The Professional Standards Authority for Health and Social Care (PSA) is the regulatory body which overseas statutory healthcare regulators and voluntary accredited registers. The PSA has recently published its performance review of healthcare regulation for 2013 - 2014.
The PSA notes that the Nursing and Midwifery Council (NMC) has improved across all key regulatory functions. This follows a highly critical report published by the PSA's predecessor, the Council for Healthcare Regulatory Excellence (CHRE) in 2012. The CHRE had described the NMC as having failings at every level, including "leadership, strategy, decision making, finance and culture". When the CHRE report was published in 2012 the NMC's Chief Executive, Jackie Smith, had acknowledged that it made for 'difficult reading' and commented as follows: "We recognise the failings that CHRE have set out in their reports, and we are sorry. It is clear that the NMC has not delivered effective and efficient regulation, and we are committed to putting that right,"
The PSA acknowledges that these efforts to address the NMC's shortcomings have delivered results. Significantly there has been an improvement in the handling of fitness to practise cases, with 87% of cases now being investigated within 12 months of a complaint being received. This figure was only 68% in 2012/2013. The PSA notes that the NMC has increased its number of scheduled fitness to practise cases to 22 per day, which has helped to address its backlog of cases. The PSA reports that by September 2013 the NMC had closed 99.6 of its historic backlog of cases, this having been a key area of criticism for the NMC.
In response to this latest report, Ms Smith remarked as follows: "I am pleased that the PSA's annual performance review 2013 - 2014 recognises the improvements we have made in all areas of our work. Significantly we have shown improvement in our fitness to practise function by investigating 87 percent of cases within 12 months and clearing our historic caseload."
However, despite these improvements, the PSA is still critical of the NMC in a number of areas, including its management of cases and decision making, customer service and revalidation.
While there has been an improvement in the investigation of cases, there remain issues in the progression of cases through the adjudication stage. The NMC's Key Performance Indicator is to ensure that 90% of cases pass from adjudication to the first day of the hearing within 6 months. The PSA found that between 2013 - 2014 this was only achieved in 23% of cases, a significant decrease from 2012 - 2013. The PSA also found that between April - September 2013 over 26,000 calls to the NMC were unanswered.
Ms Smith responded: "We want to improve that connection with anyone who comes into contact with us. But it is quite a big piece of work." The PSA is also critical of the NMC's proposals for a dealing with Revalidation, arguing that the NMC's proposed model "lacks a robust evidence base" and therefore it is not clear how the NMC can be sure that revalidation will "enhance public protection and bolster public confidence."
As such, while the NMC has clearly made substantial improvements since it was roundly criticised by the CHRE in 2012, it seems that there is still significant work which needs to be done to improve its performance as a healthcare regulator.
By Carl Johnson, Associate Solicitor in the professional discipline department