Blog: The value of personal experience statements

The Nursing & Midwifery Council (NMC) is always exploring how it can do things differently, so last year, it commissioned Traverse to carry out independent research into its new Fitness to Practise (FtP) approach.

People at the heart of investigations

In a move that could tread new ground, the latest research – The voice of people who use services, families and members of the public in fitness in practise proceedings – looks at the use of personal experience statements, which would enable people to explain more about the impact that poor care had on their personal life and wellbeing.

These statements could then help FtP panel members to deepen their understanding of a person’s experience, how it affected them and how it made them feel.

It’s all part of the NMC’s FtP strategy, which looks at the value the public can bring to an FtP hearing. It brings people affected by poor care to the heart of investigations, as well as any actions taken to address concerns.

This is something I was passionate about in my role as Head of Public Support at the NMC, which I left last December, and something I’m passionate about in my new role as Associate Director Head of Health and Social Care at Traverse.

The value of personal experience statements

The use of personal experience statements involve a change in mind-set, with a move towards appreciating the value of emotional narratives when it comes to FtP proceedings. Traditionally, emotions have been seen as having no place in proceedings but this will challenge that position with an approach that’s more about an inquisitorial process that seeks to resolve issues in a learning environment.

Obviously, the perspective of the person or people affected by an event is an important consideration when assessing harm. They are able to explain the impact beyond the physical, explaining how their mental health is affected.

What a person says is also relevant to how a nurse, midwife or nursing associate reflects on their practice in line with person-centred care and a duty of candour.

The research and the public response

Given that this approach represents a significant shift in how the NMC currently captures the voice of people affected by poor care, Traverse was asked to engage with a range of different people about how best to achieve these aims.

The research included:

• gathering general views on the proposals for capturing and valuing the voice of people affected by poor care
• the strengths, weaknesses, barriers and opportunities to implementing the new approach
• the tolerance and boundaries for the new approach 
• associated risks and how these may be addressed

The fieldwork took place between May and July 2019, and was a combination of group discussions and one-to-one interviews with 125 people from across the UK. This includes members of the public, including those with caring responsibilities, people with specific health conditions including mental health, those with learning disabilities, new mums, registered nurses and midwives including those with a personal experience of FtP, NMC staff, legal and union representatives.

There was a difference in opinion within participant groups, but overall, the response to the proposals was largely positive from patient representatives, the public, NMC staff and registrants.

Shedding new light on incidents

People recognised the importance of introducing elements that were more ‘human’ into what has been a formal and legalistic process with little room for emotion. It was seen as putting people ‘back into the processes.’

But others questioned where to draw the line, how to protect the people affected by poor care as well as the professional from further and unhelpful emotional strain.

People were generally positive, however, and it was recognised that creating an opportunity for a person affected by an event to speak about their experience in this way might provide the opportunity to shed new lights on incidents.

Overall, the findings show there is generally a good level of tolerance and interest in including personal experience statements as part of the NMC’s new fitness to practise approach.

Traverse’s recommendations and next steps

The report sets out recommendations that include the need to undertake further work on:

• how and when personal experience statements should be gathered
• supporting the emotional impact of sharing and/or receiving this type of information
• ensuring fairness to all involved

The next steps for the NMC might be to set up a task and finish group made up of a broad range of people who were involved in the initial research.

This would help identify what these personal experience statements might look like in practice and what needs to be put in place to make this a positive step in the NMC’s journey of adopting a truly person-centred approach as the independent professional regulator of nurses, midwives and nursing associates.

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