NMC sets out next steps toward change

The Nursing and Midwifery Council (NMC) has set out the next steps towards change, having accepted all the recommendations of an independent review into its culture.

Short-term

It is important that we work with our people and seek input from our partners to deliver a programme of change that's rooted in the recommendations. This will entail a huge amount of focused work over the next two years. However, there are some immediate actions which are under way, supported by external advice which will help to ensure we make the right decisions, address our cultural issues and follow through on change.

• An external Empowered to Speak Up Guardian is now in place. They will support NMC colleagues to raise concerns and ensure they get independent support from a trained professional.
• We have invested in a partner to help improve psychological safety within the organisation, starting in Professional Regulation directorate.
• We have started the process of appointing an equality, diversity and inclusion (EDI) advisor to our executive board, to support decision making.

We have also made some immediate commitments:

• We will co-opt one or more senior independent advisers to the Council – we want to increase the challenge and support that the Council receives, to ensure the necessary cultural changes are delivered and to prevent a recurrence of the findings in the report.
• We have committed to increasing the diversity of our executive board.
  We will double the amount we spend on colleague learning and development so that by October 2024, we can roll out improvements in leadership, line management, safeguarding, casework and tackling poor behaviours identified in the report.
• We will develop a competency and behaviour framework, to launch in September, that will support recruitment, career progression and performance management.
• We will offer extended decompression support to colleagues working on sensitive casework.

Medium-term

In the medium term, we are reviewing our existing plans in light of the independent report’s recommendations. For example, we already have a £30m, 18-month improvement plan for fitness to practise, but we will now identify additional external expertise to provide insight, support and advice on the improvements we need to make.

We are also working to enhance our approach to safeguarding; since January, as the executive safeguarding lead, Sam Foster has led the expansion of resources for the safeguarding team. She is increasing knowledge and training, alongside strengthening our operating procedures. This builds on work we started several months ago to better understand how we can improve our processes to reduce the impact and risk of harm to people. Sam and colleagues will have the further work fully scoped by September.

We will also revisit our people and EDI plans, which set out how we invest in and support our people to do the best job they can to deliver our purpose for the public. As an immediate step, we have appointed external EDI experts, The Equal Group, to partner to review our EDI learning, improve mandatory training and identify any gaps in our policies and approach to tackling bullying, harassment and discrimination.

Longer-term

Our longer-term plans will focus on the wider culture change that we need to deliver together with our colleagues and with input from our stakeholders. This includes the full implementation of Nazir Afzal and Rise Associates’ recommendations over a projected two-year period.

This will drive improvement across leadership and management, equality, diversity and inclusion (EDI) and anti-racism, safeguarding and fitness to practise.

Enhancing PSA oversight of the NMC’s progress

Our oversight body, the Professional Standards Authority (PSA), will establish an oversight and support group that will receive regular updates on the NMC’s progress, scrutinise the impact of measures we introduce to improve our culture and performance, and provide insight and advice on further actions required. The group will include Chief Nursing Officers from the four UK nations, representatives from trade unions, policy officials from the DHSC and devolved administrations, and relevant experts who the PSA will identify.

Appointment of an Interim Chief Executive and Registrar

We will launch the recruitment campaign for an Interim Chief Executive and Registrar next week. The Council asked that we engage with EDI specialists to recruit, and that employee and stakeholder engagement is a clear part of the process. We are working with the Department of Health and Social Care and Inclusive Boards to identify and appoint the right candidate, and we aim to make an appointment by October.

The campaign for the permanent Chief Executive and Registrar will launch in September, with a view to announcing the permanent successor before the end of the year.

Helen Herniman, Acting Chief Executive and Registrar, said:

“The independent report on our culture made difficult reading for everyone at the NMC and for many outside our organisation, including our stakeholders, the professionals on the register and members of the public who have engaged in our regulatory work. We are sincerely sorry to everyone we have let down. We are committed to delivering a change programme rooted in the report’s recommendations, and we are confident this will help us to make a step change in both culture and performance.

“I am acutely aware that these must not just be words – it will be actions that demonstrate the change needed. There is a huge amount of work to do, and it starts now – by September we will have engaged internally and externally on the resources needed to deliver on the recommendations and how best to drive culture change. That programme will continue over the next 18 months to two years.

“I recognise that internal and external trust in the NMC has been badly damaged, and it is only through action and sustainable change that we will start to earn this trust back. We will report openly on progress as we move forwards.”

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