A nurse or midwife may find themselves the subject of an NMC investigation process at any time in their career. Here’s Richard Nelson LLP’s comprehensive guide to the NMC investigation process, created specifically for nurses or midwives undergoing an NMC investigation.
1. The NMC receives a complaint
When the NMC receives a complaint about a nurse or midwife, the regulator’s screening team will carry out some preliminary enquiries to determine whether or not there are sufficient grounds for a case.
What type of NMC Fitness to Practise concerns will the NMC investigate?
Each NMC fitness to practise investigation is different, but the NMC investigate complaints relating to the following:
- Lack of competence;
- Not having the necessary knowledge of English;
- Criminal behaviour;
- Serious ill health.
Whatever the nature of the allegation, when a nurse or midwife is facing an NMC fitness to practise investigation it is essential to obtain legal advice and representation as early as possible. Through early intervention, it may be possible to persuade the NMC to stop the fitness to practise investigation on the basis that there is no case to answer. In the event that this is not possible, it may be possible to limit the damage, by narrowing the allegations or by laying the foundations for a strategic defence at a hearing.
2. The NMC informs the nurse or midwife
The NMC will write to the nurse or midwife and give details on the matters they are concerned about. The NMC will usually invite the nurse or midwife to provide an early written response at this time. Depending upon the particular circumstances of your case we might advise you to do this or advise against it. The NMC will then conduct their investigation.
3. The NMC decides next steps
The NMC will write to the nurse or midwife again and either advise they will not be pursuing matters further or specify the exact allegations and provide any evidence they have collated and wish to rely upon. The nurse or midwife is then invited to respond in writing within the next 28 days. At this stage we would nearly always recommend responding in detail.
4. The case goes to Case Examiners
Your case will then be considered by the Case Examiners and if they find there is no case to answer then the matter will either be closed with no further action or they will issue advice or a warning (up to 12 months).
5. The Case Examiners’ decision
If the Case Examiners however decide there is a case to answer, they will either refer it for further investigation, issue undertakings or refer the matter to a Fitness to Practise Committee.
6. The Fitness to Practice Committee
If your case proceeds to a Fitness to Practise Committee and if the allegations are disputed then the panel will hear evidence from you and any witnesses and make factual findings. If the allegations are then found to be proven the panel will hear submissions and decide if the nurse or midwife’s fitness to practise is impaired. If the panel finds fitness to practise is not impaired, there will be no further action.
7. Possible actions for fitness to practice impairment
If the panel find fitness to practise impaired, it’s possible they could take no further action, but more likely that they will impose a sanction.
8. Sanctions available to the NMC
Sanctions can include the following, depending on the specific circumstances of the case:
- A caution of between 1 and 5 years. A caution order will remain on your registration for a time as specified by the panel and is a formal record to show the NMC Fitness to Practise Committee had concerns about your fitness to practise;
- A Conditions of Practice Order for up to 3 years. This will place restrictions on your registration for a specified period of time;
- Suspension of up to 1 year. Your registration will be suspended for a specified period of time resulting in you being able to work as a nurse or midwife during this period of time;
Strike Off. This will remove your name from the register and prevent you from practising as a nurse or midwife. You will be unable to apply for restoration to the register for at least a 5 year period following this date.
Sanctions provided by the Fitness to Practise Committee will normally come into effect 28 days after your hearing concludes. This applies whether or not you were present at the hearing. This 28 day period allows for an appeal to be made. If however, the panel finds that you are not fit to practise during this 28 day appeal window it can impose an immediate restriction or suspension to cover this 28 day appeal window.
Consensual panel determination
It is possible to avoid a full Fitness to Practise hearing by dealing with the case by way of Consensual Panel Determination. However this will only be an option if the nurse or midwife accepts all the allegations involved in the case and also agrees that their fitness to practise is impaired. An appropriate sanction is then usually agreed between the parties and an agreement drawn up.
Interim order hearing
It is usually possible for a nurse or midwife to continue to work whilst the investigation process is ongoing. However if the NMC decides there is a public protection issue or for the best interests of the public, profession or nurse or midwife themselves, you may be asked to appear at an interim order hearing. This interim order panel will consider whether to place interim conditions or an interim suspension (for a maximum of 18 months) upon your registration whilst the initial complaint is being investigated. The evidence or facts of your case will not be tested at this time, as the panel will only be concerned with taking action if following a risk assessment, they decide that there is an immediate concern for the protection of the public or registrant.
When a nurse or midwife is stuck off the consequences can be severe, both in terms of their career and their private life. It may be possible to appeal against the NMC’s decision. There are strict time limits to do this (28 days from the decision) and the appeal needs to be submitted to the High Court.
If we can assist with any fitness to practise investigation by the NMC, then please contact us without delay for a confidential free telephone discussion about your case.