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CNO rejects NCAS plea to support nurses

Exclusive: The Chief Nursing Officer (CNO) has rejected a recommendation for the National Clinical Assessment Service (NCAS) to extend its scope to include nurses and midwives.

The recommendation followed research uncovering "widespread bad practice" with nurse managers found to be using their suspension powers "inappropriately".

The 2010 study, led by Michael Traynor, Professor of Nursing Policy at Middlesex University and commissioned by the NCAS, focused on performance concerns in nursing and midwifery.

Official figures from the National Audit Office, published in 2003, showed 562 nurses were suspended for at least a month between 2001-02, accounting for 53% of all NHS staff suspensions.

Professor Traynor found only a small number of these 562 suspended nurses were referred to the Nursing and Midwifery Council (NMC), which he claims implies their behaviour "wasn't that bad".

Despite this high proportion, the research found there is no requirement for managing staff to record nurse suspensions - a practice Professor Traynor called "astonishing" and "strange".

It is argued this lack of data has led to "widespread bad practice" with "inexperienced, poorly trained, or poorly supported managers using suspension inappropriately."

"A lack of support from personnel management leads nurse managers to "overreact rather than under react" to prove they are carrying out their role properly," said Professor Traynor.

"While training is a feasible option to take to combat the bad practice currently happening in GP surgeries, in my heart of hearts I know it will take more than that.

"Training alone will not change the power struggle that exists between managerial staff and nurses."

Julie Fagan, founder member of CAUSE (Campaign Against Unnecessary Suspension and Exclusion UK), has slammed the NMC for "failing to pick up on bad management".

She told NiP she has even been made aware of "a few" Joint NHS social service organisations that are suspending nurses in a bid to "get rid of them" and save money.

"I don't think anything will change as a result of this research as the Department of Health keeps insisting that nurses and midwives have been dealt with in this way for years and there is no reason to change," said Fagan.

"It is too big of a problem, too expensive. If they could just record the data then it would hold managers accountable and we would know just how big a problem it is."

Gail Adams, Head of Nursing at Unison, blamed the litigious environment for the high amount of nurse suspensions and called for better recording within practices.

"Suspensions shouldn't be used as a punishment but it certainly feels like they are," said Adams.

"Managers tend to overreact than try and manage it. They think speed is of the essence."

Worryingly, she told NiP she has heard that black and ethnic minority workers (BME) are receiving more suspensions than their white counterparts.

Formed in 2001, the NCAS - a branch of the National Patient Safety Agency - supports employing and contracting organisations to help resolve concerns over the practice of doctors, dentists and pharmacists.

In 2010 the NCAS commenced a review to decide whether its remit should extend to nurses and Professor Traynor's research added to the growing argument that vulnerable nurses need to be protected.

"As NCAS does not produce national policy, the findings of the literature review were used to develop a proposal for consideration by the CNO (England) to provide options for NCAS service for Nurses and Midwives," said Claire McLaughlan, Senior Adviser at the NCAS.

"The paper was submitted to the CNO late 2010. The paper responded to the recommendation in the White Paper Trust, Assurance and Safety - The Regulation of Health Professionals in the 21st Century Trust, Assurance and Safety - The Regulation of Health Professionals in the 21st Century, DH. London, 2007. 

"This recommended that "The Department [of Health] should work with NCAS [the National Clinical Assessment Service] and with stakeholders to review the cost-effectiveness of extending its scope to other health professionals, as suggested by the Public Accounts Committee."

A Department of Health spokesperson confirmed the NCAS approach the CNO with its recommendation, but told NiP it felt it would be more "beneficial" if the NCAS developed educational material to help support managers in identifying and managing poor performance instead.