Concerns requiring us to take action to protect public confidence in the professions and uphold standards

Last Updated 02/02/2021


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In rare cases, you may need to refer a nurse, midwife or nursing associate to us if their actions undermine public confidence in the professions, whether or not there is a risk to people who use services.

Conduct that could affect trust and confidence in nurses, midwives and nursing associates could include dishonesty, bullying and harassment related to professional practice. Within a nurse, midwife or nursing associate’s private life, criminal convictions that relate to specified offences or result in custodial sentences are also likely to undermine public confidence in the professions.

This would also apply where clinical failings are so serious that, even if put right, they could affect the public’s trust in nurses, midwives and nursing associates if action isn’t taken.

There is generally a high threshold for this type of referral. You should make a referral where the nature of concerns suggests that members of the public might take risks with their own health and wellbeing by avoiding treatment or care from nurses, midwives and nursing associates.

When to refer these concerns to us

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You should refer these cases at the point where you (or the police or other investigating body) have sufficient evidence to indicate serious wrong-doing. This might include police charging someone with a crime, for example, or evidence of social media activity indicating bullying, harassment or discriminatory conduct. Without some evidence, it’s unlikely that we would be able to take regulatory action.

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