Recommendation 228

The administration of the Nursing and Midwifery Council

Accepted
It is of concern that the administration of the Nursing and Midwifery Council, which has not been examined by this Inquiry, is still found by other reviews to be wanting. It is imperative in the public interest that this is remedied urgently. Without doing so, there is a danger that the regulatory gap between the Nursing and Midwifery Council and the Care Quality Commission will widen rather than narrow.

The Nursing and Midwifery Council has made clear its commitment to implementing the recommendations and achieving the required improvements in the delivery of its regulatory functions set out in the strategic review undertaken by the Professional Standards Authority in 2012, most recently in its 2013-2016 corporate plans.

In relation to the recommendation to appoint a strong leadership team to drive forward turn around work, Mark Addison was appointed Chair of the Nursing and Midwifery Council in September 2012, and Jackie Smith was permanently appointed to the role of Nursing and Midwifery Council Chief Executive in June 2013. In addition, the Nursing and Midwifery Council was re-constituted from 1 May 2013.

The government has demonstrated its determination to ensure the Nursing and Midwifery Council is an effective regulator that serves its members well.  In February 2013, the Government provided a £20m grant to support the Nursing and Midwifery Council to achieve a number of improvements including clearing a backlog of historical fitness-to-practise cases, speeding up fitness to practise proceedings, ensuring free financial reserves are at agreed levels and reducing the effect of an annual fee rise for nurses and midwives.  Departmental officials continue to closely scrutinise and monitor the Nursing and Midwifery Council’s progress in making the required improvements within the timescales specified.

In addition, the government is working on an order under section 60 of the Health Act 1999 to amend the Nursing and Midwifery Order 2001. This is in advance of any measures which may be taken forward following the Law Commission review which is considering the overhaul of the complex legislative framework that governs the Nursing and Midwifery Council and the regulators of other UK health professionals and, in England, social care professionals into a single Act, subject to parliamentary timetables. Within this section 60 order the government intends to make a number of amendments including change to achieve greater efficiency in fitness to practise procedures, including a reduction in the overall time that a case takes from start to finish.

Update

The Nursing and Midwifery Council commissioned an independent review to assess its progress in addressing recommendations made in the Professional Standards Authority’s Strategic Review of it. The report from this review was published on 15 September 2014. The review concluded that the Nursing and Midwifery Council has made a substantial number of improvements, which cumulatively place it in a much stronger position than in 2012. However, it also highlights areas where the Nursing and Midwifery Council needs to continue to make progress.

The 2012 Strategic Review was clear that high quality leadership was critical to restoring confidence in the Nursing and Midwifery Council’s reputation as an effective regulator. In September 2014, the Nursing and Midwifery Council announced that Professor Dame Janet Finch DBE had been appointed as its next Chair from January 2015.

In summer 2014 the Nursing and Midwifery Council had cleared the backlog of historical fitness-to-practise cases in advance of its December 2014 target, and has increased the number of hearings to more than 22 per day in order to meet the adjudication target by December 2014.

The Nursing and Midwifery (Amendment) Order 2014 came into force on the 11th December 2014. The Order made amendments to the Nursing and Midwifery Council’s governing legislative framework.  Associated amendments to the Nursing and Midwifery Council’s rules will come into force in March 2015.  The amendments in the Order give the Nursing and Midwifery Council powers to carry out its fitness to practise role and functions more effectively, enabling complaints to be dealt with more quickly and resulting in improved public protection.