In fitness to practise proceedings, the seriousness of a case is an important consideration which informs various stages of the regulatory processes for nurses and midwives. Generally speaking, the seriousness of a case will influence the speed of the investigation, impact on consideration of interim steps and lead to more severe outcomes.
In this article, I will look at how the Nursing and Midwifery Council (NMC) determine seriousness in fitness to practise proceedings and decisions.
At a very basic level, the NMC will undertake a risk assessment to determine “what risks are likely to arise if the nurse, midwife or nursing associates doesn’t remedy or put this concern right.” This risk assessment can be divided into three distinct parts to determine the seriousness of a NMC fitness to practise case:
The NMC will consider a case as serious where remedial action is not easy. Unless a nurse, midwife or nursing associate’s practice is (or can be) improved, there is a residual risk of harm to patients and the profession’s reputation.
In some specific circumstances, a case will be referred to the NMC’s Fitness to Practise Committee because the nature of the circumstances outlined below is not easily remedied:
The NMC will undertake a review of the evidence before it to assess the risk associated to nurse, midwife or nursing associate’s conduct or failings in the past, and what harm did or could have happened to patients because of those failings.
An important aspect of this assessment of the evidence includes an assess of “how likely the nurse, midwife or nursing associate is to repeat similar conduct or failings in the future, and if they do, if it is likely that patients would come to harm, and in what way.”
The criteria against which this assessment of the evidence is measured is, more often than not, based on a serious departure from standards such as the NMC’s Code.
The seriousness of a case does not always need to relate to patient safety. Professional standards and public confidence in nurses and midwives are also a relevant NMC consideration in fitness to practise cases.
The NMC says “This means we may need to take action even if the nurse, midwife or nursing associate has shown that they have put serious clinical failings right, if the past incidents themselves were so serious they could affect the public’s trust in nurses, midwives and nursing associates.”
Throughout the assessment by the NMC on the seriousness of a case, there is opportunity for nurses and midwives to influence the outcome of the investigation.
The NMC’s own guidance repeatedly refers to two important things:
NMC Defence Barrister
I am an experienced Nursing & Midwifery Council (NMC) Defence Barrister who has represented nurses and midwives at all levels of a fitness to practise investigation and panel hearings. I am a practising healthcare and medical law defence barrister with a proven track record of success, years of experience and renowned for being “hands on”.
I can help with all matters relating to NMC Fitness to Practise Referrals issues including:
- What to do if you have been referred to the NMC
- Advice on the NMC investigatory process
- Consensual Panel Determinations
- Interim Orders Hearings
- Advice, assistance and representation for hearings before the Conduct and Competence Committee
- Advice, assistance and representation for hearings before the Health Committee
- Appeals against the decisions of the NMC
If you have been notified by the NMC that you’re under investigation or are facing difficulties with your registration, contact me today for an initial free and no obligation consultation on 0207 060 1983 or Stephen.McCaffrey@kingsviewchambers.com.