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NMC to address blame culture in fitness-to-practise cases

The Nursing and Midwifery Council (NMC) has begun introducing a new approach to resolving fitness-to-practise (FtP) complaints, which focuses more on learning from mistakes and less on blaming those who made them.

The new process will also further take into account the context in which mistakes occur and differentiate between what is deliberate or reckless behaviour and accidental behaviour.

Under new protocol, when nurses in FtP cases can show that they have learnt from their error and are safe to continue working, the NMC may not seek to restrict their practice.

To develop a 'culture of openness and honesty' the NMC will provide tailored advice and support to employers and nurses to enable professionals to learn from their mistakes.

Practices, care homes and other employers will be encouraged to look at concerns before they reach the regulator, as they are 'best placed to understand what happened and resolve things quickly'. To enable this they will be provided with more information and support to help decide how and when escalate concerns.

As part of the new process, the regulator will also be providing improved support and information to patients and the public making complaints, including a dedicated point of contact.

NMC director of fitness to practise, Matthew McClelland, said: 'For a long time in healthcare, there has been a tendency to focus on blame and punishment when things go wrong. But we know that this can mean nurses and midwives are less likely to be open about what happened.

'Our new approach puts people at the heart of what we do and encourages a culture of openness and honesty. This is the best way for nurses, midwives and the wider health and care system to learn from mistakes and prevent them from happening again.'

Recent NMC polling on FtP processes found that over nine out of 10 people agree that encouraging nurses to learn from mistakes would improve the system.

The participants, who included members of the public, nurses and other healthcare professionals, felt that it wasn’t always necessary to remove a nurse from the register even when there had been serious harm to a patient. 'This feeling was echoed in the consultation responses about the new approach,' the NMC said.

The research also showed that, of the members of public that took part, 82% agreed that taking the context of an incident into consideration would improve the FtP process.