The Nursing and Midwifery Council (NMC) has failed to meet its Fitness to Practise (FtP) target for another year, having received record referrals in recent months.
Despite making ‘positive progress’ at the start of 2024, the regulator says the failure to reach its annual target could be partly attributed to a significant rise in referrals being made in the second half of the year.
In its annual FtP report for 2023/24, the NMC stressed that it’s committed to making the improvements and progress needed, so the regulator ‘can deliver timely and safe decisions that protect the public’.
The NMC had hoped to reduce its caseload by 4,000 cases by April 2024. But this stood at 5,944 cases by March 2024, up from 5,577 at the start of the year.
In February 2024 alone, 596 new concerns were presented to the regulator, the highest number received in any single month in the past five years.
The biggest rise in case numbers came at the screening and adjudication stages of the FtP process, while there was a 30% reduction in case numbers at the case examiner stage.
There was a 7% increase in caseloads in the year 2023 to 2023, in contrast to the 14% reduction in the caseload between 2022 to 2023.
Long waits
The NMC says it aims to complete 80 per cent of FtP cases within 15 months of receiving a referral.
In the year 2023 to 2024, the regulator completed 61 per cent of cases within this time frame, which is the same as the previous year.
Without any progress in clearing the backlog last year, the NMC failed to meet the Professional Standard Authority’s ‘Standard of Good Regulation,’ for timelines of case progression.
A new ‘fitness to practise plan’ was signed off by Council in March, committing £30 million over the next three years, with a focus on investment and improvement of the referral process.
This latest report acknowledges that the NMC may need to ‘update’ its FtP plan ‘as appropriate’, but assured registrants that changes will ‘maintain a clear strategic approach which will prepare the ground for the future’.
Looking ahead
While not committing to a specific reduction in caseload, the NMC said that it anticipates that by March 2025 it will have:
- completed the focused recruitment of additional roles to our priority casework areas and successfully onboarded our new colleagues;
- seen improved consistency across our casework teams as they are supported by streamlined processes, smart tools and KPIs and governance that help our people drive swift and safe case progression;
- consistent application of consistent and holistic quality frameworks;
- cleared our backlog of cases at the screening stage that are awaiting allocation of a case owner;
- seen improvements in the management of our oldest and most complex cases.
Workplace culture
The report also addresses concerns raised as a result of the recent workplace review, which found a ‘toxic’ and ‘dysfunctional’ culture at the NMC.
The review, led by former public prosecutor Nazir Afzal with Rise Associates, reported serious concerns around the way in which fitness to practise (FtP) cases are handled, warning that action was being taken ‘against good nurses’ while ‘bad nurses get away with it’.
The report details how there were five recorded deaths where a professional had taken their own life during their FtP proceedings in the last year, up from three recorded deaths in 2022 to 2023.
In 2021, the NMC launched a ‘fitness to practise careline’ to support professionals who are subject to a FtP investigation. The helpline received 5,925 calls in the last year alone.
Lesley Maslen, Executive Director of Professional Regulation at the NMC, said: ‘We know how important it is to make timely decisions in a safe and fair way, and we’re sorry that we’ve still not been resolving cases quickly enough. That’s why we’ve been working to deliver the £30m plan that our Council agreed in March.
‘Our latest data shows that we’re starting to make more decisions at screening, and the average age of cases at the early stages of the process is coming down. The number of decisions we’re making at the adjudication stage is also up.
‘It’s important we continue to build on this progress with zero complacency. We have a new senior team in place, and better modelling about the impact of our caseload which helps us to make the right resourcing decisions.
‘We’re determined to improve both the timeliness and quality of our decision making, for the benefit of the public and the professionals on our register.’
