NMC takes decisive action after uncovering historical failing

If you have further questions not covered in this Q&A, please use the relevant contact details below.

Email general.enquiry@nmc-uk.org

Telephone: 020 7637 7181

1. How do I know if I am one of the 421 nursing and midwifery professionals affected by this?

This morning (27 May) we’re contacting the 421 registrants affected.

We’re setting out what’s happened, what it means for each individual and what they need to do next.

If we haven't communicated with you today you are not part of the process.

Remember that this only affects registrants who have made health or character declarations in their registration or revalidation applications over the past 12 years – and it has already been determined that no further action is needed for the vast majority of those.

2. What will happen if I’m one of those who does receive a letter from the NMC?

First, if you receive a letter, please remember that this doesn’t necessarily mean that you face being removed from the register.

We believe the vast majority of people we contact will not be removed.

At this stage, we just need some more information from you - so that one of our internally-appointed Assistant Registrars can decide whether the NMC was right to accept your registration or revalidation application.

In the vast majority of cases, the Assistant Registrar is likely to decide that no further action is needed and the person concerned can stay on the register.

An Assistant Registrar may decide to make an onward referral of some of the 421 cases to an independent panel, with a recommendation to consider the removal of a registrant from the register.

It is estimated that Assistant Registrars could make recommendations that up to 15 nursing or midwifery professionals should be removed from the nursing and midwifery register of 867,935 (0.002%). The final decision will rest with the independent panel.

Please read any letter from us carefully – as it will set out exactly what you need to do.

We’re committed to the safety and wellbeing of each registrant we contact, and we’ll support each person to engage with the process.

3. If I received a letter from the NMC, do I need to tell my employer?

If you receive a letter from us, we ask that you tell your employer and if our letter asks you to share details of your employer with us, then please do that as soon as you can. You can access support from your employer if you’re worried – remember that your employer has a duty of care towards you.

We are very clear that employers should not be taking any action against individuals because of this, even if they know one of their employees is among the 421 registrants we write to.

Remember, however, that under the Code, you must tell your employer, and us, as soon as you can about any new caution or charge against you.
You must also tell your employer if you have had your practice restricted, or had any other conditions imposed on you by us, or any other relevant body.

4. If I receive a letter, when will I know whether any further action is needed in my case?

The Assistant Registrar will need to review 421 cases, to decide whether the NMC was right to accept each registration and revalidation application.

It could take 4-6 months for all the cases to be reviewed, however we hope that in some cases we can resolve them more quickly.

We know this will feel like a long wait for an outcome, however it’s important that the Assistant Registrar looks at each case carefully.

In the vast majority of cases, the Assistant Registrar is likely to decide that no further action is needed.

We’ll keep each registrant updated as this work progresses.

If you have further questions not covered in this Q&A, please use the relevant contact details below.

Email: general.enquiry@nmc-uk.org

Telephone: 020 7637 7181

1. How have you decided which nursing and midwifery professionals you need to look into further?

Our guiding principle is public protection. From this perspective, we reviewed each registration or revalidation application which included health and character declarations from a 12-year period.

In each case we looked at whether it followed the correct process – and if not, we then carefully considered the underlying circumstances of the health and character declarations.

For example, where a caution or conviction was declared, we looked at what the offence was, whether it was ‘protected’* in law, the person’s age at the time, how long ago it happened, whether it was an isolated incident, and any explanation offered for what happened and why.

*Some criminal convictions become ‘protected’ after 11 years – or after 5 ½ years if the person was under 18 at the time of the offence.

2. How will I know if any of my employees are in the affected group of 421?

This morning (27 May) we’re contacting all affected registrants, setting out the action they need to take.

In those cases where we need further information from an employer, we’ll ask the registrant to tell us who their employer is.

We’ll make direct contact with employers where possible.

All the information we receive from registrants and, where relevant, employers, will enable the Assistant Registrar to decide whether the NMC was right to accept the individual’s registration or revalidation application.

3. As an employer, do I need to do anything at this stage?

No – as an employer, if any of your employees are affected you should not take any action at this stage.

If we need information from you to support an Assistant Registrar to make a decision, we will contact you directly.

We’ll explain what is needed and why, requesting information that is relevant and proportionate.

If you know that one of your employees is affected, we’d strongly encourage you to support them through your usual wellbeing and support arrangements.

Please continue to manage any Fitness to Practise concerns through existing local processes and escalate to the NMC through the usual referral routes.

4. Can affected registrants continue to work?

Yes – during the rapid review we have undertaken risk assessments to establish whether the NMC should seek to restrict a professional’s practice through an Interim Order. At this stage, it has not been deemed necessary to seek any Interim Orders, however as always, our risk assessments are kept under close review.

We will continue to risk assess each case, and if we receive further information for any individual which leads us to seek to impose a restriction or suspension, then the registrant will need to inform their employer.

