Plans for £30m investment to tackle fitness to practise backlog

The nursing regulator has put forward a draft plan to make the biggest investment in fitness to practise (FtP) in a decade, in an effort to process decisions safely but more quickly.

The Nursing and Midwifery Council will ask its governing council next week to give the green light to a £30m investment for FtP, which will aim to progress and run more hearings, as well as increase panel capacity.

“We need a fitness to practise service that is truly person-centred, collaborative, and straightforward”

Lesley Maslen

It comes as part of a draft 18-month plan to gradually reduce the number of FtP cases and relieve the pressure on those that make decisions.

The NMC has come under fire in recent years for repeatedly missing targets to deal with FtP cases quickly enough.

These delays have had an impact on both professionals being investigated and the public. For context, the NMC has seen an increase in recent months in the number of new concerns being raised.

It has had an average of 493 referrals per month since April 2023, compared to 417 in the same period last year – an increase of 18%. In February 2024 alone, 596 new concerns were raised with the regulator.

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The NMC will, therefore, ask its governing council next week to approve a substantially increased investment in FtP.

Lesley Maslen, NMC executive director of professional regulation, said: “We need a fitness to practise service that is truly person-centred, collaborative, and straightforward for everyone involved.

“That’s why our new plan commits £30m to fitness to practise over the next three years, with a particular focus on investment and improvement over the next 18 months.

“It will ensure we can continue making decisions that keep people safe, but in a more timely and considerate way that will be sustainable into the future.”

In the 18-month plan, outlined in council papers published today, the NMC has identified seven key areas which could be improved with the funds.

Referral quality, safety and supporting stakeholders through NMC processes

The NMC has said it wants to help employers and the public understand when a referral to the regulator is appropriate, to support swift progression for cases that are.

For referrals it does receive and progress, the NMC said it will ensure everyone involved is “properly supported” and that decision makers have access to the right clinical and safeguarding advice.

Safe and swift progression of cases at screening and investigations

The NMC has proposed expanding its screening team, which is responsible for providing an initial assessment of new concerns.

In doing so, it said it would make sure more referrals are being actively progressed, especially the most serious cases which may require an interim order to restrict someone’s practice.

Releasing capacity in case preparation and presentation, and investigations

The NMC said it would continue to outsource work, where appropriate, to ensure that more FtP cases are being actively progressed.

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In addition, it said it would release its internal legal capacity to prepare and present more cases at hearings or meetings

Delivering sustainable change in case preparation and presentation

The plan has proposed new approaches to allocating and risk assessing cases, with a focus on cases with interim orders that restrict a professional’s practice.

Improving the quality and timeliness of decisions at the adjudication stage

The NMC has said it will review the skills, experience, training and support that its hearing coordinators need to manage hearings effectively, while also increasing panel capacity and running more hearings.

People, culture and organisational design

The regulator has said it will recruit and retain “skilled and engaged colleagues” and make sure that resourcing and oversight remain appropriate to the number of cases that are being progressed.

Improving NMC systems

In 2025, the NMC has said it will introduce a new case management system which will better equip FtP teams to progress cases safely and swiftly, and ensure the public is protected.

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