We recently reported on the NMC Defence Barrister’s Facebook page on a couple of Nursing and Midwifery Council (NMC) decisions that took into account the context of incidents when deciding on any sanctions to be imposed. 

In the first reported case, the Evening Times reported on a case where a “negligent nurse” was given a lenient sanction because the “ward was understaffed”.  The report stated that the NMC hearing found the nurse had not been adequately supported during the shift due to understaffing.  The nurse in question in this case was issued with a Conditions of Practice Order. 

In the second reported case in the Liverpool Echo, a senior nurse accused over failings linked to the deaths of prisoners was cleared of all wrong-doing by the NMC after it heard she had begged for help. 

The nurse in that case, it is reported, was the head of prison health care until 2014 and was accused of a raft of misconduct charges by the NMC.  However, the NMC panel heard she was facing an “impossible” situation. 

NMC’s new approach to fitness to practise 

Earlier this year, we reported on the NMC’s new approach fitness to practise. 

An important aspect and change in the NMC’s fitness to practise approach is the fact that it now includes consideration of the context of a case. 

The NMC stated that it will “…work more closely with employers so that as many issues as possible can be resolved quickly and effectively at a local level. We’ll give more consideration to the context in which incidents occur, in recognition of the complex issues and unique pressures nurses and midwives face every day in the NHS.”

The NMC’s revised fitness of practise principles makes it clear that the context of incidents is an important consideration in fitness to practise proceedings because:

“…incidents of poor practice actually happen because of underlying system failures, taking regulatory action against a registrant may not stop similar incidents happening again in the future. Regulatory action against an individual registrant may give false assurance, direct focus away from a wider problem and cause a future public protection gap.”

Giving consideration to the context of incidents should provide nurses and midwives with a level of assurance and comfort.  The reality is that the NHS (in particular) is chronically understaffed and the NMC’s new approach to fitness recognise the unique pressures nurses and midwives face every day. 

Due diligence is an important factor for nurses and midwives to consider.  It is important that corporate and system failures affecting your ability to practise safely is highlighted and, where possible, records of this is retained for future reference in any fitness to practise cases.