This site is intended for health professionals only

FtP investigations see 25% of nurses return to work at lower level

Almost a quarter of nurses and midwives found to be fit to practise after being investigated by the Nursing and Midwifery Council (NMC) returned to work at a lower level position, according to a new survey. 

NMCWatch, a support group for nurses and midwives referred to the NMC, surveyed its members in an online poll. Of the 106 respondents were found to have no case to answer in a fitness to practise (FtP) investigation, nearly two-thirds (63%) said their career was negatively impacted afterwards.  

Of those, 24% (25 respondents) said they returned to work at a lower position, 22% (23 respondents) decided to leave the profession and 18% (19 respondents) remained on the register but have not worked since.  

In total, 147 NMCWatch members – who had varying outcomes in the FtP process – responded to the survey, which was carried out over 11 months up to February 2019.  

Respondents highlighted mental health as the area most affected by FtP, with 65% ranking it as more negatively impacted than financial security, employment choices, self-confidence, ability to work and wider family issues.  

But 64% (93 respondents) said they did not feel they knew where to go for support, and a further 12% (17 respondents) said they were too embarrassed to get support.  

Responding to the survey, one nurse wrote: ‘I now work as a nurse, but damages done to me are permanent; my health deteriorated; my passion and vocation is gone. I am considering leaving the profession.’ 

Another commented: ‘Should be more support and information on the whole process.’  

However, one registrant wrote: ‘The experience was much better than I expected at the hearing and I felt that the NMC did listen.’  

A spokesperson for NMCWatch said that the impact of the FtP process on mental health is ‘enormous’.

The organisation said: ‘Even if registrants get though the process with no sanctions or case to answer, they are forever affected.  

‘Not only does it affect the ability to gain employment afterwards, but professional confidence is damaged, sometimes permanently, and we need to look at how we can help registrants remain on the register - not celebrate how many have been removed.’ 

NMCWatch is calling on the NMC to ensure registrants have access to a 24-hour telephone service that offers psychological support. 

Last year, the NMC began introducing a new approach to FtP, focused more on learning from mistakes, and the context in which they occur, and less on blaming those who made them. 

Matthew McClelland, director of fitness to practise at the NMC, said that at the heart of the new FtP strategy was ‘ensuring that all those involved in the process are treated fairly and with respect’. 

He continued: ‘We are working closely with employers to make sure they are supported and able to resolve more issues at a local level so that we receive only the right referrals. And where we do receive referrals, will give proper consideration to the context in which mistakes happen. 

‘But we also know there is more we can do. For example, while many nurses, midwives and nursing associates have excellent sources of support from professional bodies or unions, others may not.  

‘Therefore, as we continue to improve our ways of working, we are exploring how we can provide a limited amount of pro bono support for those who may not be represented. In the coming weeks, we will also be introducing a new, independent, support line for professionals going through our fitness to practise process.’ 

The NMC’s annual FtP report shows that its case examiners made decisions on 2,234 cases in 2017/18.