A duty of care to the nurse as well

The Nursing and Midwifery Council (NMC) states that a nurse or midwife is fit to practise when they have the skills, knowledge, health and character to do their job safely and effectively. The NMC will consider referrals the following areas:

In recent years, the NMC has made changes to how it handles fitness to practise cases. This is referenced in the 2017-18 annual report (NMC, 2018a) as in response to criticism of the NMC following a review into the handling of cases involving midwives at Furness General Hospital. The NMC's new strategic direction in this area, ‘Ensuring patient safety, enabling professionalism’ (NMC, 2018b), focuses on reducing risks to patients by encouraging openness and learning, working more closely with employers, and considering the context in which incidents occur, recognising the complexity of the current practice environment.

With 4 in 10 referrals to the NMC coming from employers, there is a responsibility on us to consider our internal processes and ensure that they are fit for purpose. In 2018 a report undertaken by Verita (an independent investigation consultancy for regulated organisations) was commissioned by Imperial College Healthcare NHS Trust (Seale et al, 2018). The investigation focused on the management of the Trust's disciplinary process resulting in the dismissal of Amin Abdullah. Mr Abdullah had worked on a ward in the Trust for nine weeks up to September 2015, when concerns raised by a patient prompted an investigation. In October 2015, the investigator recommended that the case progress to a disciplinary hearing. In October 2015, Mr Abdallah's union representative asked the Trust to make an urgent referral to occupational health for him. In December 2015 Mr Abdullah was dismissed, in late December he served a notice of appeal, and he submitted a letter of appeal in January 2016. In February 2016, Mr Abdullah took his own life.