The government has confirmed that it will not undertake a national inquiry into the performance and operations of the UK’s nursing regulator, despite calls from the profession to do so following a damning review into its culture.
Leaders and campaigners from across nursing and midwifery have been urging the government to launch an independent review into the Nursing and Midwifery Council (NMC) and the performance of its regulatory functions.
“Without the government stepping in, we fear little will change”
NMC Watch spokesperson
It follows a review into the NMC’s culture, published last month, which revealed widespread bullying, racism and toxicity at the regulator that it said was putting nurses and midwives at risk.
Following its publication, the Queen’s Nursing Institute (QNI) wrote to the health and social care secretary, Wes Streeting, calling for an independent inquiry into the NMC, in order to restore public confidence in the regulator and the wider profession.
The QNI had called for it to look at how the NMC managed fitness to practise (FtP) cases, engaged with the profession on standards, and how standards were assured for individual entry to the register.
Separately, campaigning group NMC Watch, which supports nurses and midwives who are going through the FtP process, also wrote to Mr Streeting calling for an independent inquiry.
The open letter was signed by 145 people, including nurses and midwives who had been referred to the NMC as well as concerned members of the public.
In the letter, seen by Nursing Times, NMC Watch urged the government to undertake the review to examine several issues, including what support was in place for registrants who were feeling suicidal after a FtP referral.
It comes as the NMC culture review found that six nurses had died by suicide in the last year alone while under or having concluded an FtP investigation.
NMC Watch also called for the inquiry to investigate referrals with no supporting evidence within three months of the referral being made, arguing they should be closed until strong evidence was presented.
In addition, it said the inquiry should examine the impact of unrepresented and absent registrants at FtP hearings, review employers who were making the most FtP referrals, and look at whether the NMC’s vexatious referral policy was robust enough.
Despite the ongoing calls from the profession for an inquiry to take place, the government has confirmed it would not be doing so at this time.
In an email, seen by Nursing Times, the Department of Health and Social Care (DHSC) said there were “no plans to undertake a national inquiry into the NMC’s operations and performance”.
However, it said that the government expected the NMC’s governing council “to ensure swift and robust action is taken” to deliver against the 36 recommendations set out in the culture review.
The email noted that Mr Streeting and the minister of state for health, Karin Smyth, had both met with NMC council chair Sir David Warren, to seek further assurance that changes would be implemented urgently.
An NMC Watch spokesperson told Nursing Times that the organisation was “really disappointed” and “particularly with so many people coming forward with their dissatisfaction” with the NMC.
They said: “We hope they will reconsider. Without the government stepping in, we fear little will change.
“There needs to be new leadership with people committed to real change and immediate transparency, rather than what we’ve seen so far.”
In its email, the DHSC noted that the NMC was in the process of making improvements following the culture review, particularly around FtP and its regulatory processes.
The regulator has committed to appointing one or more senior independent advisers to its governing council, to improve the support that it receives to ensure the necessary cultural changes are delivered.
In addition, it has promised FtP improvement by identifying additional external expertise to provide support with the NMC’s goal of improving the speed in which it processes FtP cases.
Meanwhile, the Professional Standards Authority for Health and Social Care, which oversees the work of the NMC, had committed to “enhanced monitoring” of the regulator.
It will do this by establishing an oversight and support group that will receive regulator updates on the NMC’s progress, scrutinise the impact of measures introduced and provide advice on further action.
This group will include chief nursing officers from the four UK nations, trade union representatives, government policy officials and other experts.
Separately, the NMC is currently in the process of appointing an interim chief executive and registrar, who will lead the organisation through a process of change.
The regulator is also due to launch its search for a permanent successor in September, with the aim of appointing someone to the position before the end of the year.
