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'Patient experience statements' in NMC cases could lead to ‘bias’ against nurses

Fitness-to-practise cases should feature ‘patient experience statements’ according to a report commissioned by the Nursing and Midwifery Council, sparking concerns that the move would see nurses subjected to ‘unfair bias’.

The statements, in which service users share how an incident has affected them, would assist the NMC with assessing patients’ mental health and also help a nurse, midwife or nursing associate reflect on their practice, said the report, drawn up by independent consultancy firm Traverse.

They could also be used to get an apology from the nurse, midwife or nursing associate, added the report authors.

But union and legal representatives interviewed by Traverse warned the statements could give service users ‘undue weight’ in the fitness-to-practise process by ‘stacking the odds’ in favour of patients and ‘unfairly biasing’ the process against registrants.

The statements could also ‘prolong the strain and distress’ of registrants, said the union and legal officials in the report, called ‘The voice of people who use services, families and members of the public in fitness-to-practise proceedings’.

The report, which the NMC said it will not consult on, said: ‘Participants expressed concern about fairness, as it was thought that elevating the value of personal reaction and emotion on the part of service users/families/public would give their views – and perceptions of events – undue weight in the fitness-to-practise process,’ it noted.

The report claimed registrants were ‘largely positive’ about the proposals to include patient statements in FtP cases – as were patient representatives, members of the public and NMC staff.

These groups particularly welcomed the opportunity to make the ‘formal, legalistic’ fitness-to-practise process more ‘human’, said the report.

They saw the proposals ‘as a way to diffuse and moderate anger from referrers and reduce anxiety and upset from registrants', it added.

The proposals form part of a wider review of the NMC’s fitness-to-practise process.

NMC director of fitness to practise Matthew McClelland said the regulator is working to ensure its approach is ‘inclusive and takes into account the voices of everyone involved’ in an incident.

He said: ‘In the same way that we already encourage nursing and midwifery professionals involved in our proceedings to be open with us about what happened, understanding this experience from the perspective of an individual person who has also been affected could be incredibly valuable when assessing what else we may need to do to ensure the safety and wellbeing of people using and working in health and care services.’

He added: ‘While the development of this work is still in its early stages, it could really allow us to tread new ground as a regulator.’

The NMC told Nursing in Practice that the next steps would not involve a public consultation but that is it co-producing a piece of work with its stakeholders to decide whether to go ahead with the proposals.

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