Stage three: obtaining credible evidence

Reference: SCR-2c

Last Updated 28/07/2017

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Whether evidence will be forthcoming

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Once we are satisfied that the referral discloses concerns that are sufficiently serious to be treated as an allegation of impaired fitness to practise (or of incorrect or fraudulent register entry), we will consider the evidence supporting the referral.

There needs to be enough evidence supporting an allegation to justify a full investigation, so we assess whether it is possible to obtain credible and admissible evidence to support the allegation. This is particularly relevant where potential witnesses wish to remain anonymous or tell us they do not wish to cooperate with our investigation.

This does not mean that we weigh the evidence in the same way as a practice committee dealing with a final hearing, and our initial consideration does not involve us deciding the facts of the case. It is the case examiners’ function to decide whether a nurse or midwife has a case to answer at the conclusion of the investigation, and the function of our practice committees at final hearings or meetings to make findings of fact.

Disciplinary investigations not complete

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Where employers have not yet completed their disciplinary investigation we would not generally pursue an investigation at that stage. Sources of evidence may not have been identified and are, in fact, unlikely to be in a form that would allow us to make a confident judgement about the case. However, we will always assess the seriousness of what has been alleged at this early stage.  If the nurse or midwife presents such an imminent risk to patients that an interim order may be needed to restrict or suspend their practice, we would commence an investigation. 

However, if we do not need to apply for an interim order, we will generally inform the referrer that we do not intend to investigate unless their own investigation is complete, but ask that the employer make a new referral to us when their investigation has concluded.

Where an organisation employing a nurse or midwife is aware of other investigations, such as criminal investigations by the police, the considerations above will not generally apply

We emphasise, however, that we strongly encourage effective engagement with employers, and we aim to work with senior employer stakeholders to improve awareness of our referrals process. Our Employer Link Service1  provides advice for employers on making referrals in a way which best allows us to investigate cases promptly and effectively. Employers who need guidance on referrals are encouraged to contact the team using the details below.

Examples of useful supporting evidence

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We will always need some indication of sources of potential evidence, or other lines of inquiry. During our initial consideration, we will make preliminary enquiries and may contact referrers and other sources such as healthcare settings or employers. Useful supporting evidence will usually include:

  • a clear and logical narrative explaining the conduct which is being alleged
  • dates of the incident(s) (including exact time and dates if possible)
  • locations where the incident(s) took place (including name and address of the organisation, and specific wards or departments where possible)
  • details of who was present (including patients, colleagues or any other witnesses)
  • copies of contemporaneous notes and statements of anyone who witnessed the events alleged
  • copies of medical records, MAR charts, prescriptions, which should be provided with the informed consent of the patients concerned if possible, or a clear indication as to why this has not been possible
  • local policies
  • details or documentary records of any admissions made by the nurse or midwife
  • where the evidence that can be provided by the referrer is limited, details of other sources of evidence in support of the allegation.

Where allegations are made anonymously by an individual who is the only witness to the alleged events, or where the only direct witness is not willing to cooperate with our investigation, more evidence will be required in order to support the concerns. In the absence of any indication that other admissible evidence is available, we will not be able to continue with an investigation.

1 Employer Link Service can be contacted on employerlinkservice@nmc-uk.org and the advice line is (020) 7462 8850.