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NMC fitness to practise referrals reach record high

The nursing and midwifery regulator has had an increase in fitness to practise (FtP) referrals and enquiries in wake of the Lucy Letby conviction, as monthly cases have peaked to the highest on record.

In September, the Nursing and Midwifery Council (NMC) received 579 FtP referrals – 34% higher than the regulator had predicted it would see.

The FtP caseload now stands at 5,500, according to council papers published last week.

The NMC said that it would no longer reach its target of having 4,000 cases by the end of this financial year, but that it remained “committed” to reducing its backlog.

“We have to balance our ambition for transformation with the reality of what’s happening on the ground”

Lesley Maslen

During a meeting of its governing council, held today, the NMC said it had not found a conclusive pattern in the increase of referrals, however some council members suggested that recent events surrounding the regulator, including the Letby conviction, could have had an impact.

Letby was sentenced to life in prison on 21 August for the murder of seven babies and the attempted murder of six others.

Her FtP hearing will take place at NMC headquarters in December, with the regulator intending to strike her off the register.

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While the reasons driving the additional referrals are unclear, council papers revealed that the Letby conviction had caused an increase in the number of enquiries to the NMC.

“We saw an increase in September with half of the enquiries received relating to the Lucy Letby case,” the papers said.

This was echoed in the council meeting by executive director of professional regulation Lesley Maslen, who also noted that, since the Letby conviction, the NMC had been contacted by several trusts regarding matters they were dealing with internally relating to incidents involving staff.

Ms Maslen described the circumstances in which the NMC currently found itself as a “perfect storm”, describing how, on top of the Letby conviction, the regulator had been the subject of several headlines in recent months.

In September, it was announced that an investigation would be launched into the NMC’s handling of FtP and whistleblowing, after it was alleged earlier this year that it had prioritised speed over thoroughness to cut down its FtP backlog, and a “culture of fear” in the organisation was preventing staff from speaking up.

Also in September, the NMC uncovered “widespread fraud” at a testing centre in Nigeria for international nurses seeking to apply for UK registration. As such, almost 2,000 registrants and applicants have been asked to retake their computer-based test (CBT), which is necessary to obtain UK registration.

Ms Maslen explained that all these contentious events had “generated additional work” for the NMC and had been “destabilising” over this period.

“I think we just have to be mindful that we have to balance our ambition for transformation with the reality of what’s happening on the ground,” she said.

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The NMC noted in its council papers that referrals were increasing for other regulators covering health and social care, and that it was “not an issue unique to our work”.

Registrant council member, Dr Lynne Wigens, reiterated in the meeting that nursing and midwifery referrals were “going in the wrong direction”.

She added: “Clearly one of the things that is quite striking is the significant increase in referrals into the NMC, but I do find it helpful to know that has been the same within other healthcare regulators as well.

“So, we are not an outlier in having this significant increase.”

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