Thanks to Nursing Standard for including us in this article
Self-referral to the NMC: what are nurses’ obligations?
A self-referral is when a registrant informs the Nursing and Midwifery Council (NMC) of a serious professional or personal issue that means they may be unable to continue in their role because they could be in breach of the Code.
When is self-referral to the nursing regulator not required?
As a nurse, nursing associate or midwife, you would not need to self-refer in any of the following instances:
- If you have a health condition that is being well managed and you are still able to carry out your professional work effectively.
- You are involved in a private legal dispute that is irrelevant to your practice.
- If you have been given a protected police caution. Protected cautions don’t register on criminal record checks by the Disclosure and Barring Service in England and Wales, Disclosure Scotland, or Access NI in Northern Ireland; they are filtered out during the checking process.
- If you are being investigated by your employer.
- You receive a public transport fine or penalty.
- You receive a civil penalty that is not relevant to your practice, for example, a county court judgement or an award for damages.
- For parking offences, a penalty charge notice violation, or a fixed penalty notice for a motoring offence, such as speeding.
What about driving offences?
The NMC says it will assess other motoring or drink-driving offences on a case-by-case basis. Regulatory action will only be taken if the offence is closely linked to your professional practice, or if there is a concern about your health.
When should I self-refer?
The NMC code states that you are expected to ‘maintain the level of health you need to carry out your professional role’. If you are not able to meet this expectation, for example if you have a health condition that affects your neurological function and even with medication and support from your employer you are still struggling, then you should inform the NMC.
The regulator says it is entirely up to the registrant whether to self-refer or not. However, failing to self-refer in certain situations could result in the NMC taking additional regulatory action. These circumstances include:
- If you have received a police caution or are charged with an offence.
- If you have received a conditional discharge about, or have been found guilty of, a criminal offence that isn’t a protected caution or conviction.
- If you have been disciplined by another regulatory or licensing organisation. This includes non-healthcare organisations.
How do I go about self-referring, and what happens next?
You can complete a form on the NMC website.
After the NMC receives the form, a three-stage screening process will begin:
1. The NMC will verify that you are on the register and that a written account of the concern has been provided.
2. It will then assess if the evidence points to a serious concern that would require it to take action to protect the public.
3. The NMC will assess if there is enough evidence to prove you are currently fit to practise.
If I self-refer, do I have to tell my employer?
Yes, you are expected to tell your employer. In addition, when the NMC opens a case they will contact your employer to ensure they have been informed.
Will a self-referral lead to a fitness to practise (FtP) hearing?
Not necessarily. The NMC says if there is clear evidence a registrant has reflected appropriately on the issues raised in the concern, or, where appropriate, provided evidence of relevant retraining, it may decide the case does not need to be referred to the FtP committee.
Where can I go for further support?
The NMC recommends contacting your trade union for advice if you are considering a self-referral.
The RCN provides guidance for registrants about the referral process, including self-referral.
NMC Watch is an independent organisation that offers support to registrants going through their regulator’s fitness to practise investigation process. Its founder, Cathryn Watters, says registrants sometimes mistakenly believe they should refer themselves. She advises that nurses speak to their union or NMC Watch before self-referring. ‘Pause, educate yourself and get advice,’ she says.
She also encourages people to seek mental health support if they need it. ‘See what help is out there. Don’t worry about talking about your mental health. That is why organisations such as NMC Watch exist – you can talk to people who have also been through investigations.’