Our approach to fitness to practise

Our commitment to change

Our new strategic direction for Fitness to Practise (Cymraeg) builds on improvements we’ve already made to the way we investigate concerns about the people on our register.

It draws on the rich insights from:

• our public consultation held in 2018
• qualitative research by ICE
• feedback from the consultation including input from patients, service-users and families, the professionals on our register, employers and other stakeholders.

We believe this new approach will help us to protect the public in a fairer, more effective, proportionate and consistent way.

Improving the way we handle people's concerns and reducing our fitness to practise caseload

Improving the way we handle concerns about people on our register is one of our main priorities for 2021 - 2022.

As the regulator of almost 732,000 nursing and midwifery professionals, we have a crucial role in promoting and upholding high professional standards. These standards support the professionals on our register to deliver kind, safe and effective care.

To ensure we’re getting this right, we’re building on our new approach to fitness to practise to deliver a number of sustainable improvements to our processes and decision making.

Fitness to practise caseload

Last year, as part of improving the way we handle concerns, we began taking steps to address an increase in our fitness to practise caseload.

But the coronavirus pandemic meant that we had to pause some cases and prioritise others to allow professionals to focus on Covid-19. That meant that our caseload increased further.

We're making changes to reduce the caseload quickly and fairly, creating long-lasting improvements to the way we regulate.

Making changes that are fairer and kinder to people

To reduce the caseload as quickly as possible, we're modernising the systems that support our regulatory work and investing in additional resources. This will help us to make the right decisions at the right time.

We're improving how we handle people's concerns by:

• building on the experience of virtual hearings where it is fair and practical to do so.
• working with others in the sector to foster a culture of openness and learning that supports people to improve their practice.
• continuing to support employers to resolve concerns locally with Managing Concerns: A resource for employers.
• making our screening process and guidance as straightforward as possible.
• taking a new approach to taking account of context and using a set of commitments to help us do this.
• improving the information on our website to help people find what they need, when they need it.

Read our Chief Executive and Registrar, Andrea Sutcliffe's blog, where she explains what we're doing to improve how we regulate for the benefit of the people we serve.

People at the heart of fitness to practise

Alongside a focus on keeping people safe, we're committed to people being at the heart of everything we do.

We're providing better information and more support for patients and families, as well as a rolling programme of training and development for our employees.

We’re also engaging with members of the public who have experienced the fitness to practise process to help us shape what we do, to ensure that people are truly at the heart of our work and that we are fair to everyone involved.

We are reviewing the support we offer to those with specific needs to ensure we can meet them and that our processes are accessible. We have produced accessible information regarding fitness to practise for those who find reading hard.

Alongside this, the Fitness to Practise Careline has been set up which is a new support service for the professionals on our register going through a fitness to practise investigation. And we continue to offer an independent emotional support line for those who have raised concerns about a registrant, and for witnesses.

Referrals helpline

As a member of the public, it can be really hard to raise a concern about a nurse, midwife or nursing associate. Not only will they have been through a difficult experience, but the regulatory process can be complicated.

So we’re introducing a referrals helpline for members of the public to call before they refer a professional. A dedicated and supported team will help members of the public to understand more about who we are, whether we're the right place to come, how we can help them and most importantly, what support we can offer them.

We hope it’ll give us the information we need to be able to act. And it’ll provide early clarity and information on alternatives for people whose complaints we can’t help with.

The referrals helpline is available at: 020 3307 6802. Some calls will be recorded to help us train colleagues and monitor the quality of support we provide. We might use the recording to check details about fitness to practise referrals and complaints. There’s more information in our privacy notice.

Enabling remediation

Our new approach to fitness to practise promotes a culture of openness and learning, and not punishing people for past events. 

We want to give the professionals on our register the chance to remedy and address any concerns that have been raised with us.

We'll be providing new remediation guidance to help the professionals on our register better understand how they can demonstrate that they are safe to practise after a complaint has been raised against them.

This might include information such as their reflection on what has gone wrong, extra training they have undertaken, or the views of their employer or other healthcare professionals on their practice since the incident.

How these changes will help

The changes we’re making will help us to reduce our caseload quickly and fairly, and help us make the right decisions at the right time.

We're carrying out these changes in a planned and collaborative way. We've listened and engaged with people to develop these changes, and we're delivering them in the order in which we think they will have the greatest impact for those involved in the fitness to practice process.

The changes we’re currently making are within the limits of our existing legislation. But we could do even more if we had greater flexibility.

That’s why we’re currently working with the government to modernise the legal framework that governs what we do and how we do it.

You can read more about this work in our Executive Director of Strategy and Insight, Matthew McClelland’s blog.