Campaign update: Is the NMC fit for purpose?

ISSN 2516-5852 (Online)

AIMS Journal, 2018, Vol 30, No1

By the AIMS Campaign Team

Change at the NMC: why is this important to AIMS?

AIMS recognises that a large number of taxpayer funded national bodies are key to driving improvements in the maternity services. AIMS is keen that each of these bodies plays its part effectively, and that they work in partnership with us and other stakeholders to achieve this. This is central to our primary mission of campaigning for better births for all.

Regarding the regulation of individual healthcare professionals, AIMS considers that the body of regulators working under the umbrella of the Professional Standards Authority (PSA) (including the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC)) plays a key role in undertaking ongoing quality assurance and regulation of the maternity services via their regulation of individual professional staff.

Effective and efficient regulatory bodies are vital for safeguarding maternity service users and AIMS ­ on behalf of all maternity service users, and dependent on the volunteer resources we have to carry out this task ­thus seeks to keep their activities under close review and to campaign for improvements to the maternity-related regulatory system as necessary.

The NMC: the renewed case for change

Regarding the NMC in particular, AIMS notes the publication in May 2018 of the PSA’s Lessons Learned Review ­ reporting on their investigation into the Nursing and Midwifery Council’s (NMC’s) handling of the Morecambe Bay cases ­ together with the recent resignation of the NMC’s chief executive, Jackie Smith.

AIMS is founded on the principle that the actions of service-users are key to maternity service improvements, and AIMS pays tribute to the affected families, who were not only instrumental in the setting-up of this investigation, but who have been steadfast in their determination to ensure that lessons are learnt from the deaths of their family members in what has become known as the Morecambe Bay scandal.

The Nursing and Midwifery Council (NMC) exists to play a key role in the regulation of the maternity services, and effective and efficient regulation is vital for the safeguarding all maternity service users. In that context, the highly critical nature of the Lessons Learned Review is of great concern to AIMS. It is also of concern to AIMS that the methodology of the performance review process carried out annually by the PSA does not seem to be sufficiently attuned to picking up the major concerns about the NMC which have been well-known and publicised in the media and social media during the last few years.

AIMS notes that the ‘Lessons Learned’ report from the PSA is not the first critical report of the NMC’s operations, and in this context recalls concerns about the functioning of the NMC that date back many years (and that have been regularly covered in the AIMS Journal). AIMS is clear that improvements in the performance - and changes to the deep-seated culture and poor communication habits - of this regulator are long overdue and that such improvements would make an important contribution to the ongoing improvement in the maternity services in the UK.

The NMC and the way forward

Following the Lessons Learned Review, AIMS therefore looks forward to scrutinising the detailed action plan as it emerges from the NMC, which should set out how the NMC will address the many criticisms set out in the Review, as a step towards restoring - and indeed warranting - renewed public confidence in its operations. We are also keen to know more about the process for appointing a new chief executive.

AIMS of is of the view that it may be, however, that only wholesale reform of the regulatory structure, involving significant changes to the organisation of current regulatory functions, will deliver the objective of having in place a midwifery regulator which both the public and professionals can trust.

This is in line with proposals put forward by the PSA, which suggests that a shift to a ‘super-regulator’ is a sensible way forward, to ensure the efficiency and effectiveness of all regulators in the healthcare sector. Certainly, there is much evidence that the NMC has never worked well enough for maternity service-users (nor for midwives) and it may be that a significant redesign of the regulatory sector is the best way to achieve the clear improvements needed. In that context, we look forward to the next steps following the Department of Health’s recent consultation exercise on reforms to the regulatory system to ensure “better and more responsive healthcare professional regulation”. The AIMS response to that consultation can be found on our website. But whether the NMC remains, or whether the regulation of midwives is taken on by a new or existing organisation, AIMS is strongly of the view that all the recommendations of the Lessons Learned Review must be fully implemented.

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