INMA Forum 15 August 2024

Agenda items covered

1. Welcome from the Acting Chief Executive and Registrar

• Grace Batterham (GB), Senior Stakeholder Engagement Officer, gave apologies for Sam Foster, Chair of the INMA Forum.
• Helen Herniman (HH), Acting Chief Executive and Registrar, gave a short introduction to the Forum as she is new in post. She then went on to provide a high-level update about the publication of the review into the NMC’s culture.
  • HH acknowledged that the report provided a sobering moment for the NMC and that on behalf of the Executive Team, she wanted to apologise to NMC colleagues who have had poor experiences, as well as apologise to registrants who have been impacted by our Fitness to Practise (FtP) processes.
  • HH also acknowledged the impact that recent riots may have had on INMA Forum members and the professionals they represent. Sadly, Islamophobia, racism and other forms of discrimination do exist in society, and recent events have reinforced the need to ensure the NMC has a stronger position on discrimination. HH reassured the group that support has been available to NMC colleagues who may have been impacted by the events.
  • We know that the professionals on our register have been affected by the culture review, and HH provided an update on some of the immediate actions we’re taking to address issues. These include setting up a safeguarding hub to ensure colleagues have the right support to deal with these types of concerns, as well as starting the recruitment process to appoint an Equality, Diversity and Inclusion Advisor to our executive board.
  • HH closed her welcome by assuring INMA Forum members that we want to continue working with them to address issues and ensure the international/diaspora voice is heard within the NMC.

2. Reflections from the Head of NMC Culture Investigation

• Karen Lanlehin (KL), Head of the NMC Culture Review, provided an overview of the culture review findings, what our immediate actions are and what we’re planning to do in the longer term (ACTION 1).

