the deaths of inmates at Liverpool prison.
It was also found that she bullied and intimidated colleagues, including telling one nurse that she had "wasted 35 years of her life in the nursing profession".
The NMC had sought to have Ms Lockett struck off the nursing register. Instead the Fitness to Practise panel issued a 12-month Suspension Order.
Clare Strickland, Deputy Director of Fitness to Practise at the NMC is reported to have said: "We believe the panel took a rigorous approach to this complex case and was right to find Ms Lockett's fitness to practise impaired.
"However, in our view the panel's reasons do not adequately explain why a 12-month suspension order was sufficient in light of the panel's own findings and the NMC's guidance on sanctions."
The case of Ms Lockett has been the subject of significant debate including in Parliament where Labour MP Rosie Cooper criticised the NMC for not permanently striking off the Ms Lockett and called on the NMC to be “replaced with a body which can instil confidence” saying its reputation was in "complete disrepute".
The fact that the NMC panel chose to suspend Ms Lockett instead of removing her from the register ultimately came down to the context of the case.
Whilst there has been criticism of the reasons given by the panel for its decision, it has been reported that the panel’s justification was that, it the panel’s view, “it was not in the public interest to permanently remove such an experienced and respected nurse from the practice.” Apart from the circumstances that lead to the NMC fitness to practise hearing, Ms Lockett has otherwise had an unblemished 30-year nursing career.
In this article, I am not endorsing, or otherwise, the fitness to practise panel’s decision as being right or wrong. This has been widely debate, often in public and in the media. The point I wanted to drawn on in this article is the importance and significance of contextual matters in fitness to practise proceedings.
I have extensively written on this generally, but in this case the context that proved to be an important determinative factor was Ms Lockett’s “unblemished” career. The charges against her were extensive and significant and resulted in “unnecessary harm”. Under the circumstances, a Striking-off Order would have been an appropriate sanction.
However, as has been demonstrated in this case, context is an important factor and one that can be persuasive. Had Ms Lockett not been able to demonstrate her otherwise extensive experience and “unblemished” career, the sanction would probably have been very different.
This case was in the context of the NMC but the principle applies to any other healthcare regular. As pressure on healthcare workers and professionals increase, context in fitness to practise proceedings is becoming an increasing important persuasive factor.
This case is also another example of the importance of expert legal representation in fitness to practise cases. It is also clear that without a clear case strategy, approach and representation, the outcome for Ms Lockett’s case may very have been very different.