Blog: What we’re doing to improve how we regulate, for the benefit of the people we serve

Earlier this month, I was delighted to meet the teams at North Middlesex University Hospital and University College London Hospitals to celebrate International Day of the Midwife and International Nurses Day, respectively. It was fantastic to see the amazing work being done at both hospitals. And it was so lovely that the easing of restrictions meant I could do this in person! 

This year has been like no other and I’ve been inspired by the extraordinary contribution that nurses, midwives and nursing associates have made in the national response to Covid-19. They’ve given people kind, safe and effective care in the most challenging circumstances.

Although our role in the response to the pandemic is by no means over, the incredible work of those delivering the vaccine rollout means we can now look forward to delivering on wider priorities set out in our 2021–2022 Corporate Plan.

Through this blog, I’d like to tell you about our top priority for the coming year in more detail: bringing down our fitness to practise (FtP) caseload and making improvements to the way we handle people’s concerns about nursing and midwifery professionals.

Making changes that are fairer and kinder to people

Last year we identified an increase in the number of cases we were investigating, which we were addressing. But the pandemic meant that we needed to pause some cases and prioritise others, to allow professionals to focus on Covid-19. That meant that our caseload increased further.

We’re now working on an ambitious range of improvements to our FtP processes and decision making. These changes will help us to reduce this caseload quickly and fairly. They’ll also help us to make the right decisions, at the right time. And they’ll ensure that people’s concerns are handled appropriately at every stage.

We’ve listened and engaged with people to develop these changes. They’re guided by our values and our commitment to equality, diversity and inclusion. We want to be fair and kind, and foster the culture of openness that gives professionals the chance to address concerns. And we want to encourage more concerns to be resolved locally, so that we only take forward the most serious cases to keep the public safe.

Supporting employers to resolve concerns locally

One of the initiatives already in train is a new part of our website with information for employers. This digital resource supports employers to take action when concerns are raised about a nursing or midwifery professional’s practise. It includes best practice principles for employers to consider when investigating and managing concerns locally.

Updating our forms and guidance

We’ve revised our online referral forms and are strengthening our guidance for everyone on when to make a referral. By supporting those considering making a referral in this way, we’re able to be more efficient and focus our work on referrals that are necessary to protect the public.

We’ve also improved our guidance about screening – the first stage of our investigatory process. It’s more flexible for our decision makers, and it helps them know which concerns should be investigated locally. It also helps our decision makers to take context into account when looking at concerns.

Taking account of context

I firmly believe that the best way to encourage a safe, fair and open nursing and midwifery culture is to take into account how and why something has gone wrong, giving professionals the chance to address and learn from concerns.

So we’ve also developed a new approach to taking account of context when reviewing concerns. Health and social care settings are complex, so concerns that may appear to be the result of poor individual practice can actually be caused by pressures on the health and care system they work in. Our new approach means we’ll take greater account of this going forward.

Making the right decisions quickly

We’re trialling a new approach that we call ‘multi-disciplinary decision making’. This brings the right people from different teams together at the outset when concerns are raised with us. It will enable robust and informed decisions to be made more quickly and with the appropriate specialist input at the earliest opportunity. 

We’re also building on the experience of virtual hearings delivered over the past year of the pandemic, so that we can be more flexible for the people involved. And we’re changing the language we use to make sure we prioritise people over process.

All these changes are within the limits of our existing legislation. To go further, we’re working with the government to set out how we can deliver our core regulatory functions in a modern, efficient and fair way through regulatory reform. You can read more about this work in Matthew McClelland’s blog.

Becoming a kinder, fairer regulator

Ultimately, our regulatory work should inspire public confidence in nursing and midwifery. That’s why we’ll always take action when needed.

But we know that investigations can have an emotional impact on the people involved, including nursing and midwifery professionals, and the members of the public affected. That’s why we’re committed to getting this absolutely right.

If you’re a professional on our register and you’re going through our fitness to practise process, please remember there’s an independent emotional support line. And if you’re a member of the public there’s support available through our Public Support Service or you can contact our independent Victim Support careline.

Improving the way we handle people’s concerns about nursing and midwifery professionals is vitally important. But it’s not our only priority. We have nine other commitments in our plan for 2021–2022, which you can read about here.

We’ll be sharing more as we make progress with all of these priorities. In the meantime, follow us on Twitter or sign up to our newsletters to get the latest updates about our work.

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