3. Discussion

• As a result of the report, the NMC have said they’ll double the learning and development budget for colleagues. If the NMC reduced turnover of staff, would doubling the budget be necessary?
  • When reflecting on the culture findings, the NMC realised that we have identified and rectified under investment in technology and our estates but had not realised the under investment in the development of our people. We want to ensure that colleagues at the NMC have the right tools to do their roles well and so we need to start investing in their development.
  • The NMC does have a high turnover, but as we begin to invest in our people more, we hope more people will stay at the NMC for longer.
• The culture review may result in people not wanting to work for the NMC. This will affect both registrants and current colleagues, because there will be more pressures within the organisation as there aren’t enough staff to cover all the work.
  • The NMC needs to refine how we look after our staff to ensure they can enjoy their roles and feel they are well equipped to do their jobs.
• How will the NMC ensure they listen to employees to understand how they want the NMC to be? And how will the NMC ensure they listen to external stakeholders to understand what they want the NMC to be?
  • It's important for the NMC to look at the culture review with those two strands: the internal and the external. Both are important for us to move forward and make the changes we want to see.
  • The culture change needed at the NMC is bigger than just the recommendations included in the review. The recommendations are a good starting point, but we will be conducting a wider culture assessment to understand where the issues are. We know that change will take several years but we’re already starting to implement strategies to make a difference to professionals and colleagues, such as the work around safeguarding.
• For culture and the FtP plan, what is the link between engagement the NMC is doing internally and externally? How will the comments from stakeholders drive change at the NMC?
  • It’s important that both internal and external stakeholders are engaged on the FtP plan and our culture change programme.
  • Colleagues have had time to reflect on both plans and we have internal mechanisms to ensure they have the opportunity to provide their views – this may be through our recognised union, the employee forum, team meetings or our upcoming employee conference.
  • For external partners, our plan for engagement is still taking shape as there are many areas of interest that stakeholders may want to provide views on. The stakeholder engagement team are working on a plan for engagement, and the INMA Forum will be part of that.
• Culture takes a long time to change, but there is an immediate impact to professionals going through the FtP process. This is especially true where there are wellbeing or safeguarding concerns. Are there any immediate actions to deal with the issues in FtP?
  • FtP has been a priority for a number of years and the NMC does have a plan to support a reduction in the time it takes us to process FTP referrals.
  • The culture report highlighted the impact of FtP timeliness on professionals and so we are revisiting the plan in light of those findings. We do know that we need to be more radical.
  • Our current technology systems do not help with timeliness issues and there is work already underway to improve those systems, but it will take 12-18 months to see improvements.
  • Colleagues in Professional Regulation are working hard to make other improvements to the FtP process (ACTION 2).
• For many years, the Code has been used as a threat to instil fear into global majority professionals. As part of the training budget, you need to ensure NMC colleagues have cultural intelligence so that they can discern where there may be discrimination within referrals and what the impact of that is – the Royal College of Nursing has the Cultural Ambassadors Programme. Do you have any plans for cultural intelligence training or adopting the RCN’s programme?
  • The NMC aren’t looking to adopt the RCN’s programme, but we’ll take away the idea and do some more research (ACTION 3).
  • We know that cultural intelligence would help us achieve the outcomes we want, especially within the FtP process, we just need to have a clearer scope of what that would look like for the NMC.
• The report highlighted safeguarding concerns. Have condolences been offered to the families of those bereaved? And is the NMC providing support to families?
  • We have contacted families involved and we have reported these tragic incidents to the Charity Commission. 
• It’s important to understand the origin of a referral before it reaches the NMC as there may be malicious intent or bias that has caused the referral in the first place. It’s also important to have a constant eye on culture because discrimination and racism are not new and are ever evolving. Is the NMC committed to ensuring their plans are reviewed and this report isn’t going to just make one off changes?
  • Culture should be an evolving process. The NMC need to invest heavily and make changes now, but any plans should be tracked, reviewed and revised on an ongoing basis.
  • The Professional Standards Authority (PSA) are creating and independent oversight group that will keep track of the progress we’re making.
  • The Professional Regulation directorate are doing a lot of work on referrals and can come to a future meeting to discuss this (ACTION 4).
• Are there any plans to engage more closely with registrants on the recommendations of the review?
• Registrants have lost trust in the NMC. What plans are there to keep professionals up to date on how the NMC are dealing with the issues and implementing the recommendations?
• How can the stakeholders monitor that all these promises are being followed through with?
  • We are still scoping out how we’ll be engaging with registrants, but we’ll be able to share more information at the next INMA Forum meeting.
  • At the September Council meeting, we’ll also be sharing more information on our plans to implement the recommendations. This meeting is open for anyone to attend. You can sign up here to join the meeting: NMC Council Meeting September 2024 Tickets, Tue 24 Sep 2024 at 09:30 | Eventbrite.
  • We’ll continue to update on progress against the recommendations through our Council meetings. The PSA will also keep track of the progress we’re making.
• Wales is not very diverse and so there needs to be more cultural sensitivity training, not only within the NMC, but also for employers and professionals. It’s also sad to know that the report has made a lot of registrants lose trust in the NMC, what will the NMC be doing to rebuild that trust?
  • The NMC works very closely with the Chief Nursing and Midwifery Officers, as well as employers, and so we’ll be looking to share this insight with them and understand what can be done to make changes in this area (ACTION 5).
  • Words won’t be able to increase the credibility of the NMC or professionals’ trust in us. It is actions that will demonstrate that we’re making changes and ensuring that FtP cases are dealt with in the right way, will rebuild trust.
• The name NMC instils fear in professionals and there is more support needed for registrants going through FtP processes.
  • The NMC should never instil fear in professionals, and it concerns us that this is the case.
  • We want to continue building better relationships with employers and professionals to reduce the fear factor and ensure we have good engagement with professionals when they do have to go through our processes.
  • Professionals should feel supported throughout their careers so that they can provide the best care possible to the public.
• There was a research piece by the University of Greenwich which highlighted issues with panel members. The NMC doesn’t have a good track record of implementing recommendations because those issues are persisting.
  • The NMC hasn’t always delivered on recommendations from previous reports, so we need to do things differently this time around.
  • Thank you for highlighting the research, we’ll bring it back to the next meeting to discuss (ACTION 6).
• Part of repairing the reputation of the NMC is by ensuring that staff who are perpetrators of discrimination are dealt with appropriately.
  • The NMC has a range of HR policies that will aid us with any issues of inappropriate behaviour. Any historic or new issues that are raised will be dealt with firmly. The NMC does not tolerate racism or any other discrimination.
  • We know that colleagues have felt unable to speak up before. We now have an independent Speak Up Guardian in place, who we hope will help build colleagues’ trust in speaking up at the NMC.

4. Close

• HH closed the meeting by thanking the group for the constructive discussion and reminding them that if any of them want to have further conversations, she will make herself available (ACTION 7).
• GB added that there will be other opportunities for INMAs to get involved in the NMC’s work and details would be shared shortly (ACTION 8).

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