Nursing and Midwifery Council: changes to governing legislation IS.60 consultation response Organisation: 1. Please tick one box which best describes the type of organisation you work for? Government or public body Regulator Professional organisation or trade union NHS employer of nurses or midwives Independent sector employer of, or agency for, nurses and midwives Education provider Consumer or patient organisation Other - please specify: 2. Please give the name of your organisation The General Medical Council 3. Would you be happy for your comments to be attributed to your organisation in reporting? Happy for comments to be attributed to my organisation Please keep my responses anonymous
4. Please state where your organisation mainly operates: UK England Northern Ireland Scotland Wales Other please specify: Case Examiners - Questions: These questions refer to section 2.1 of the consultation document 5. We are proposing to introduce Case Examiners to the NMC s fitness to practise process. Do you agree with this proposal? We agree with the NMC s proposal to introduce the role of Case Examiners to consider the appropriate disposal of allegations at the end of an investigation. This approach is likely to deliver improved efficiency and quality of decision making. 2
6. We are proposing that one lay and one professional Case Examiner should make a joint decision about whether there is a case to answer in each case. Do you agree with this proposal? Joint decision making by lay and medical case examiners working in pairs represents a robust model for decision making. 7. We are proposing that decisions should be referred to the Investigating Committee for a decision when the pair of Case Examiners cannot reach agreement. Do you agree with this proposal? With instances where the two case examiners are unable to reach a unanimous decision about whether a registrant s fitness to practise is impaired, it is appropriate that the case should be considered by the Investigating Committee where two case examiners are unable to agree on the appropriate disposal of a case. 3
8. We are proposing that the Investigating Committee should be able to make interim orders at any time before the substantive hearing or meeting. Do you agree with this proposal? Patient safety is of paramount importance. Healthcare regulators are accountable to the public. Where there are serious concerns about a practitioner s fitness to practise, it is important that appropriate consideration is given to the necessity of interim action to mitigate risk to the public. This is to ensure confidence in the profession pending the substantive outcome of a case. It may also be appropriate to consider the need to take interim action in the practitioner s own interests, for example in health cases. It may be helpful to consider establishing a dedicated Interim Orders Panel to ensure panellists receive appropriate training to deal with such cases. 9. We are proposing that the Investigating Committee should be able to review any interim order it has made until the final determination of the case. Do you agree with this proposal? Additional information may come to light in the course of an investigation which may require an initial decision to be reconsidered in order that the public may be adequately protected. It may also be helpful to consider the appropriateness of additional powers for the Health Committee and Conduct and Competence Committee to review or impose interim orders during a hearing. 4
No case to answer decisions - Questions: These questions refer to section 2.2 of the consultation document 10. We are proposing to introduce the power to review no case to answer decisions in certain circumstances. Do you agree with this proposal? We strongly agree with this proposal. There must be a route by which decisions that fail to protect patients can be revisited when information is received that would materially affect the initial decision and it is in the public interest. 11. Is the one year proposed time limit for starting a review, other than in exceptional circumstances, appropriate? Yes No The NMC may wish to consider whether a two year limit might be appropriate. A one-year time limitation is tight when dealing with members of the public who may take time to present new information. 5
12. Are the proposed grounds and processes for this review power appropriate? Yes No It may be in the public interest to review where new information has come to light which may wholly or partially materially alter the no case to answer decision. Changes to the composition of Registration Appeal Panels - Questions: These questions refer to section 2.3 of the consultation document 13. We are proposing that Council members should no longer play any part in a registration appeal panel. Do you agree with this proposal? We agree that separation between Council and operational processes is critical in upholding public confidence in the fairness of decision making. 6
14. We are proposing to remove the current requirement for a registration appeal panel to include a registered medical practitioner where the health of a person making an appeal is an issue. Do you agree with this proposal? Where issues arise in relation to a practitioner s health, a better model is for the panel to consider advice from expert witnesses. Requesting and verifying information - Questions: These questions refer to section 2.4 of the consultation document 15. We are proposing that we will be able to request certain information relating to the requirement to hold an appropriate indemnity arrangement. Do you agree with this proposal? We strongly agree with the arrangements to ensure registrants have adequate arrangements to allow them to practice safely, and in order that the public are protected. 7
16. We are proposing that we should have the ability to disclose certain information supplied to us relating to the requirement to hold an appropriate indemnity arrangement to a third party for verification. Do you agree with this proposal? We agree. The NMC s proposals are within the remit of the Health Care and Associated Professions (Indemnity Arrangements) Order 2013 which permits disclosure to third parties for verification purposes. General Questions: 17. What impact, financial or otherwise, will these proposals have on you, your organisation or those you represent? Please provide supporting evidence and a rationale. None. The GMC is the professional regulator for doctors in the UK and the proposals will not impact on our work. 18. Will the proposed changes have any equality and diversity impacts on you, your organisation or those you represent? No. 19. Do you have any further comments on the proposed legal drafting in Annex A which would be used to bring the proposed policies into effect? No. 20. How did you find out about this consultation? NMC website Email or e-newsletter from the NMC 8
Email or e-newsletter from another organisation University Friend/colleague NMC event My organisation Other 9