We would also inform their employer, where known.

Also remember that the public-facing register is updated daily, to show the status of each professional on the register – whether they are effective to practise, or subject to restrictions or a suspension.

4. Who can I speak to if I have a concern about an employee in relation to this issue?

If any of your employees is in the group of 421 registrants we’re contacting this morning (27 May), and if we need more information from you, as the registrant’s employer, then we’ll contact you directly.

In the meantime, you do not need to do anything – you shouldn’t take action against employees because of our writing to them, and we’d strongly encourage you to provide your usual wellbeing support where needed.

If you’re still feeling unsure or have any outstanding queries not already covered in this Q&A, please contact the Regulation Adviser for your region.

If you have further questions not covered in this Q&A, please use the relevant contact details below.

Email: general.enquiry@nmc-uk.org

Telephone: 020 7637 7181

1. How can I be confident that my nurse, midwife or nursing associate has been properly checked and is safe to care for me?

There are 867,935 nursing and midwifery professionals in the UK and this issues only affects 421 individuals.

We are having to seek extra information on 421 nursing and midwifery professionals to make sure they are capable of delivering safe and effective care because we didn’t consistently complete our full checks for health and character declarations for 12 years. This is completely unacceptable.

However, this issue does only affects 0.05% of nursing and midwifery professionals.

This means there is a very small chance that your nurse, midwife or nursing associate is involved in this situation.

During the rapid review we have undertaken risk assessments to establish whether the NMC should seek to restrict a professional’s practice through an Interim Order. At this stage, it has not been deemed necessary to seek any Interim Orders, however as always, our risk assessments are kept under review.

On top of that, employers carry out their own pre-employment checks, which may include DBS checks, reference checks, identity verification, and assessment of suitability for the role.

An Assistant Registrar may decide to make an onward referral of some of the 421 cases to an independent panel, with a recommendation to consider the removal of a registrant from the register.

It is estimated that Assistant Registrars could make recommendations that up to 15 nursing or midwifery professionals should be removed from the nursing and midwifery register of 867,935 (0.002%). The final decision will rest with the independent panel.

So, you should continue to feel very confident that your nurse, midwife or nursing associate will provide you with safe, excellent and effective patient care.

2. What action is the NMC taking?

We brought in a team of paralegals, who worked alongside our staff team, to carry out a rapid review of the 18,060 health and character declarations made in registration and revalidation applications over a 12-year period. We’ve determined that no further action is needed in 17,639 cases (98%).

This morning (27 May) we’re contacting 421 nursing and midwifery professionals, to request further information, to enable an internally-appointed decision maker known as an Assistant Registrar to decide whether they are capable of safe and effective practice.

In the vast majority of cases, the Assistant Registrar is likely to decide that no further action is needed.

However, they may make an onward referral of some of those nursing and midwifery professionals to a panel, to consider removal from the register – meaning they would no longer be able to practise.

It is estimated that Assistant Registrars could make recommendations that up to 15 nursing or midwifery professionals should be removed from the nursing and midwifery register of 867,935 (0.002%). The final decision will rest with the independent panel.

We’ll provide regular updates on our website, but if you are worried or have an urgent query in the meantime, please contact us.

3. Why have you not taken immediate action to stop the 421 nursing and midwifery professionals from practising?

Each month, around 50 Interim Orders are imposed to restrict the practice of nursing or midwifery professionals where we believe there is a serious risk to the public.

During the rapid review we have undertaken risk assessments to establish whether the NMC should seek to restrict a professional’s practice through an Interim Order. At this stage, it has not been deemed necessary to seek any Interim Orders, however as always, our risk assessments are kept under review.

We will continue to risk assess each person concerned, and if we receive new information which means we need to act now, then we will consider applying for interim orders.

4. How could someone with a criminal record be a nurse, midwife or nursing associate?

Not all criminal offences would necessarily be incompatible with being on the nursing and midwifery professional register.

In each case, where a nursing or midwifery professional makes a health or character declaration, we look at the underlying circumstances.

We’ll look at what the offence was, the applicant’s age at the time, how long ago it happened, whether it was an isolated incident, and any explanation offered for what happened and why.

5. What should I do if I’m worried about the nurse, midwife or nursing associate looking after me?

First, speak to their employer – the NHS Trust or independent provider where you’re being cared for.

They will have policies and procedures to look into concerns that members of the public raise about their staff. Local providers are usually best placed to investigate and resolve a concern.

If you’re not satisfied with the local investigation, or if your concern is very serious and evidenced, and definitely about a nurse, midwife or nursing associate on the NMC register, then you can call our referral helpline on 020 3307 6802.

Our expert call handlers will guide people on making the right referrals and including all the information we need to make a decision quickly and safely. Where we’re not the right organisation for a particular concern, we’ll steer you toward those better placed to help.