NMC signs off record investment in fitness to practise

At a meeting of its governing council yesterday, the regulator gave the green light to the funding boost, which will be the biggest investment in FtP in a decade.

"This is about getting us back onto stable footing"

Lesley Maslen

It comes as the NMC’s FtP caseload continues to rise, with a record number of referrals last month.

The £30m investment has been put forward as part of a new 18-month plan to gradually reduce the delays in closing FtP cases, as well as reduce the pressure on decision makers.

In its most recent council papers, the NMC noted that progressing referrals in a safe and timely way was now its “key priority” and was therefore where it would direct significant investment.

It comes as the nursing and midwifery regulator continues to see its FtP caseload rise.

As of February 2024, the FtP caseload stood at 5,920, which was an increase of 209 cases in a month.

On average, the NMC has seen 493 referrals per month since April 2023, compared to 417 referrals per month in the same period the previous year – an 18% increase.

The regulator received 596 referrals in February 2024 alone – the highest number it has received in a single month in the last five years.

As such, the 18-month plan has identified seven key areas which could be improved with the funds.

Areas of focus include improving support for employers and the public with the FtP process, expanding the NMC’s screening team and introducing a new case-management system for decision makers.

Lesley Maslen, executive director of professional regulation, told NMC council that the changes proposed with the additional investment were not just about improving timeliness of FtP, but also about delivering “sustainable change”.

She said: “The cost is very significant, but I think the cost also reflects the fact that we’ve probably underinvested in fitness to practise over recent years, and this is about getting us back onto stable footing.”

Ms Maslen cited several reasons that the NMC had struggled to tackle the FtP backlog, including challenges with staff turnover and dealing with old and complex casework.

She argued that these had been “compounded” by other challenges facing the NMC, including the ongoing reviews into the regulator’s culture.

The reviews follow the publication of a series of articles by the Independent last year, which alleged a culture of racism, sexism and fear of speaking up in the NMC.

The articles also alleged that NMC staff were encouraged to prioritise the speed of clearing the FtP caseload over handling the cases sensitively and thoroughly.

The chief executive and registrar at the NMC, Andrea Sutcliffe, told the council there was a “huge risk” if the regulator could not progress FtP cases in a “swift and safe way”.

She said: “[There is] a risk in terms of the impact that that has on all of the individuals who are involved in it, the impact on the trust and confidence that people can have in our operation, and in the maintenance of the register in terms of the integrity of people who are on the register.”

Andrea Sutcliffe

Meanwhile, Ms Sutcliffe also noted the “significant external scrutiny” of the NMC’s approach to FtP that had taken place in recent months.

It comes as the Professional Standards Authority warned last year that the NMC had failed to meet the standards for clearing its FtP caseload for the fourth year in a row.

Ms Sutcliffe said the PSA’s concerns had been escalated to the secretary of state for health and social care, as well as the chief nursing officers in all four UK counties.

“So the fitness to practise risk flashes scarlet and that is the reason why that has really driven where we are," she warned.

The 18-month plan will be officially launched in April, tied in with the NMC’s corporate plan for 2024-26.