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Nursing and Midwifery Council

Volume 713: debated on Monday 12 October 2009


Asked By

To ask Her Majesty’s Government what assessment they have made of how the Nursing & Midwifery Council and its judging panel, the Professional Conduct Committee, is carrying out its duty to represent the public interest with reasonable punctuality.

My Lords, the assessment carried out by the Council for Healthcare Regulatory Excellence, CHRE, in June 2008 on the Nursing & Midwifery Council, NMC—I apologise for all the acronyms—raised a significant number of concerns, one of which was the length of time the NMC was taking to deal with its fitness-to-practise cases. The report noted that significant improvements have been made in the past 12 months. It expects further improvements to be made and will continue to monitor closely progress in the next 12 months.

My Lords, I am grateful to the noble Baroness for her helpful Answer but is it not appalling that six years after serious allegations of abuse and neglect in an old persons’ home came before the NMC, the case has not yet been heard? The patients concerned have long since died but their relatives are entitled to at least a verdict in this case and six years is simply not acceptable.

My Lords, I thank the noble Baroness for sharing these concerns with me. I absolutely agree that it is completely unacceptable that the proceedings in this particular case have taken so long. It is unfair on both the complainant and the staff in question. I am pleased to say that the NMC and its new leadership are well aware of this matter and have a plan to address these issues. Improvements can and will be seen and will continue in the coming years, including resolving the issues that the noble Baroness has raised.

My Lords, I declare an interest as chair of the Council for Healthcare Regulatory Excellence, the CHRE, which has already been mentioned. Is my noble friend aware that one of the ways in which CHRE operates is to encourage co-operation, information exchange and shared learning between the healthcare regulators to help improve their practices? Are the Government now giving consideration to implementing that section of the Health and Social Care Act which places a duty of co-operation on regulators?

My Lords, my noble friend raises a very important point about sharing information across healthcare professional organisations. I am pleased to say that the consultation on the duty of co-operation is imminent. I will write to my noble friend with further details but we are expecting the date very soon.

My Lords, is this case of six years ago a single isolated incident or are there other cases? Is it just the tip of the iceberg?

My Lords, at any one time about 2,500 fitness-to-practise cases are being considered by the NMC—that is, 0.2 per cent of the number of registered nurses and midwives. We are talking about a very small number. It is disappointing that there are still a small number of cases which are taking longer than they should. I think there are eight cases still outstanding which have taken more than five years. We are very unhappy about that and the matter is being pursued by both the regulator and the CHRE.

My Lords, the Prime Minister announced earlier this year that there would be a commission on the future of nursing and midwifery. Will that commission address how nurses and midwives should be held accountable for their actions?

The Prime Minister’s Commission on the Future of Nursing and Midwifery in England has been hard at work over the summer; I know that the noble Baroness, Lady Emerton, who is a member of that commission, has spent a large part of her holidays doing this. Last week it published its 10 hot topics that it intends to pursue, and I note that number nine is taking responsibility and bringing to account the quality and safety of patient care—that is, how well nurses and midwives are supported in the job that they do, and whether the performance development supervision systems are fit for purpose. The commission will be looking at that.

My Lords, in its June 2008 report the CHRE criticised,

“the quality, comprehensiveness and variability of information and statistics provided by the executive to Council members on fitness to practise cases”.

Does the council of the NMC receive, as an automatic part of its council meeting papers, an aged analysis of fitness-to-practise cases?

I do not know the answer to that specific question, but the average time that cases are taking is coming down. When the special report was published, that time was 29 months, which is clearly unacceptable. The average age of cases is now 13 months, and the aim is that, within the next two years, 90 per cent of cases should be settled within a 15-month period. I will ask about the specific point that the noble Earl has raised.

My Lords, I declare an interest as a previous chairman of the UKCC, now the Nursing & Midwifery Council, and I have experience of the professional conduct and fitness-to-practise systems. What concerns me is that there are 2,500 cases still waiting. Is there any information on the progress in implementing a new computerised system that will assist case management? That seems to be one of the aspects that is holding things up.

I thank the noble Baroness for her record of helping to improve nursing practice in this country. She makes an important point. The NMC has appointed a permanent director of fitness to practise. The electronic case management system has been developed for that, and will be implemented by the end of the year. These are complex cases and better monitoring of them, improved agreement for the provision of services for their investigators, additional staff and the redesign of their fitness-to-practise processes are all in hand. I hope that by this time next year we will have seen some significant improvements.