In 2017 Mary was referred to the NMC with 12 allegations. She had no representation at the time so managed the whole process as a litigant in person. The process included a workplace dispute and other issues leading her to leave her place of employment where she had worked for 37 years without incident.
Whilst the NMC process was going on she secured employment with NHS professionals, moved abroad and continued to work to a high standard all through the pandemic, giving vital resource to the nursing profession while ensuring the recruitment of staff. This employer fully supported her whilst the NMC investigation was continuing and was keen to see the order review hearing conclude with the hope she could return to work for them soon.
In December 2022 she attended an NMC Fitness to Practice hearing as a litigant in person, it was completely overwhelming to do so and despite having a legal assessor who was extremely helpful she received a 5-month suspension order. Out of the 12 allegations that were put in front of the panel, only 2 were upheld as proven. These were the allegations that involved the referrer.
When we met her she was enquiring as to whether it would be worth appealing the decision of the FtP panel via the High Court. We reviewed her case file and recommended that this would be a good route to go down, that there were no guarantees but that from our assessment some serious issues had occurred with the case. Read our section on appeals to find out how this process works.
After lots of discussion, she decided that she did not want to appeal and instead wanted to focus on recovering from the process and preparing properly for the substantive order review hearing. She felt she was still recovering from the process and that it would be too stressful to appeal even with our support.
During the next few months, we worked with her on the buddy program and also with another nursing professional to assist her in addressing the aspects that the NMC would need her to look at. This was a hard process as she was still angry that she had been referred by someone vexatiously and this had not been picked up by the NMC. This person was known to raise complaints against other colleagues maliciously and had behaved poorly in the workplace despite this nurse trying to address them with her informally as her manager and friend.
However, she did appreciate by looking back over the incidents and having mentorship sessions with us, that if the situation arose again she would have behaved very differently. At the time she had been encouraged to go off sick by her manager to avoid further confrontation adding to her struggles that were going on in her personal life at the time. But as a dedicated professional she did not want to put her colleagues under more pressure nor did she want to let her patients down, so she put them first as many of us do. In hindsight, she now sees that removing herself from that situation may have protected her from the events that followed.
We helped her to build her portfolio to show the NMC that despite disagreeing with the allegations she took them seriously and understood why process had occurred. We also worked with her to help her reflect, respect the process and explain why, although very frustrating, it was important for the NMC to take the allegations seriously.
Today after 6 years of process she attended the Substantive Order Review hearing (SORH). During this time she had left her employer of 37 years, moved abroad, got divorced and remarried and found new employment. She attended the hearing in a much different head space than her previous one, mainly due to the fact that she had support today, whereas before had none. The panel reached their decision after 3 hours of deliberation:
“The panel determined that, in this case, a finding of continuing impairment on public interest grounds is also not required. For these reasons, the panel today finds that, although your fitness to practise was impaired at the time of the incidents, given all of the above, your fitness to practise is not currently impaired.“
However, the outcome is bittersweet as despite no further impairment being found she still has to wait another 6 weeks for the order to expire, during which time she still can not work. So although found no longer impaired …”The panel considered Mr Holborn’s suggestion to revoke the suspension order today, however it has borne in mind that its primary function is to protect patients and the wider public interest which includes maintaining confidence in the nursing profession and upholding proper standards of conduct and performance. Because of the wider public interest, the panel concluded that the suspension should continue until its expiry date at the end of 5 June 2023”.
There was an observer at the hearing who was identified as working at Mary’s old employer – did this influence the decision-making? Was the panel cautious to change the previous panel’s decision-making as this may indicate that they disagreed with the original outcome? If someone is no longer impaired is it really fair to continue their suspension?
In summary, this case study has highlighted the following areas:
- It is important for panels to be brave when reviewing cases and if no impairment is found give a clear explanation as to why the nurse can not be allowed to return to practice immediately or lapse the order with immediate effect.
- Vexatious referrals are still poorly handled by the NMC and skilled investigators are needed to unpick the dialogue around these to get to the facts and balance those facts with the damage to the registrant that may be caused if allegations are not in their entirety.
- A registrant with a 5month suspension order is unlikely to elongate the process by doing a High Court appeal – there needs to be an internal review mechanism within the NMC to ensure ALL decisions are correct and appropriate
- It is easy for registrants to get consumed by anger or flight/fight reactions and avoid facing the process. Registrants need to maintain professionalism and engage, seek peer-to-peer support to cope with the emotional reaction that referral brings and work through this for a positive outcome.
She has given us feedback also:
“There is no doubt that I could not have gone through this without NMCWatch. Following the suspension order I was broken, considered leaving nursing and coming off the register. NMCWatch put me back together and made me a stronger and better version of myself, I will always be grateful xxx”